On 11 September 2012, the Health Select Committee conducted its second accountability hearing with CQC. It has now published its report which finds that CQC still has some way to go in winning the confidence of the public.
Some of the key recommendations are set out below:
Regulatory approach
The Committee stressed the need for CQC to define its regulatory role given at present it is not sufficiently clear. It agreed, however, that CQC’s fundamental purpose is to ensure that health and social care providers meet those essential standards that ensure patient safety.
CQC has consulted on it strategy for the next three years. A report from CQC should be issued in the next few months confirming their intentions around regulating the sector.
The Essential standards
The Committee conclude that the first priority is for CQC to apply its existing standards consistently and effectively. It expects a progress report from CQC on how it is achieving this goal. It also wants to know the plans for the “progressive raising of these standards in line with public expectation.”
The Department of Health’s National Response to Winterbourne View Hospital published in December 2012 indicated that CQC would be publishing revised guidance about compliance in 2013, linked to the Department’s review of the quality and safety regulations.
Inspecting the professional culture of registered services
The Health Select Committee stressed the need for CQC to assess the culture which prevails among professional staff within individual care providers. Inspection is not just about facilities and records. This is linked to the importance placed on staff being able to raise issues through accessible procedures at their place of work.
The assessment of the professional culture of an organisation is an issue that the Health Secretary, Jeremy Hunt, stressed recently before the Public Service and Demographic Change Committee of the House of Lords. Mr Hunt proposed an Ofsted-style rating system for the NHS and adult social care under plans to improve standards of care for older people. The planned inspections would evaluate the culture inside registered services such as hospitals, care homes and GP surgeries.
CQC’s management and governance
The Committee stressed the need for CQC’s new Chair, David Prior, to overhaul the governance arrangements of CQC, stating that “the Board must provide strategic direction to the organisation and hold the Executive effectively to account for their performance against defined objectives.” The Committee was particularly concerned that one of its Board members, Kay Sheldon, felt it necessary to approach the Mid Staffordshire Public Inquiry to express her concerns about the management, functions and culture of CQC. The Committee noted that “it was essential that CQC reforms its culture and working practices to address these shortcomings.”
All change ahead for CQC?
There can be no doubt that 2013 is going to be an important year for CQC in trying to convince the public that it is fit for purpose and in satisfying the Health Select Committee at its next meeting that real progress has been made in meeting its public protection responsibilities.
Finally, the Mid Staffordshire Public Inquiry Report should be published in the next few weeks and this will comment on the effectiveness of the range of regulatory and supervisory bodies that occupy the busy health and social care landscape, including CQC. We will be reporting on The Inquiry’s recommendations about CQC in a forthcoming Ridout Report.
