Press Release - The Care Quality Commission: Regulating the
quality and safety of health and adult social care
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.
Amyas Morse, head of the National Audit Office, said
today:
"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."
Notes for Editors
- The Care Quality Commission is the independent regulator of
health and adult social care services in England. Its objective is
to protect and promote the health, safety and welfare of people who
use these services. The Commission is a non-departmental public
body, overseen by the Department of Health. In 2010-11, its
expenditure was £139 million, funded by grant-in-aid and fees paid
by health and social care providers.
- The Commission was established under the Health and Social Care
Act 2008 and began operating on 1 April 2009. It took over
responsibilities from three bodies: the Healthcare Commission, the
Commission for Social Care Inspection, and the Mental Health Act
Commission. The Department proposes that the Commission should
assume a variety of additional responsibilities, such as oversight
of fertility clinics and responsibility for HealthWatch England,
the national consumer body for health and social care.
- The Commission's safety and quality assurance work comprises:
registering providers against 16 essential standards of quality and
safety; checking that registered providers are complying with the
essential standards, including by carrying out inspections; taking
enforcement action against providers where services fail to meet
the essential standards; and undertaking special reviews of
particular on aspects of care, and investigations where concerns
about quality have been identified.
- Press notices and reports are available from the date of
publication on the NAO website, which is at www.nao.org.uk. Hard copies can be
obtained from The Stationery Office on 0845 702 3474.
- The Comptroller and Auditor General, Amyas Morse, is the head
of the National Audit Office which employs some 880 staff. He and
the NAO are totally independent of Government. He certifies the
accounts of all Government departments and a wide range of other
public sector bodies; and he has statutory authority to report to
Parliament on the economy, efficiency and effectiveness with which
departments and other bodies have used their resources.
Press Notice 70/11
All enquiries to Sarah Farndale, NAO Press Office: Tel:
020 7798 5350
Mobile: 07985 274421