Final report into Care Quality Commission identifies “significant internal failings”

October 15, 2024

The Government has pledged further action to strengthen patient safety after a final report identified “significant internal failings” at the Care Quality Commission (CQC), hampering the regulator's ability to identify poor performance at hospitals, care homes and GP practices.

The final report, undertaken by Dr Penny Dash, Chair of the North West London Integrated Care Board, confirmed failings at the CQC in regard to its operational effectiveness - including poor performance in relation to inspections and a lack of capacity and capability to deliver improvements.

It provided seven specific recommendations for improvement, including that the CQC formally pauses the implementation of its assessments of Integrated Care Systems, and that it clarifies how ratings are calculated and makes the results “more transparent”.

The report’s interim conclusions, published in July, prompted the Health and Social Care Secretary to order “immediate action” to restore public confidence in the effectiveness of health and social care regulation.

The Government stated today (15 October) that patient safety is “at the heart” of its plans for healthcare reform, and that it has “ordered action” to improve regulator performance.

The CQC said it is taking “rapid action” in response to the report, and has appointed a new chief executive, Sir Julian Hartley.

Following the publication of Dr Dash’s interim report in July, the CQC Board also asked Professor Sir Mike Richards to conduct an internal review of the single assessment framework and its implementation.

Professor Richards’ report, also published today, warned that far fewer inspections have been carried out than in previous years; publication of inspection reports has been seriously delayed, and providers have expressed serious concerns about both the inspection process and the quality of the reports.

Ian Dilks, Chair of CQC, said: “We welcome the final part of Dr Penny Dash’s review – we accept the findings and we will address the recommendations with urgency. Today also sees the publication of the review we commissioned from Professor Sir Mike Richards – we are extremely grateful to Sir Mike for his helpful work and will be using his recommendations to help us respond to the serious failings identified by Dr Penny Dash.

“[…] Both reviews have reaffirmed the support for a robust health and care regulator and recognised the dedication and experience of CQC staff. We are committed to rebuilding trust in CQC’s regulation and are taking action to make sure we have the right structure, processes, and technology in place to help us fulfil our vital role of helping people get good care and supporting providers to improve.”

Commenting on her findings, Dr Penny Dash said: “This report reiterates the findings of my interim report while providing further detail and analysis of the CQC’s performance. It builds on insights and perspectives from patients and users, and a wide range of health and social care providers as well as senior leaders from the NHS and local authorities.

“I am delighted that Sir Julian Hartley will be appointed as the CQC’s new Chief Executive - he is an outstanding leader, and I am confident he will restore the regulator’s ability to inspect and rate the safety and wider quality of health and social care services across England.”

The Health and Social Care Secretary has asked Dr Dash to conduct two further reviews moving her focus from operational effectiveness to patient safety and quality.

The first review will examine the roles and remits of six key organisations and make recommendations on whether patient safety could be bolstered through a different approach. These are: