The recent interim report reviewing the operational effectiveness of the Care Quality Commission (CQC) underscores several pressing issues that are affecting the quality of health and social care services in England. The findings highlight an urgent need for strategic improvements to ensure services remain safe, effective, and compassionate.

Operational Performance Gaps

The CQC has experienced significant operational challenges, particularly following the COVID-19 pandemic. The number of inspections has drastically reduced, with only 7,000 assessments conducted in 2023-2024 compared to over 16,000 in the 2019-2020 period. This reduction has contributed to a backlog in provider registrations, with 54% of applications pending completion for more than 10 weeks by the end of 2023-2024, up from 22% the previous year. Delays in re-inspection, particularly for providers rated as ‘requires improvement’, further exacerbate the problem, potentially affecting hospital discharge decisions and service capacity.

Technological Shortcomings

The introduction of new IT systems intended to streamline CQC operations has instead posed significant challenges. Users have reported difficulties in uploading documents and lengthy waits for password resets, pulling staff away from patient care duties. These inefficiencies not only frustrate providers but also hinder the CQC’s regulatory capabilities, highlighting the need for immediate technical improvements.

Credibility and Expertise Concerns

Restructuring within CQC has resulted in a perceived loss of sector expertise. The move towards employing generalist assessment teams has diluted the deep knowledge traditionally held by specialists familiar with healthcare and social care intricacies. This shift has led to diminished trust in CQC’s assessments and a missed opportunity for sharing best practices. Rebuilding internal expertise is crucial for restoring credibility and fostering collaborative improvements with healthcare providers.

Issues with the Strategic Assessment Framework (SAF)

The SAF was designed to standardise quality assessments across care sectors. However, the lack of clear definitions for ‘good’ or ‘outstanding’ care has left providers uncertain about the standards required. The SAF includes 34 areas of care quality, yet there is inconsistency in the focus on outcomes and the efficient use of resources. For example, some organisations have not been re-inspected for nearly a decade, which undermines the credibility of current ratings. It is essential for the SAF to offer transparent and actionable benchmarks to guide providers in maintaining high-quality care.

Path Forward

Addressing these challenges demands collaboration among CQC, healthcare providers, and government bodies. By enhancing operational performance, resolving IT issues, and restoring sector-specific expertise, CQC can play a pivotal role in elevating the quality of healthcare and social care services. The focus must remain on delivering care that ensures patient safety and wellbeing, devoid of the adverse influences of substances like drugs and alcohol. Improving how the CQC works is crucial for reliable health and care services. With practical changes, we can help make sure these services meet the needs of everyone safely.

Source: GOV.UK