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Care Quality Commission not yet an effective regulator

11 December 2015

The Committee of Public Accounts today raises new concerns about the performance of the Care Quality Commission, the independent regulator of health and adult social care in England.

Its 12th report of this Session recognises the Commission has made "substantial progress" since 2012 but finds "it is behind where it should be, six years after it was established, in that it is not yet an effective regulator".

Impact of staff shortages

The report highlights the significant impact staff shortages are having on the Commission's ability to complete its inspection programme, and identifies weaknesses in the consistency, accuracy and timeliness of its initial draft reports. 

The Committee is also concerned about the Commission's ability to respond quickly and effectively to information received from service users and staff, in particular issues raised by whistleblowers, as well as the quality of information on offer to people seeking a care provider.

Implementation unclear

Measures to assess the Commission's performance remain inadequate and it is still unclear how the Commission will implement and coordinate new responsibilities for assessing hospitals' use of resources.
The Committee's recommendations to Government set out measures to address these points, as well as a framework of deadlines by which it expects to see improvement.

Chair's comments

Meg Hillier MP, Chair of the PAC, said:

"Six years after being set up the Care Quality Commission is still not fully effective. There's too often a long gap between inspections and reports being published - and sometimes an alarming lack of attention to detail when reports are being prepared.

One NHS Foundation Trust told us staff had identified more than 200 errors in a draft Commission report, including data inaccuracies. The fact these errors were picked up offers some reassurance but this is clearly unacceptable from a public body in which taxpayers are placing their trust.

Recruitment at the Commission is going too slowly, meaning too many members of the public don't have up-to-date independent information about the quality of services provided. It is vital the public is clear on what the Commission has actually inspected, and when.

If the Commission is to properly fulfil its duty to taxpayers we must see improvements in the way it collects, acts upon and publishes information. At the same time it should set out a coherent plan for managing its new responsibilities.

When the Commission falls short, there must be robust measures in place to enable Parliament and the public to hold it to account."


The Care Quality Commission is a non-departmental public body, sponsored by the Department of Health (the Department). Its purpose is to "make sure health and social care services provide people with safe, effective, compassionate, high quality care, and to encourage them to improve".

The PAC last took evidence from the Department and the Commission in 2012. In its report the Committee expressed serious concerns about the Commission's governance, leadership and culture, and its failure to intervene quickly or strongly enough in failing providers of health or social care services.

The Commission has since been working with the Department to implement significant changes, under a three-year transformation programme between 2013-14 and 2015-16.

Report summary

The Care Quality Commission has made substantial progress since the Committee last reported in 2012. But it is behind where it should be, six years after it was established, in that it is not yet an effective regulator of health and social care.

Because of staff shortages it is not meeting the trajectory it set itself for completing inspections of hospitals, adult social care and primary care. There are also concerns about the consistency and accuracy of draft inspection reports, and the time the Commission takes to finalise a report after carrying out an inspection.

At the same time, the Commission is not yet ready to implement new responsibilities it takes on in April 2016 to assess the efficiency with which hospitals use their resources. In addition, the Commission does not yet have the quantified performance measures, linked to explicit targets, that are needed to show whether it is satisfactorily performing its statutory duties.
We will be returning to this subject to review what further progress the Commission makes in the coming year.

Further information 

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