CQC not fit for purpose according to independent investigation into the NHS

The recently published independent investigation into the NHS in England, led by The Rt Hon. Professor the Lord Darzi has shed light on numerous challenges facing the NHS.

Among the critical points raised, the report offers a particularly scathing assessment of the Care Quality Commission (CQC) calling the regulator “not fit for purpose”.

The report claims the emphasis on meeting regulatory requirements has overshadowed the primary goal of improving patient care and outcomes. This misalignment has contributed to inefficiencies and has placed undue pressure on hospital staff, who are already struggling with the demands of a system in crisis.

Impact on hospital staffing 

The CQC’s approach, which has focussed on input rather than output, has led to an increase in hospital staffing but a fall in productivity and patient care.

Despite the highest level of hospital employment in the world, the report says, there appears to be “no problem for which the CQC believes the solution is something other than to add more staff.”  It gives the example of a Trust issued with a warning notice by the CQC on grounds that inspectors were told that a ward was short staffed and unsafe only for it to emerge that the ward in fact had better than one-to-one staffing. The CQC had made no effort to establish the facts prior to issuing the warning notice, which was subsequently withdrawn.

While the number of hospital staff has grown, the number of appointments, operations, and procedures has not kept pace.  This discrepancy has resulted in falling productivity, which in turn has negatively impacted staff morale and patient care. The report suggests that the CQC’s regulatory framework needs a fundamental overhaul to focus more on outcomes and less on bureaucratic processes.

Regulatory overload

The investigation raises concern about the issue of regulatory overload within the NHS. The CQC is just one of many regulatory bodies that providers must answer to, and the sheer number of these overseer organisations has created a complex and often counterproductive system. The report notes that nearly 80 people are employed in regulatory and headquarters functions for each NHS provider trust, a figure that has doubled over the past 20 years.

This proliferation of regulatory bodies has led to a situation where NHS organisations are more focused on compliance than on delivering high-quality care to patients.

A call for reform

The report echo’s Dr Penny Dash’s interim review in calling for a significant reform of the CQC and the broader regulatory framework within the health and care sector.  The focus of regulation, it says, should shift from inputs to outcomes, with a greater emphasis on patient care and staff engagement.  There also needs to be a reduction in the number of regulatory and overseer bodies and a streamlining of the scrutiny of services to make regulation more effective and less burdensome for providers.

Conclusion

Lord Darzi’s report highlights the urgent need for reform within the CQC and the broader regulatory environment of the NHS and, in doing so, emphasises that a better future for the NHS is contingent on there being a more efficient, streamlined and outcome-focused framework for its regulation.