FEATURE


KEEPING UP WITH THE JONESES


The Care Quality Commission (CQC) is in crisis but does the answer to its transformation lie beyond the English border? Jenny Wilde and Beverley Jones, senior lawyers in health and social care at Acuity Law, delve into recent developments and highlight future opportunities for the regulator to change how it operates and regain public trust.


Jenny Wilde Beverley Jones


https://www.cqc.org.uk/


Over the last year, England’s adult health and social care regulator, the Care Quality Commission (CQC), has suffered an unceremonious fall from grace, marred by severe internal failings and widespread public criticism.


https://www.gov.uk/government/publications/review-into-the-operational-effec- tiveness-of-the-care-quality-commission-full-report


The independent review led, by Dr. Penny Dash and published in full in October 2024, exposed stark deficiencies in the regulator’s operations, including reduced inspection levels, inconsistent assessments, and a worrying lack of clinical expertise among inspectors. These failings have significantly weakened the CQC’s ability to assess and assure the quality of health and social care services across England.


Health and Social Care Secretary Wes Streeting responded with frank concern, declaring: “It’s clear to me the CQC is not fit for purpose.” His statement reinforced the urgency of reform to restore public confidence in the regulator.


https://www.cqc.org.uk/news/independent-review-cqc-technology-published


That urgency was amplified by the revelations of a failed £99m transformation programme – an expensive misfire riddled with technical issues and a poor user experience, which caused widespread operational disruption rather than progress.


https://www.careprovideralliance.org.uk/


In October 2024, the newly appointed Chief Executive, Sir Julian Hartley, took the helm, inheriting a regulator in crisis. He has since openly acknowledged the CQC had “lost its way” and committed to regaining public trust by rebuilding the organisation’s credibility and performance. Part of that work has involved collaborating with providers and sector leaders, such as the Care Provider Alliance, to map out what a reformed CQC should look like and how it should behave. The transformation is, at last, underway.


A sceptic (or perhaps a seasoned lawyer) might view these listening sessions as strategic PR, intended to project an image of reform and responsiveness. The real test lies in


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whether those views are heard, taken on board and reflected in the final product.


But in this moment of reform and introspection, is the CQC missing an opportunity to look outward, beyond England, and learn from its counterparts in the devolved nations?


PRACTICAL LESSONS FROM BEYOND THE ENGLISH BORDER


Each devolved nation has its own regulator: Care Inspectorate Wales (CIW), the Care Inspectorate in Scotland, and the Regulation and Quality Improvement Authority (RQIA) in Northern Ireland. Lawyers and providers operating across these borders oſten speak of clear cultural and procedural differences – most notably a more collaborative and constructive approach to regulation.


https://www.careinspectorate.wales/


https://www.careinspectorate.com/ https://www.rqia.org.uk/


Take CIW, for example. It has a reputation for working alongside providers, offering guidance on training, promoting best practice, and fostering supportive environments to improve care. Inspectors are more likely to offer concrete advice or signpost resources when concerns arise. Compare that with the CQC’s more rigid model: a tick-box inspection, a grade, and oſten radio silence when providers ask how they might improve. The CQC’s long-held stance – that it is not there to advise providers – feels increasingly unhelpful in a sector that relies on practical improvement and learning.


Clients have reported that dealing with Care Inspectorate (Scotland) is like interacting with a fellow care provider and there is no “us and them” approach. The Care Inspectorate’s mission is that “everyone in every community, experiences high-quality care, support and learning, tailored to their rights, needs and wishes”. The tone is such that “we” (the Care Inspectorate and the care provider) are for the same reason:


www.tomorrowscare.co.uk


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