UK health watchdog ‘not fit for purpose’, says Wes Streeting
Wes Streeting has branded the UK’s health watchdog “not fit for purpose” after an interim report found significant failings hampering its ability to identify poor performance in hospitals, care homes and GP practices.
The Health and Social Care Secretary has pledged to tackle the crisis at the Care Quality Commission (CQC) by taking immediate action to increase oversight of the agency and give patients greater confidence in their care.
He announced four immediate steps the government and the CQC will take to restore public confidence and provide patients with a more accurate picture. One of these is appointing an experienced cancer specialist to review the agency’s assessments.
The interim report, led by Dr Penny Dash, chair of the North West London Integrated Care Board, found that inspection levels were still well below pre-Covid levels, there was a lack of consistency in assessments and problems with a faltering IT system.
She found that around a fifth of the sites the CQC is allowed to inspect had never been rated, while other organisations had not been re-inspected for years, with one inspection around ten years old.
There was a lack of experience among inspectors, the report said, with some inspecting hospitals who had never visited one before. Another inspector of a care home had never met a person with dementia.
Dr Dash, who began her research in May, also found that social care providers were waiting too long to update their registration and assessment, impacting local capacity.
Health officials said the watchdog’s failings left it unable to consistently assess the quality of health and care services, including those that urgently need improvement.
After taking over as head of the Department of Health and Social Care, Streeting called for an interim report so the government could make immediate improvements, ahead of the publication of the full report this autumn.
“When I joined the department it was clear that the NHS was broken and the social care system was in crisis,” he said. “But I am appalled by the scale of the failings of the agency that is supposed to identify and address failings. It is clear to me that the CQC is not fit for purpose.
“I know this will be a worrying development for patients and families who rely on CQC assessments to make choices about their care. I want to reassure them that I am determined to tackle this crisis and give people confidence that the care they receive has been assessed. This Government will never turn a blind eye to failure.”
The CQC apologised earlier this month after care homes complained about a “hostile” inspection regime and a major new computer system that was malfunctioning.
The former CEO, Ian Trenholm, resigned abruptly late last month, midway through reforms aimed at improving the quality assessment of healthcare providers. One of Streeting’s first tasks will be to recruit a permanent replacement.
Other first steps include the appointment of Prof Sir Mike Richards, the CQC’s first Chief Inspector of Hospitals in 2013 and a senior oncologist, to review the inspection and rating system.
The government wants to increase the transparency with which the CQC determines its ratings for care providers, to rapidly improve operational performance and increase oversight. The agency is expected to provide the department with regular updates on its progress.
Dr Dash, who has spoken to hundreds of senior managers, carers and clinicians across the sector over the past two months, has also been asked to assess the effectiveness of all patient safety organisations.
The CQC regulates almost 15,000 care homes, 13,000 home care agencies, 11,500 dentists, 8,600 GPs and 1,200 hospitals, as well as community services and supported living facilities.
Prof Martin Green, chief executive of Care England, said: “This report recognises the serious and systemic problems underlying the health service. heart of the CQC and sets out a specific set of steps the regulator must take to improve performance and restore the sector’s long-eroded confidence. This will be a long and difficult journey for the CQC, but one that is absolutely necessary.”
NHS Providers CEO Sir Julian Hartley said: “Trust leaders will welcome this announcement. Based on their clear and consistent feedback, we have called for urgent reform of the CQC. We fully agree with these recommendations.”
The National Care Association, which represents independent care home operators, publicly warned in February that “the workplace culture within CQC remains hostile” and forced providers to consider closing.
“The CQC has failed to respond to the challenges facing the sector due to poor inspection methodology for some time,” NCA chair Nadra Ahmed said this month as he welcomed the earlier apology. “Many providers found the process very challenging, intimidating and staff were in tears.”