The Care Quality Commission is “not yet an effective regulator of health and social care”, a highly critical report by a parliamentary committee has concluded.
The report by the Commons public accounts committee, published on Friday, expressed “new concerns” about the regulator’s performance, and accused it of “weaknesses in the consistency, accuracy and timeliness” of its inspection reports.
The committee highlighted the CQC’s persistent recruitment troubles, and raises “serious concerns” about the government’s plans to hand it responsibility for inspecting providers’ efficiency.
While the MPs say the CQC has made “substantial progress” since it last reported on the regulator in 2012, it makes numerous criticisms of the watchdog.
The report noted the impact staff shortages have had on the CQC’s ability to complete its inspection programme. Sluggish recruitment has meant the CQC is set to miss key inspection deadlines that it had already pushed back.
In mid-April, the regulator had a vacancy rate of 34% for inspectors, 36% for senior analysts and 35% for managers. The shortfall has been worsened by staff turnover of nearly 8%, against a target of 5%.
The committee identified “weaknesses in the consistency, accuracy and timeliness” of the CQC’s draft reports, and raised concerns about its ability “to respond quickly and effectively to information received from service users and staff”, including whistleblowers.
Committee chair Meg Hillier said there was “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”.
Hospital inspection reports are taking on average 83 days to complete – considerably behind the CQC’s 50 day target.
The committee also raised concerns about Jeremy Hunt’s plan for the CQC to begin assessing trusts’ “use of resources” from April.
“We are concerned that there is not adequate preparation for this important additional area of work, which has been introduced before the [CQC] has the capacity to implement it and while it is struggling to fulfil its existing responsibilities,” the report said.
At the same time as the CQC is behind on its inspection pipeline and about to shoulder new duties, the organisation could face a cut of up to 40% in its government grant.
According to the report, the Department of Health informed the committee that the CQC’s “costs could be passed on to providers in the form of fees”.
“These are not new issues and we have been working hard to improve our performance”
However, the MPs said that with providers being asked to pay “substantially more” in CQC fees, it was “more important than ever” the CQC could demonstrate the quality of its work.
The committee recommended that the CQC should set out how it will improve the quality and timeliness of its draft reports, and publish new “quantified” performance targets for 2016-17.
It also called on the DH to clarify the roles of the CQC, Monitor and the NHS Trust Development Authority for assessing use of resources to stop “duplication of effort and unnecessary burdens”.
David Behan, the CQC’s chief executive, said: “We have always maintained that there is more we have to do, in particular with regards to improving the timeliness of our reports and inspecting all health and adult social care services.
“These are not new issues and we have been working hard to improve our performance,” he said. “What is essential is that we do not take any shortcuts, which could compromise the quality of the important work that we do.”