The NHS’s main regulator has so far failed to perform properly in its role and could struggle in the upcoming task of registering all GP practices, MPs have concluded in a report published today.
The public accounts committee report on the Care Quality Commission is critical of the regulator, saying it has failed to carry out enough inspections, dropped a whistleblowers helpline and not filled vacancies.
In the report The Care Quality Commission: Regulating the quality and safety of health and adult social care, MPs said they were unconvinced that the CQC was ready for the “major challenge” of registering all 10,000 GP practices later this year.
The commission, however, has defended its performance, saying that massive improvements in its operations were underway such as carrying out more inspections and strengthening arrangements for helping whistleblowers.
Between September of this year and April 2013, the commission is due to register 10,000 GP practices, but the report says: “In the past, the commission’s inspection work has suffered when it has had to register large groups of providers. It shifted its focus to registration and carried out far fewer inspections than planned.”
As a result of problems, the commission has now changed its processes and registration would be decided primarily on the information provided by GPs themselves.
GP practices will have to declare whether or not they are meeting the essential standards, an approach that carries risks, says the report, so the commission will have to ensure the registration process is robust and provides meaningful assurance about the quality of GP practices.
MPs said the CQC’s role of ensuring appropriate quality standards and deterring poor quality and unsafe care had not been fulfilled effectively and had failed to achieve the right balance between registration and inspection.
They added that the Department of Health had underestimated the scale of the task it set in requiring the commission to merge three bodies while taking on an expanded role with a smaller budget than its predecessors.
MPs noted this had contributed to the commission’s problems, such as the fact that it did not act quickly enough on vital issues such as information from whistleblowers nor had it dealt with problems effectively.
Committee chair Margaret Hodge said: “The CQC plays an absolutely vital role in protecting people from poor quality or unsafe care, but it has failed to perform that role effectively.
“We are far from convinced that the CQC is up to the major challenge of registering and assessing 10,000 GP practices this year. Registration will now be decided on the basis of information from GPs themselves and there is a risk that the CQC will simply become a postbox.”
A CQC spokesman said: “We are disappointed that the report does not recognise the significant improvements of recent months.”
The number of unannounced inspections was rising – 2,400 in January of this year alone – and the report’s claim that the CQC has recently closed its dedicated whistleblowing hotline was inaccurate, when in reality the Commission recently strengthened its arrangements for dealing with whistleblowers.
“The CQC asked the Secretary of State for additional time to get GP registration right, and we are on track to deliver this major piece of work successfully by April 2013,” added the spokesman.
Health minister Simon Burns said: “This report makes clear that Labour let down patients by constantly reorganising the healthcare regulator, setting an unrealistic timescale for the registration of providers which resulted in diverting focus from inspecting hospitals, care homes and other healthcare providers.
“We are determined to strengthen the role of CQC as an effective regulator for patients and the public.”