The Care Quality Commission should take on responsibility for “corporate governance” and “financial competence” alongside quality, Robert Francis QC has recommended.
The proposals for a single regulator, set out in the three volume Report of the Mid Staffordshire Foundation Trust Public Inquiry, call for Monitor to be merged into the CQC.
Mr Francis warns ministers to “avoid the temptation” of abolishing both regulators and starting again.
He writes: “A merger of the system regulatory functions between Monitor and the CQC should be undertaken incrementally and after thorough planning. Such a move should not be used as a justification for reduction of resources… it would be vital to retain the corporate memory of both organisations.”
The recommendation follows evidence to the inquiry that the CQC’s predecessor the Healthcare Commission and Monitor had not worked well together. This led to the trust becoming authorised as a foundation trust despite the Healthcare Commission having serious concerns.
Mr Francis has also recommended the CQC be given more powers to bring criminal prosecutions. Concluding that the Health and Safety Executive is “clearly not the right organisation to be focusing on healthcare”, Mr Francis calls for the CQC to be given comparable legal powers to bring prosecutions.
He also recommends providers should be criminally liable for a “breach of fundamental standards”.
The prime minister is expected to respond to Mr Francis’ report early this afternoon, with a detailed response published in coming months.