Care Quality Commission: Report on Operational Effectiveness

Wes Streeting Excerpts

Tuesday 15th October 2024 Written Statements

[The Secretary of State for Health and Social Care (Wes Streeting)]

The full findings of the review into the operational effectiveness of the Care Quality Commission (CQC), conducted by Dr Penny Dash, have today been published on www.gov.uk. I would like to place on record my sincere thanks to Dr Dash for the swift and thorough job she has done on the review.

An interim report of Dr Dash’s work, published in July 2024, summarised her emerging findings to allow for early conversations on the necessary changes to improve the CQC. Those findings were shocking, and led to my conclusion that the organisation was not fit for purpose. This full report expands on that work and incorporates feedback from recent discussions with user groups and a larger number of staff.

The findings of the review highlight 10 key conclusions and provide specific recommendations for improvement, which I fully support. Notably, the review recommends that the CQC should:



Rapidly improve its operational performance.

Rebuild expertise within the organisation and relationships with providers in order to resurrect credibility.

Review the single assessment framework to make it fit for purpose.

Clarify how ratings of providers are calculated and make the results more transparent.



Continue to evolve and improve its assessments of local authorities.



Formally pause its assessments of integrated care systems (ICSs).

The review also recommends that the Department of Health and Social Care should strengthen its arrangements for sponsorship of the CQC, a recommendation upon which my Department has already acted.

Significant work is already under way to act on these findings. Last week, the CQC announced that Sir Julian Hartley will be appointed as the new chief executive of the CQC. This is a significant step forward as Sir Julian’s experience of turning around large, complex health organisations will be vital as the CQC embarks on its improvement plan. He will be supported by sector expertise through the appointment of a number of chief inspectors.

Following the publication of the interim report, the CQC commissioned Professor Sir Mike Richards to undertake a review of the single assessment framework. Findings from the first part of Sir Mike’s report will also be published by the CQC today so that both reports can be read together.

In response to the recommendations that are additional to the interim report, we are working with the CQC and the adult social care sector to ensure that local authority assessments evolve in a way that maximises their value in driving outcomes for people who draw on care and support, and their carers. I agree with Dr Dash’s recommendation to pause ICS assessments, which have not yet launched, to allow the CQC to focus on getting the basics right before introducing new functions. I am working on next steps.

By implementing Dr Dash’s recommendations, the CQC will be better positioned to fulfil its mandate of ensuring that everyone receives safe, high-quality care. A strong regulator is critical to the safety and effectiveness of our health and care system, and I am personally determined that its performance improves so that it can regain the confidence of both the public, and the health and care system.

Following the conclusion of this review, I have asked Dr Dash to lead a review of patient safety in the wider health and care landscape in England, for which I am also publishing the terms of reference today on www.gov.uk. The primary task of this review is to assess whether the current range and combination of patient safety organisations delivers effective leadership, listening, learning, and regulation to the health and care system in relation to patient and user safety.

Subject to the outcome of this second review, I will also ask Dr Dash to conduct a third review on quality and its governance. Further detail on this third review will be forthcoming in due course.

[HCWS133]