Health and Social Care Secretary, Wes Streeting, has slammed the Care Quality Commission (CQC) as ‘unfit for purpose’ following the release of a damning report which identified major failings by the regulator.

An independent review of the CQC has identified significant internal failings which is hampering its ability to identify poor performance at hospitals, care homes, and GP practices.

The interim report, led by Dr Penny Dash, chairman of the North West London Integrated Care Board, found inspection levels were still well below where they were pre-COVID, there was a lack of clinical expertise among inspectors, a lack of consistency in assessments, and problems with the regulator’s IT system.

These failings mean the organisation is currently unable to consistently and effectively judge the quality of health and care services, including those in need of urgent improvement.

The report also found that social care providers are waiting too long for their registration and rating to be updated, with implications for local capacity.

Following the release of the report the Government has promised to  take ‘immediate steps’ to restore public confidence in the effectiveness of health and social care regulation, including by increasing the level of oversight of CQC, ahead of a full report by Dr Dash, which will be published in the autumn.

This works forms part of the Government’s wider efforts to identify the challenges facing the NHS and take action to address them head on as part of its mission to build a health service fit for the future.

Streeting said: “When I joined the department, it was already clear that the NHS was broken and the social care system in crisis.

“But I have been stunned by the extent of the failings of the institution that is supposed to identify and act on failings.

“It’s clear to me [the] CQC is not fit for purpose.

“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.”

Streeting has announced four immediate steps the Government and CQC will take. These include:

• The appointment by the CQC of Professor Sir Mike Richards to review CQC assessment frameworks. Sir Mike was a hospital physician for more than 20 years and became CQC’s first chief inspector of hospitals in 2013, retiring from this role in 2017
• Improving transparency in terms of how CQC determines its ratings for health and social care providers
• Increased government oversight of CQC, with CQC regularly updating the department on progress, to ensure that the recommendations in Dr Dash’s final review are implemented
• Asking Dr Dash to review the effectiveness of all patient safety organisations

Dr Dash was asked to carry out a review of the CQC in May and over the last two months she has spoken to around 200 senior managers, caregivers, and clinicians working across the health and care sector, along with over 50 senior managers and national professional advisors at the CQC.

Her emerging findings include:

• Of the locations CQC has the power to inspect, it is estimated that around one in five have never received a rating
• Some organisations not being re-inspected for several years, with the oldest rating for an NHS hospital dating from over 10 years ago and the oldest rating for a social care provider dating from 2015
• There is a lack of experience among some inspectors – with ith the review hearing of inspectors visiting hospitals and saying they had never been in a hospital before and an inspector of a care home who had never met a person with dementia

Commenting on her findings so far, Dr Dash said:  “The contents of my interim report underscore the urgent need for comprehensive reform within CQC.

“By addressing these failings together, we can enhance the regulator’s ability to inspect and rate the safety and quality of health and social care services across England.

“Our ultimate goal is to build a robust, effective regulator that can support a sustainable and high-performing NHS and social care system which the general public deserves.”

To start to rebuild its credibility, Dr Dash has highlighted urgent actions CQC can take, including overhauling the inspection and assessment system, rapidly improving operational performance, and fixing faltering IT systems.

Professor Martin Green OBE, chief executive of Care England, said: “It is clear that Dr Dash has listened to the voices of care providers, resulting in a clear set of recommendations.

“This report acknowledges the severe and systemic problems that sit at the very heart of CQC and gives a specific set of steps that the regulator must take to improve performance and re-establish the sector’s long-eroded trust.

“This is going to be a long and difficult journey for CQC, but one that is entirely necessary.

“Care England stands ready to work with the regulator to help them deliver an effective and supportive regulatory system that will be the cornerstone of public protection and delivers fair judgements across health and social care.”

Dr Dash’s interim report comes just days after the announcement of Lord Darzi’s independent investigation into the NHS, the findings of which will inform the Government’s 10-year plan to radically reform the NHS and build a health service that is fit for the future.

