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Amanda Pollard: 'Speaking out helped the CQC to change its inspection methods'


It’s worth persevering to get your concerns heard, says Amanda Pollard

I started with the Healthcare Commission in 2008, as part of a national team inspecting infection control. The team comprised about 25 people, including specialists, and had successes at improving infection control practice in hospitals. A quality control panel assessed our conclusions and ensured similar regulation judgments were made countrywide. Inspectors had frequent specialist training, and at least one specialist was “on call” for questions that arose during inspections.

The Care Quality Commission took over the Healthcare Commission a few years later. Inspectors started to feel uneasy about the direction in which roles were moving during the first summer of registration. We were told we would lose our specialist role and become generic inspectors, responsible for hospitals, nursing homes, learning disability homes and domiciliary care services. We would also move from looking purely at infection control to all 21 essential outcomes. While this change was a shock to many of us, we tried to see the benefits of an extended role - working in different sectors could expand our skills and experience. We waited for the training; it never came.

My colleagues and I came from a range of backgrounds. I had worked as a senior NHS manager with no clinical background so to be told to “hit the ground running” and inspect dementia care, learning disability services and nursing homes with no experience, knowledge or training was more than puzzling to me - it was dangerous.

“You must tell a person/organisation who needs to know the concerns; if you don’t get a successful response, try another”

Equally, my colleagues from the Commission for Social Care Inspection were being asked to inspect hospitals when they had no experience or training in healthcare. There was real discontent and staff meetings saw angry, fearful and concerning scenes. Our protestations fell on deaf ears. I later learnt from Kay Sheldon’s evidence at the Mid Staffordshire Foundation Trust Public Inquiry that many of the managers had written a group letter to the board to raise their concerns. But nothing happened. It was becoming very clear that if the new methodology wasn’t to one’s taste, we needed to look elsewhere for a job.

I wrote to the National Audit Office, which was assessing the CQC. Asking for anonymity, I spelt out my concerns. The NAO told me to contact Public Concern at Work. PCaW appreciated the nature of what I was trying to raise and knew it would be relevant to the Mid Staffs inquiry. The NAO finally replied to me on the eve of my appearance at the inquiry; they concluded my concerns about training and patient safety were outside their remit. Luckily, the inquiry didn’t share their view. This is key - you must tell a person/organisation who needs to know the concerns; if you don’t get a successful response, try another.

I remember the conversation with the inquiry’s lead solicitor about losing my anonymity; my evidence would be inadmissible if anonymous. He believed my role was protected by the Public Interest Disclosure Act; he was right. I didn’t lose my job, but I did leave the CQC earlier this year. I’m unable to comment further for legal reasons.

I genuinely believe if I hadn’t told the inquiry what CQC inspectors were being told to do, the CQC would not be starting to change its inspection methodology now. Thankfully, many inspectors contacted the inquiry after my appearance to reinforce my concerns, albeit anonymously.

If you have concerns about practice at work, contact PCaW. There’s been some movement in the right direction about whistleblowing and more people appreciate that whistleblowers don’t want to cause trouble but have genuine concerns that organisations need to see as opportunities to learn and change.

● Sign up to Nursing Times’ Speak Out Safely campaign at

Amanda Pollard was compliance inspector at the Care Quality Commission


Readers' comments (3)

  • michael stone

    Well done Amanada, but it is still much too difficult - in the sense that often it still requires 'too much courage' - for staff to speak out adequately forcefully about concerns. Until that is somehow changed, the problem will remain.

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  • I made a complaint about a manager. The person who I made the complaint to; I later saw smoking and drinking coffee with the said manager. It turned out that they were good buddies. Needless to say my complaint, despite RCN input, went nowhere. At every stage of the complaint process, this manager was on good terms with the next level of authority. I persisted with the process, because of the seriousness of my grievance. Altimately I feel I wasted my time. Work became difficult, so I left the hospital. This manager was promoted.

    I feel deeply about bad behaviour were ever I find it. No matter how senior the person, I will challenge them if they are performing badly or allowing bad behaviour from their staff. Once when a few members of staff came to me about a senior manager. I stated I would report it if they supported me. They agreed to do so. The result was the Matron gathered every one in the staff room and said " hands up those who have a grievance ?". No put their hands up, so it left me to fight on. The fact was those few who complained had a good case. Essentially they were intimidated out of coming forward.

    This is how it is in nursing. In every hospital I've worked I keep encountering the same type of personality in charge. Almost like identikit bullies. There are great leaders out there, but are kept from voicing their opinion and concerns.

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  • Amanda

    Interesting to read your story .

    You were of course working for a totally corrupt organisation whose sole purpose was to protect the Labour Party from having to answer difficult questions about failures within health/social services .

    Cynthia Bower and her sycophants eviscerated the "inspection" process when Dr Heather Wood and her team were sacked.

    Bad practice and poor outcomes are the result of incompetent "management".

    It is "management" who reduce staffing levels and employ excessive numbers "care assistants"

    Nothing will change until "managers" are held to account !

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