18 January 2013

The Health Select Committee has published its annual accountability report on the Care Quality Commission (CQC), concluding that the regulator has not yet successfully defined its core purpose or earned public confidence.

Following criticism for failing to act on poor care, or achieve a balance between registering services, ensuring they meet minimum standards and inspecting them rigorously, CQC chief executive Cynthia Bower resigned last September and CQC chair Dame Jo Williams said she would step down early. New appointments have been made and a strategic review conducted.

Launching the report from the annual accountability hearing with the CQC, Health Select Committee chair Stephen Dorrell MP concluded: “The CQC’s primary focus should be to ensure that the public has confidence that its inspections provide an assurance of acceptable standards in care and patient safety. We do not believe that the CQC has yet succeeded in this objective.”

The report recommends that the CQC undertake a consultation on effective regulatory methods, including on how inspectors should assess the culture amongst professional staff in care provider organisations. It said the CQC’s Essential Standards should “reflect a current understanding of good clinical practice” and ensure that service providers have robust staff procedures that foster a culture of challenge and response, including a requirement to recognise and address shortcomings in service provision.

Mr Dorrell said the CQC needed to act more swiftly when it receives information from the public and ensure its inspections find shortcomings where they exist. He called on the regulator to be more diligent about automatically communicating the outcomes of its inspections promptly and accurately to service providers, service users and their families, as well as to public sector commissioners. He added that no one who relies on a service should be expected to “scour the CQC website for inspection results, or chance upon them in a local newspaper report”.

The report found that 87% of the CQC’s inspections carried out since clinical expert advisors became available did not use them. It said the CQC should develop a consistent methodology for its inspectors to ensure these resources are available when needed.

Furthermore, Mr Dorrell stressed that the new CQC chair needed to overhaul the regulator’s governance structures as a matter of urgency, making sure its board sets clear objectives and holds the executive to account.

CQC chief executive David Behan said the regulator’s strategic review was addressing key points, including purpose and role, better communication of findings and improved partnership with care providers.