CQC still ‘adversarial and fault-finding’, NHS bosses warn

NHS bosses have warned of a “punitive” inspection culture at the Care Quality Commission (CQC), two years into the regulator’s recovery from a damning review.

Just one in five trust leaders (21%) believe the CQC is making changes that will improve its long-term performance, with 27% disagreeing, 37% neutral and 16% unsure.

The NHS Alliance, which represents most trusts and integrated care boards, surveyed 166 chief executives, chairs, company secretaries, and medical and nursing directors at 116 trusts in August. Its report, shared exclusively with HSJ, says “numerous” leaders described the regulator’s approach as adversarial.

One trust chair said inspection teams “arrive with conclusions in advance, and use evidence inappropriately to justify those conclusions”. A director at another trust said: “The way they run the inspection is aggressive.”

Another leader said: “The CQC used to add value – it doesn’t any more, and has lost credibility.”

Just 12% cent agree the CQC’s current approach supports innovation and the spread of good practice, while 60% disagree. Fewer than two in five (38%) say it is supporting their trust to improve the quality of care, with 31% disagreeing.

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Source: HSJ, 11 November 2026