Review into the operational effectiveness of the Care Quality Commission: interim report (26 July 2024)

Summary

This is the interim report of a review led by Dr Penelope Dash into the operational effectiveness and culture of the Care Quality Commission (CQC). The review spoke to 170 senior managers, caregivers and clinicians working in the health and care sector, along with over 40 senior managers and national professional advisors at CQC. All shared considerable concerns about the functioning of the CQC, with a high degree of consistency in the comments made. At the same time, there was widespread recognition of the need for a strong, credible and effective regulator of health and social care services.

A more detailed report will be published in autumn 2024.

Content

Emerging findings

The Penny Dash review found significant failings in the internal workings of CQC which have led to a substantial loss of credibility within the health and social care sectors, a deterioration in the ability of CQC to identify poor performance and support a drive to improved quality—and a direct impact on the capacity and capability of both the social care and the healthcare sectors to deliver much needed improvements in care.

The findings are summarised around five topics:

1. Poor operational performance.
2. Significant challenges with the provider portal and regulatory platform.
3. Considerable loss of credibility within the health and care sectors due to the loss of sector expertise and wider restructuring, resulting in lost opportunities for improvement.
4. Concerns around the Single Assessment Framework (SAF).
5. Lack of clarity regarding how ratings are calculated and concerning use of the outcome of previous inspections (often several years ago) to calculate a current rating.

Recommendations

The interim report makes five recommendations:

1. Rapidly improve operational performance.
2. Fix the provider portal and regulatory platform.
3. Rebuild expertise within the organisation and relationships with providers in order to resurrect credibility.
4. Review the SAF to make it fit for purpose.
5. Clarify how ratings are calculated and make the results more transparent particularly where multi-year inspections and ratings have been used.