Outgoing CQC chief suggests health and care services may deteriorate in coming year

The health watchdog has made assumptions that the standard of health and social care may deteriorate this year, one official has said.

In an interview with the Health Service Journal (HSJ), outgoing boss Sir David Behan said the Care Quality Commission (CQC) had adjusted its 2018/19 plans to anticipate more work.

He said that some of the regulator’s plans had worked on the assumption of “deterioration”.

In recent years, the health and care watchdog has issued stark warnings through its State of Care reports – that social care is facing a “tipping point” while the NHS is straining at the seams with staff shortages and rising demand.

“We have a model to work out our resource allocation, which basically says how many inspections do we need to do (and) what allowance do we need to make for inspections we have brought forward because of risk. Between April and October 2017, 17% of our inspections were reactive,” Sir David told the HSJ.

“The number of reactive inspections we have done has informed our model. We have made some assumptions about deterioration and reactive inspections and they were included in it. That is a dynamic model.”

Asked if the model was still based on the assumption of no deterioration, Sir David told the HSJ: “No it’s not, because we have assumed there will be deterioration because that is what we have been saying in our State of Care reports.”

A CQC spokeswoman added: “This model takes into account the number of services rated inadequate, requires improvement, good and outstanding, and also how often we need to reinspect outside the planned inspection frequency, focusing particularly on services whose ratings deteriorate from good and outstanding.

“It considers the resource implications of a number of possible scenarios, ranging from a 10% to a 50% deterioration in good and outstanding services, and is regularly updated against inspection activity.”

Commenting on the interview, Dr Nick Scriven, president of the Society for Acute Medicine, said: “It is good to hear such frank views from the regulator.

“We need a plan to turn this trend around without it being a stick to beat staff with – even the Secretary of State has acknowledged they can’t work any harder.”

In January, Sir David announced he will be stepping down from his role as chief executive of the CQC this summer.

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