England’s healthcare regulator has issued a public apology over reforms to its monitoring of tens of thousands of hospitals, care homes, dentists and GPs.
The apology from the Care Quality Commission (CQC) came in the wake of care organisations complaining of a “hostile” inspection regime and a major new computer system failing to work properly.
The government-established watchdog said sorry after the chief executive, Ian Trenholm, abruptly quit at the end of last month midway through reforms that were supposed to improve the assessment of the quality of health and social care providers.
The CQC regulates close to 15,000 care homes, 13,000 homecare agencies, 11,500 dentists, 8,600 GPs and 1,200 hospitals as well as community services and supported living facilities. Care England, which represents private care providers, had complained of “CQC’s over-reliance on outdated data, the lack of transparency in their regulatory approach, and vast inconsistencies between assessments”.
“I want to start with an apology,” said Kate Terroni, the interim CQC chief executive, in an email circulated on Monday. “We’ve got things wrong in the implementation of our new regulatory approach. I know that the changes we’ve delivered so far are not what we promised. It’s made things more difficult than they should be.”
Providers have been experiencing delays to registration and have been unable to upload information to a new online “provider portal” system intended to make regulation more efficient. Some have compared the hostility from inspectors – who give ratings from “inadequate” to “outstanding” – to that of Ofsted, which inspects schools and had to apologise over its role after the suicide of a headteacher, Ruth Perry.
Terroni admitted the regulator “didn’t listen properly” when care providers and even members of the CQC’s own staff warned of looming problems such as faults with the provider portal.
“Though there was significant engagement and co-production of the high-level elements of our approach, we didn’t follow that process into the detail of how we’ll assess providers,” she said. “I know that, for some of you, we’ve lost your trust because of this. I’m sorry.”
The apology comes two months after the Cabinet Office and the Department of Health and Social Care launched a wide-ranging independent review of the CQC’s effectiveness, chaired by Dr Penny Dash.
The National Care Association, which represents independent care home operators, had in February publicly warned that “the culture in CQC remains hostile at the ground level” and was forcing providers to consider closing.
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“For some time now the CQC has not been responsive to the challenges that the sector has faced because of poor inspection methodology,” said Nadra Ahmed, the chair of the NCA, who welcomed the apology. “Many providers have found the process very challenging, intimidating, and staff have been left in tears. A new framework for inspections was unveiled but the online portal to support evidence to be uploaded to the regulator … has failed to work. Providers have had to spend weeks trying to get online.”
Terroni said: “With my new role comes my commitment to urgently and rapidly improve how we’re using our regulatory approach and to making the changes we need to steer us in the right direction.”