An independent review of the Care Quality Commission (CQC) has found significant internal failings which is having an impact on its ability to identify poor performance at hospitals, care homes and GP practices.
The interim report found inspection levels were still well below where they were pre-Covid, a lack of clinical expertise among inspectors, a lack of consistency in assessments and problems with the CQC’s IT system.
Led by Dr Penny Dash, chair of the North West London Integrated Care Board, the report also found that as a result of these failings, the regulator is currently unable to consistently and effectively judge the quality of health and care services, including those in need of urgent improvement.
It was also discovered that social care providers are waiting too long for their registration and rating to be updated, and this has an impact on local capacity.
Dr Dash said: "The contents of my interim report underscore the urgent need for comprehensive reform within the 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."
Dr Dash found that of the locations the CQC has the power to inspect, it is estimated that around 1 in 5 have never received a rating and some organisations have not been reinspected for several years. The oldest rating for an NHS hospital dated from over 10 years ago and the oldest rating for a social care provider dated from 2015.
The government has said it will now take four immediate steps to restore public confidence in the effectiveness of health and social care regulation, including by increasing the level of oversight of the CQC.
Professor Sir Mike Richards has been appointed by the CQC to review CQC assessment frameworks and Dr Dash has also been asked to review the effectiveness of all patient safety organisations.
There will also be improved transparency in terms of how the CQC determines its ratings for health and social care providers.
Health and social care secretary, Wes 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.
"We cannot wait to act on these findings, so I have ordered the publication of this interim report so action can begin immediately to improve regulation and ensure transparency for patients.
"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. This government will never turn a blind eye to failure."
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 the 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 the 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.
"The CQC must embark on a radical improvement program that should not only include some tangible improvements in their performance, but also needs to move away from a culture of blame. We all want proportionate and effective regulation, and the challenge now is for CQC to take action and work with organisations across the sector to deliver it."