Health and Social Care Secretary, Wes Streeting, has slammed the Care Quality Commission (CQC) as ‘unfit for purpose’ following the release of a damning report which identified major failings by the regulator.

An independent review of the CQC has identified significant internal failings which is hampering its ability to identify poor performance at hospitals, care homes, and GP practices.

The interim report, led by Dr Penny Dash, chairman of the North West London Integrated Care Board, found inspection levels were still well below where they were pre-COVID, there was a lack of clinical expertise among inspectors, a lack of consistency in assessments, and problems with the regulator’s IT system.

These failings mean the organisation is currently unable to consistently and effectively judge the quality of health and care services, including those in need of urgent improvement.

The report also found that social care providers are waiting too long for their registration and rating to be updated, with implications for local capacity.

Following the release of the report the Government has promised to  take ‘immediate steps’ to restore public confidence in the effectiveness of health and social care regulation, including by increasing the level of oversight of CQC, ahead of a full report by Dr Dash, which will be published in the autumn.

This works forms part of the Government’s wider efforts to identify the challenges facing the NHS and take action to address them head on as part of its mission to build a health service fit for the future.

Streeting said: “When I joined the department, it was already clear that the NHS was broken and the social care system in crisis.

“But I have been stunned by the extent of the failings of the institution that is supposed to identify and act on failings.

“It’s clear to me [the] CQC is not fit for purpose.

“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.”

Streeting has announced four immediate steps the Government and CQC will take. These include:

• The appointment by the CQC of Professor Sir Mike Richards to review CQC assessment frameworks. Sir Mike was a hospital physician for more than 20 years and became CQC’s first chief inspector of hospitals in 2013, retiring from this role in 2017
• Improving transparency in terms of how CQC determines its ratings for health and social care providers
• Increased government oversight of CQC, with CQC regularly updating the department on progress, to ensure that the recommendations in Dr Dash’s final review are implemented
• Asking Dr Dash to review the effectiveness of all patient safety organisations

Dr Dash was asked to carry out a review of the CQC in May and over the last two months she has spoken to around 200 senior managers, caregivers, and clinicians working across the health and care sector, along with over 50 senior managers and national professional advisors at the CQC.

Her emerging findings include:

• Of the locations CQC has the power to inspect, it is estimated that around one in five have never received a rating
• Some organisations not being re-inspected for several years, with the oldest rating for an NHS hospital dating from over 10 years ago and the oldest rating for a social care provider dating from 2015
• There is a lack of experience among some inspectors – with ith the review hearing of inspectors visiting hospitals and saying they had never been in a hospital before and an inspector of a care home who had never met a person with dementia

Commenting on her findings so far, Dr Dash said:  “The contents of my interim report underscore the urgent need for comprehensive reform within CQC.

“By addressing these failings together, we can enhance the regulator’s ability to inspect and rate the safety and quality of health and social care services across England.

“Our ultimate goal is to build a robust, effective regulator that can support a sustainable and high-performing NHS and social care system which the general public deserves.”

To start to rebuild its credibility, Dr Dash has highlighted urgent actions CQC can take, including overhauling the inspection and assessment system, rapidly improving operational performance, and fixing faltering IT systems.

Professor Martin Green OBE, chief executive of Care England, said: “It is clear that Dr Dash has listened to the voices of care providers, resulting in a clear set of recommendations.

“This report acknowledges the severe and systemic problems that sit at the very heart of CQC and gives a specific set of steps that the regulator must take to improve performance and re-establish the sector’s long-eroded trust.

“This is going to be a long and difficult journey for CQC, but one that is entirely necessary.

“Care England stands ready to work with the regulator to help them deliver an effective and supportive regulatory system that will be the cornerstone of public protection and delivers fair judgements across health and social care.”

Dr Dash’s interim report comes just days after the announcement of Lord Darzi’s independent investigation into the NHS, the findings of which will inform the Government’s 10-year plan to radically reform the NHS and build a health service that is fit for the future.