"Against a backdrop of considerable upheaval, the Care
Quality Commission has had an uphill struggle to carry out its work
effectively and has experienced serious difficulties. It is welcome
that it is now taking action to improve its
performance.
"There is a gap between what the public and providers
expect of the Care Quality Commission and what it can achieve as a
regulator. The Commission and the Department of Health should make
clear what successful regulation of this critical sector would look
like."
Amyas Morse, head of the National Audit Office, 2
December 2011
The Care Quality Commission had a difficult task in establishing
itself and has not so far achieved value for money in regulating
the quality and safety of health and adult social care in England,
according to a report by the National Audit Office today. The
Commission missed deadlines for registering health and social care
providers, other than NHS trusts, at the same time as levels of
compliance and inspection activity were falling significantly.
The Commission, formed in 2009, had to merge three existing
regulators to establish a new organisation and implement a new
regulatory approach, which for the first time integrates health and
social care. The Commission's budget is less than the combined
budget of its predecessor bodies, even though it has more
responsibilities. Even so, it underspent against budget in both
2009-10 and 2010-11. This was partly because it had a significant
number of staff vacancies. At the end of September 2011, 14 per
cent of staff positions were vacant. The Commission was unable to
fill vacancies as quickly as it might, because of government-wide
recruitment constraints.
The process for registering care providers did not go smoothly.
Although 21,600 providers are now registered, the timetable for two
of the three tranches of registrations was not met. The Commission
diverted inspectors from compliance activity to registration work
in a bid to meet the timetable. As a result of this and the number
of inspector vacancies, the Commission completed only 47 per cent
of the target number of compliance reviews between October 2010 and
April 2011.
Public expectations of the Commission are high, arising from a
misunderstanding of what it can achieve as a regulator. Although
clearly defined, the Commission's role as a regulator has not
always been communicated effectively to the public and providers.
In addition, proposals to extend the Commission's role risk
distracting the Commission from its core work of regulating health
and social care.
In the absence of measures of impact, the National Audit Office
assessed value for money in terms of whether the Commission
delivered what it set out to deliver.
Publication details:
HC: 1665, 2010-2012
ISBN: 9780102977011