The health secretary has declared that the CQC is ‘not fit for purpose’ and needs ‘increased oversight’, following the damning findings of an independent review.
An interim report on the watchdog’s operational effectiveness, which was led by North West London ICS chair Dr Penny Dash, identified low levels of inspections, a ‘lack of clinical expertise’ and a ‘lack of consistency’ in assessments.
Wes Streeting said he was ‘stunned by the extent of the failings’ highlighted in the report and has taken ‘immediate steps’ to address them.
Dr Dash also found that of the providers the CQC has the power to inspect, around one in five ‘have never received a rating’, and that some providers have gone years without reinspection.
The review also highlighted a ‘lack of experience’ among inspectors, with reports of some visiting hospitals without ever having been to a hospital before.
To address these issues ahead of the report’s full publication in the autumn, Mr Streeting has ordered ‘increased government oversight’ of the watchdog, with regular updates on progress, and the CQC was told to ‘take immediate steps to restore the confidence of health and care providers and the public’.
An oncologist and former CQC chief inspector, Professor Sir Mike Richards, has been appointed to review the organisation’s assessment frameworks.
Another ‘immediate step’ announced this morning was ‘improving transparency in terms of how the CQC determines its ratings’.
Dr Dash also urged the regulator to take other urgent measures such as ‘fixing faltering IT systems’.
As part of her review, which started in May, Dr Dash interviewed around 200 senior managers and doctors working across health and care.
The health secretary said that when he took up his role, it was clear the NHS ‘was broken and the social care system in crisis’.
‘But I have been stunned by the extent of the failings of the institution that is supposed to identify and act on failings. It’s clear to me the CQC is not fit for purpose,’ he said.
Mr Streeting continued: ‘We cannot wait to act on these findings, so I have ordered the publication of this interim report so action can begin immediately to improve regulation and ensure transparency for patients.’
Dr Dash said her interim report highlights ‘the urgent need for comprehensive reform’ within the CQC.
‘By addressing these failings together, we can enhance the regulator’s ability to inspect and rate the safety and quality of health and social care services across England,’ she added.
In response to the report, the CQC confirmed that it accepts the findings and recommendations ‘in full’, and said many of the areas of improvement ‘align’ with its own priorities.
Interim chief executive Kate Terroni said: ‘We are working at pace and in consultation with our stakeholders to rebuild that trust and become the strong, credible, and effective regulator of health and care services that the public and providers need and deserve.’
She said the organisations is ‘committed’ to increasing the number of inspections and to increasing the number of staff working in registration to ‘improve waiting times’.
‘We’re working to fix and improve our provider portal, and this time we’ll be listening to providers and to our colleagues about the improvements that are needed and how we can design solutions together,’ Ms Terroni added.
Earlier this month, the CQC admitted that it ‘got things wrong’ in the implementation of a new regulator approach.
The regulator has also agreed to be flexible and take into account the CrowdStrike IT outage when assessing GP services.
Londonwide LMCs wrote to the CQC expressing concern about the ‘impact any routine inspection activity’ might have on practices who are catching up after the ‘major IT disruption’.
Dr Michelle Drage, the LMCs chief executive, said: ‘I am encouraged to be advised that assessments of services will take the IT outage into account and that CQC will be flexible in their activity.’
A primary source here should be Ian Treholm, but is there any report from him? Treholm allowed to step down just before report. CQC has never worked for patients or for NHS organisations.
Instituted by McKinsey and subsequently investigated by Dash’s McKinsey, there is a deep rotten stench of something being covered up.
Get McKinsey and its pall-bearers out of the NHS.
You cannot inspect quality into systems. The whole premise of CQC is wrong. If you inspect an organisation and find it is unsafe you are too late, if you find it is OK you have wasted a lot of time and resources. CQC has so far cost £230Million with no discernible increase in quality or patient safety. It should be disbanded and commissioners given the resources to improve local monitoring, and supporting services to develop.
