CQC attracts criticism in the Paterson Inquiry

Topics covered: CQC, CQC enforcement, NHS

The Paterson Inquiry was established following the conviction of Ian Paterson, a doctor suspected to have harmed more than 1,000 patients, who was eventually convicted of 17 counts of wounding with intent and 3 counts of unlawful wounding.

The Inquiry, chaired by the Right Reverend Graham James was tasked with investigating the circumstances surrounding Mr Paterson’s malpractice and other practices within the NHS and the independent healthcare sector. After some delays, the Inquiry published its Report on 4 January 2020.

The Report is pretty damning of the whole healthcare sector, as summarised in the opening statement:

“It is the story of a healthcare system which proved itself dysfunctional at almost every level when it came to keeping patients safe, and where those who were the victims of Paterson’s malpractice were let down time and time again”

The Care Quality Commission (“CQC”) is just one of the many regulators attracting criticism in the Report. All are accused to some degree of passing the book, and “waiting for someone else to act” in the events surrounding Paterson’s activities.  The CQC attracts particular criticism for the way it engaged with the Inquiry, and a lack of co-ordination with other regulators.

It should be noted that many of the individual patient cases involving Paterson, pre-dated some large scale reforms of health and social care regulation which have taken place, and all regulators told the Inquiry that it would be less likely to happen in today’s landscape. However, the Report concludes that this is not in fact the case, although it does acknowledge that improvements may have been made.

The Report makes a number of high level recommendations which appear intended, amongst other things, to improve communication, transparency and accountability, promote better public awareness of health and social care regulation and the roles that various organisations play within that landscape, promote a more proactive approach to dealing with concerns and complaints, and encourage better coordination between regulators and healthcare providers.

The Report, notably, does not call for more regulation, but calls for changes to what it perceives as the current “culture of avoidance and denial” and “poor behaviour”. It states “our healthcare system does not lack regulation or regulators. The resources they possess, both human and financial, are very considerable.”

In other words, we already have the tools to do a better job, and with a bit of work the current regulatory landscape is perfectly adequate to enable that to happen. To be fair to the CQC, it cannot be solely their responsibility and if we want to see real improvements across the sector, and it will require engagement and efforts from all stakeholders.

Providers need not worry that the regulatory landscape is going to change dramatically overnight, for better or for worse. The CQC is by no means the only organisation criticised in the Report and many of the recommendations will take time to work through at a government level. There are likely to be rounds of consultation and sector review and analysis, during which it should become clearer what response there will be from the government and the CQC.

The CQC are already under considerable public scrutiny, not least in the fall out from some high profile cases, including the Whortlon Hall abuse scandal. The CQC will want to be seen to be proactive in its approach and Providers will probably see some changes in the CQC’s policies and guidance over the coming months. It is worth keeping an eye on the CQC Citizen Lab consultation portal.

Public awareness of the CQC’s role is probably already on the rise and if the recommendations are adopted, the CQC will need to engage even more proactively and be more transparent with the public. We expect that increased public awareness, over time, will prompt a rise in complaints to the CQC, which may see Providers facing more focused inspections and a more active approach to enforcement.

The full Report is available online at this link.

If Providers wish to discuss this article or the implications of the Paterson Inquiry, or require any legal advice on CQC matters, please contact Ridouts on 0207 317 0340.

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