News / Streeting slams CQC as ‘not fit for purpose’ after independent review

The Care Quality Commission (CQC) is ‘not fit for purpose’, according to health secretary Wes Streeting (pictured). His comment came after an interim independent review into the running of the regulator was released. 

The review, led by Penny Dash, who is the chair of the North West London Integrated Care Board, was commissioned in May after concerns had been raised about the CQC’s performance. The final report will be published in the autumn, but the interim review found a number of failings in the way in which the body operates, including:

• a lack of sufficient experience among inspectors, particularly in care homes.
• a large backlog of assessments, with one in five services never having been given a rating, including newly opened care providers, GPs and private health clinics.
• an example was found of one NHS hospital having gone more than 10 years since its last inspection.
• social care providers waiting too long for an update on their registration and rating, which had implications for local capacity.
• an overall lack of consistency with assessments.

Mr Streeting said he was ‘stunned’ by the findings of the report, adding: ‘We cannot wait to act on these findings, so I have ordered publication of this interim report so action can begin immediately.’ One of the health secretary’s immediate actions has been to appoint Mike Richards, who has previously worked in government as national director of cancer care and spent four years as the chief inspector of hospitals, to work with managers at the CQC to conduct a rapid review of the body.

Mr Streeting added that he would take current CQC ratings ‘with a pinch of salt’. ‘How can you tolerate a situation where one in five of your health and care providers has not received a rating?’ he said. ‘How can you tolerate ratings being reached on the basis of only a partial inspection of the organisation, melded in with inspection reports dating back over a number of years?’

Last month, Ian Trenholm announced he was stepping down as head of the CQC, and was replaced by Kate Terroni, who took the job on an interim basis. Mr Streeting told the BBC that he is looking to appoint a new chief executive of the CQC and chief inspector of hospitals.

In response to the review, Ms Terroni said that she accepted in full its findings and recommendations. ‘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 added.

‘Work is under way to improve how we're using our new regulatory approach. We’ve committed to increasing the number of inspections we are doing so that the public have an up-to-date understanding of quality and providers are able to demonstrate improvement.’

The findings of the review were broadly welcomed by NHS and care leaders. Martin Green, the chief executive of Care England, said: ‘This is going to be a long and difficult journey for the CQC, but one that is entirely necessary.’

Matthew Taylor, the chief executive of the NHS Confederation, said that its members would be ‘pleased’ that the government was taking swift action on the CQC’s failings. ‘NHS leaders frequently say they feel the current system is out of step with the parameters in which they are operating and doesn’t recognise the full extent of the pressures they are working under,’ he added.

NHS Providers chief executive Julian Hartley said that trust leaders would welcome the intervention, and added that winning back credibility for the CQC will take a lot of work. ‘We recognise the important role of regulation in the NHS, but for that to really add value you need good behaviours, effective leadership, the right expertise and close attention to the issues that matter,’ he said.