Get rid of it and the uhljebs that inhabit it.
is it reasonable for an organization to be inspected by another organization that has been declared as not fit for the very purpose of those inspections ??
CQC is an abysmal and failed organisation. It is not fit for purpose as has just been highlighted and something many of us have been saying for years.
It needs scrapping entirely.
before we celebrate this sudden grasp of bleeding obvious by the health minister, let’s remember what party he represents. he probably thinks it’s not draconian enough, or they (CQC) are using wrong forms or placing ticks not in the center of the boxes and that’s the inadequacies that our Wes is burning to immediatelly address.
The minister is right. Just like the GMC is also not fit for purpose. An inspector who has not been in a hospital cannot be inspecting it. How can a person who has not been a doctor a single day be aware of what the job involves and runs it?
The optimists on here seem to think CQC will be scrapped.
The pessimists realise that Wes wants CQC beefed up to do more frequent and more rigorous inspections.
Dear All,
They have squandered such an opportunity. It has been a scandal for many years, on one of our inspections the GP “expert” hadn’t realised the red book had been replaced by nGMS, and that was in 2021! They should sack the lot of them and start again with a fresh crew who understand how the NHS works, or rather doesn’t.
Regards
Paul C
There’s no natural law that says we need to be over-regulated by the CQC, GMC, appraisal, revalidation etc. It’s a political choice. Govt doesn’t over-regulate the private sector (in accordance with neoliberal dogma). Wes should abolish the CQC and if oversight is needed, decentralise it to localities in the form of a light touch voluntary code of conduct or a Trustmark scheme. A lot of time, GP stress, money and paperwork could be saved.
Has probably done more harm to GP than even the RCGP.
Thank god Kate Terroni is now “…working at pace” to fix it all. Any f£&k up these days and someone somewhere pops up to say they’re “..working at pace” to fix it. Never heard this phrase before about 18 months ago..now everybody who’s f£&king up is doing it. Thank goodness for bullshit jargon crap like this. Couldn’t get to the end of an article without this kind of meaningless crap. Well done intermin chief executive. Where did they train you? You did the bullshit legalese meaningless drivel press release course I see. “…working at pace” ..Nice
Sadly its too late to claw back all the honourary degrees, professorships and gongs from the individuals past and present especially GPs who have done so much to undermine General Practice.
CQC has done its job perfectly. The demolition of primary care was always the objective. Bravo 👏🏼 you can now bow out disgracefully.
The CQC remit is entirely arse-about-face. The primary barrier to good care in the NHS is access, waiting times, and nonexistent continuity of care. All of this caused by funding and government. And the CQC is tasked with punching down on us, as a distraction from the real failures elsewhere. THAT is why they are unfit for purpose. Government stooges who couldn’t get into traffic warden school.
The CQC have already responded by saying “we’ll do more inspections”.
This is exactly what we don’t need.
The whole process needs to me for supportive rather than confrontational. This is like a wounded animal flailing around and biting anyone that it can.
Prior to CQC, quality and post-payment-verification visits were rolled into one visit locally, and were undertaken by the local primary care team who understood the practice and the context the practice worked in. If any problems were identified, they would work with the practice in a broadly collegiate manner to resolve things quickly. This would appear to be a reasonable model to follow and IMHO should be reinstituted.
CQC has failed general practice by not understanding how we work, and how national gross underfunding (as a political choice) impacts our ability to deliver a safe service. Every single CQC report on general practice should start with a public statement about the gross underfunding and deliberate defunding of the service, so as to contextualise their report for when the public read it.
CQC – or a smaller and more efficient successor organisation – can continue to inspect Trusts. However, it needs to pin its courage to the sticking place: in the last five years huge swathes of the secondary care system have been failing and unsafe for patients for months on end, and yet CQC has not called them out on this, preferring instead to sit in ivory towers and look the other way.
CQC is too political in the case of NHS Trusts, and not political enough when it comes to general practice.