The Department of Health today published its findings from the Performance and Capability Review of the Care Quality Commission.
The Review sets out that the CQC has made considerable achievements since it was established in 2009 as the new watchdog for health and social care services in England. It has brought together three different organisations, creating the largest organisation of its kind in the world, and set up a new system of regulation. It has delivered a challenging programme of work, registering more than 21,000 providers since April 2010 and is increasing the number of inspections taking place.
However, the Review found that the scale of this task had been underestimated by CQC and the Department, and more could have done more to manage risks during the early years of the organisation’s operation. The Review also acknowledges that the role of the CQC has not been as clear as it needs to be to health and care providers, patients and the public.
But the review recognises that over the last nine months, the CQC has made significant improvements, increasing inspection staffing and focusing more on its core duties to register and inspect healthcare providers.
The Review has made a series of recommendations that are designed to support its continuing improvement, by strengthening the CQC Board and building on what has already been learnt:
• The CQC must become more strategic and set out more clearly what success looks like.
• The Board should be strengthened with the appointment of additional members and that there should be clearer arrangements between the Board and the Executive to ensure that the Board is holding the operation of the CQC to account.
• The CQC should build an evidence base for its regulatory model to demonstrate and ensure confidence in its effectiveness.
• Frontline inspectors should have greater access to individuals with professional experience, such as doctors, nurses or social care experts. There should also be more consistency in how inspections are carried out and there should be enough inspectors to meet future demand.
The Review also recognises that the Department has more to do to support the CQC and ensure that it is held to account for its role in regulating health and social care. Therefore, we will be working with the CQC to recruit additional non-executive members to the Board. This recruitment process will start imminently.
In a letter to the Chair of the CQC, Una O’Brien, Department of Health Permanent Secretary, said:
“Over the last nine months, CQC has made significant improvements in performance and in focus on core purpose. However, the evidence has clearly shown there is more work to do to build on recent successes to ensure the organisation has the capability and capacity to respond to patient, public and Parliamentary expectations in the future. Lessons need to be learned from the performance shortcomings of the early years. The leadership of the organisation are willing to listen and act on issues raised about the organisation’s performance.”
In a letter responding to the Review, Jo Williams, Chair of the CQC said:
“I would like to give a broad welcome to the findings of the review. The process has recognised the context and complexity of CQC’s work, progress made and where more work is needed to further develop our regulatory approach. We take seriously the recommendations of the review and have a desire to make further progress on all areas of the review.”
The Department will also take steps to strengthen the Board to ensure improvements can be sustained. This includes proposing changes to the Board so that instead of comprising only non-executives, it becomes a unitary Board made up mainly of non-executives but with senior executives also on the Board who are held more systematically to account. DH will set out shortly how it plans to take forward this recommendation.