The Independent regulator of healthcare and adult social care in England, the CQC has come under significant fire in the last three days, following an interim report by Dr Penny Dash, requested in May this year by the outgoing Government.
Dr Dash has spoken with 170 clinicians, caregivers and senior managers to inform her high-level interim report.
The request for investigation was triggered, at least in part, by a new system introduced in November 2023 – a single assessment framework (‘SAF’). The intention behind which was to replace the previous process for inspections and assessments with a simpler and more adaptable one. In practice however, the new framework has generated concern that it is not operating as intended, a viewpoint validated in the interim report.
Though it may have been the catalyst for the investigation, the SAF is revealed to be by no means the only source for concern. Emerging findings published state that in its current form the CQC suffers from:
- poor operational performance
- significant challenges with the provider portal, it’s IT system and regulatory platform,
- considerable loss of credibility within the health and care sectors due to the loss of sector expertise and wider restructuring, resulting in lost opportunities for improvement,
- the aforementioned concerns around the SAF, and
- a lack of clarity regarding how ratings are calculated.
The interim Chief Executive, Kate Terroni has accepted the findings in full and stated in her response to the publication that the CQC will “work to restore trust with the public by listening better, working collaboratively and being honest about what they’ve got wrong.”
Whilst a fuller substantive report will be published in autumn 2024, the interim report has already made some recommendations to include rapidly improving operational performance, a goal, likely to be spearheaded by the interim Chief Executive and achieved by the introduction of additional experienced staff.
The report identifies that the IT systems used need to be fixed and that the regulator needs to rebuild its expertise within the organisation, building relationships with providers to resurrect credibility.
It is recommended that the SAF is reviewed to make it fit for purpose and flowing from that, should clarify how ratings are calculated and make the results more transparent particularly where multi-year inspections and ratings have been used. The CQC has already appointed Professor Sir Mike Richards to focus on this specific area of reform.
It is notable that the interim report has deemed the regulator not fit for purpose even before the phase for interviews with patients, which will no doubt add a further layer of concern to inform the full report.
In the meantime, the report encourages the Department for Health and Social Care to increase its oversight of the CQC by way of monthly director level meetings and regular performance review meetings.
Whilst the initiative was not commissioned by the incumbent Health Minister, it is clear from Mr Streeting’s response that an overhaul of the healthcare sector is high on the agenda for the new Government and it’s likely that widespread change is on the way. If you are concerned about what any of these findings might mean for your business, please contact Francesca Reason or any of the Regulatory and Corporate Defence Team.
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The content of this article is for general information only. It is not, and should not be taken as, legal advice. If you require any further information in relation to this article please contact the author in the first instance. Law covered as at July 2024.