The country’s health watchdog is carrying out just half the number of inspections of hospitals, GPs and care homes as it was before the pandemic, a damning report warns.
Wes Streeting has ordered immediate changes to the Care Quality Commission (CQC) as a result of the findings, declaring the regulator “not fit for purpose”.
A former chief inspector of hospitals will be sent back to the watchdog to overhaul the way it works.
The detailed interim report, released on Friday, shows that the regulator – which paused routine inspections during the pandemic – never got back to doing the job it was supposed to do.
The report by NHS chief Dr Penny Dash, found just 7,000 inspections and assessments were carried out across the country in 2023-24 – compared with 16,000 in 2019-20. It details a catalogue of failings.
One in five of the organisations it should inspect and rate has never had a rating, while some hospitals have gone without checks for more than a decade.
It also highlights a lack of expertise at every level with a “noticeable lack of healthcare experience” among its executive team.
It says the decision to start using “generalist” staff instead of those with expertise in the area they were inspecting meant some of those inspecting hospitals had never been to one before.
Long delays in registration processes also meant care homes have been unable to open, despite being desperately needed, the report warns.
Dr Dash, chairman of North West London integrated care board, will carry out a final report which is due to be published in the autumn.
On Friday, Mr Streeting said the CQC needed “radical reform,” saying its assessments of the safety and quality of hospitals, care homes and GPs were so inadequate and out of date that anyone looking at their ratings should “take them with a pinch of salt”.
In comments to BBC Radio 5 Live, the Health Secretary said he was “brutally honest” with the public before the election that problems with the NHS would “take time to fix”, but had not anticipated that the regulator would have “failed to such an extent”.
The CQC was established by Gordon Brown in 2009 to protect patient safety and drive improvements in health and social care.
But it has failed to prevent a string of scandals, in particular in maternity, at a time when NHS performance on most basic standards has fallen dramatically.
The watchdog is supposed to inspect and assess hospitals, GP surgeries and care homes, publishing ratings which inform the public.
The report suggests there was little transparency about how ratings were derived, or about the standards by which organisations were measured.
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Providers were given little understanding of how ratings are calculated, believing it came down to “a complicated algorithm, or a “magic box”, the report said.
In fact, the reality was that different ratings were being calculated by aggregating outcomes from inspections over several years, creating an assessment that was neither credible nor right, she said.
The report found the watchdog failed to make use of a wealth of data which is routinely published to assess the safety and quality of organisations.
Nor did it take proper account of the outcomes for patients, even when such information was available.
Dr Dash said the findings show “the urgent need for a rapid turnaround of CQC”.
She said this process had started with the appointment of an interim chief executive in June 2024.
Ian Trenholm, CQC chief executive, who was on a salary of £225,000, resigned in June after six years in the post.
Within days, a leaked document revealed concerns from Kate Terroni, his interim successor, that the regulator was “not working and we are not consistently keeping people who use services safe”.
2024-07-26T19:15:30Z dg43tfdfdgfd