Keeping patients safe is an issue facing the hospitals regulator, internal document suggests

Keeping patients consistently safe and losing the confidence of the Department of Health are issues facing the hospitals regulator, an internal document suggests.

Produced by the Care Quality Commission (CQC), the document says “stakeholders and the Department of Health and Social Care are losing confidence in our ability to deliver our purpose”.

The CQC said the internal document was a “problem definition statement” which seeks to “interrogate the most challenging risks captured in our risk register and stress test the mitigations we have in place”.

The document, part of which has been seen by the Health Service Journal (HSJ), adds: “The way we work is not working and we are not consistently keeping people who use services safe.

“Our people are not able to effectively identify and manage risk and encourage improvement and innovation.

“Our organisational structure, flow of decision making, roles, internal and external relationships do not promote a productive and credible way of working.”

In December, the Cabinet Office and Department of Health announced a review of the CQC’s effectiveness and a new approach to inspections, led by Dr Penny Dash, chairwoman of North West London integrated care board.

More than 30 Cabinet Office reviews of public bodies are planned for 2024/2025, with the reviews intended to identify any improvements that are needed.

Commenting on the new document, Sir Julian Hartley (pictured), chief executive of NHS Providers, said: “CQC has confirmed what trust leaders have long known: the regulator is in urgent need of reform.

“As our recent report showed, trust leaders support the important role of regulation in ensuring high-quality healthcare services but have repeatedly raised concerns about the CQC’s approach.

“We now have a critical opportunity to reset the relationship between CQC and healthcare providers.

“Trust leaders want to see collaborative and transparent relationships between regulators and healthcare providers and a responsive regulatory regime which is driven by the principles of proportionality, consistency, transparency, and agility.

“They’re also calling for a series of changes, ranging from improving the training, attitude and behaviours of CQC inspection teams to better reflecting challenging operational circumstances in its reports.”

Kate Terroni, who is interim deputy chief executive at the CQC, said in a statement: “Open and honest conversations, along with accountability, have to be at the heart of meaningful change.

“Just like the regular updates we publish and discuss in our public board meetings around risk and managing change, it’s only right that we understand and reflect on the potential impact of not getting this vital work right.

“This is how we continue to fulfil our role and give people the assurance they deserve about the care they have every right to expect.

“As part of a piece of quality improvement work specifically focused on reviewing the roles of regulatory leadership and operations now that those functions are two years old, we have developed a problem definition statement which seeks to interrogate the most challenging risks captured in our risk register and stress test the mitigations we have in place.

“We will be publishing regular external updates including information on what we’ve learned about how well our new assessment approach and technology is working.

“Our intention is to be transparent with the public, providers and other stakeholders on how we need to improve the way we work.”

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