Health secretary dubs care regulator 'unfit for purpose'

Report finds Care Quality Commission is unable to "consistently and effectively" judge the services it regulates
The CQC has its headquarters in Stratford, east London Photo: RSHP

By Jim Dunton

26 Jul 2024

Health secretary Wes Streeting has declared that the Care Quality Commission is "unfit for purpose" after an independent review found shortcomings with inspection levels and the skills of staff.

Streeting said the interim findings of a review led by the chair of the North West London Integrated Care Board, Dr Penny Dash, had identified failings that mean the regulator is currently unable to "consistently and effectively" judge the quality of health and care services.

The CQC,  an executive body sponsored by the Department of Health and Social Care, is responsible for inspecting and regulating services such as care homes, clinics, dentists, hospitals, mental health services and home care agencies.

Details of Dash's findings released by DHSC suggest inspections undertaken by the CQC are still well below pre-Covid levels. Around one in five organisations the CQC has the power to inspect were said to have never received a rating from the organisation, which was founded in 2008.

Dash's report also flagged a lack of clinical expertise among inspectors, consistency shortcomings with assessments and problems with the CQC’s IT system.  DHSC said the review had heard evidence of a care home inspector who had never met someone with dementia and hospital inspectors with no previous experience of visiting hospitals.

Streeting, who declared the NHS to be "broken" in some of his first public comments on becoming health secretary earlier this month, said he was "stunned" by the failings identified at the CQC.

"It’s clear to me the CQC is not fit for purpose," he said. "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.

"I know this will be a worrying development for patients and families who rely on CQC assessments when making choices about their care. I want to reassure them that I am determined to grip this crisis and give people the confidence that the care they’re receiving has been assessed. This government will never turn a blind eye to failure."

Dash began her review in May and is due to continue work on it over the summer, reporting in full in the autumn.

As part of a package of immediate measures, Streeting said he had appointed cancer specialist and former CQC chief inspector of hospitals Prof Sir Mike Richards to review the CQC's assessment frameworks. Richards retired from his previous CQC role in 2017.

CQC will also be subjected to increased government oversight and required to be more transparent about the way it determines the ratings of health and social care providers.

Interim CQC chief executive Kate Terroni said the organisation accepted the findings and recommendations of Dash's interim review "in full".

"Many of these align with areas we have prioritised as part of our work to restore trust with the public and providers by listening better, working together more collaboratively and being honest about what we’ve got wrong," she 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."

Ian Trenholm stepped down as CQC chief executive at the end of last month after six years in the role.

Earlier this month, Streeting appointed surgeon and former New Labour health minister Lord Ara Darzi to lead a "warts and all" review of the NHS over the summer. It will feed into a 10-year turnaround plan for the health service the government has pledged to produce.

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