CQC ICS inspections paused: Patient safety concerns
CQC failings: A crisis in patient safety and what it means for the future of healthcare
By Dr Richard Dune
Image by DC_Studio via Envato Elements
The Care Quality Commission (CQC), once seen as the cornerstone of health and social care regulation in England, is now facing unprecedented scrutiny following a damning independent review led by Dr Penny Dash. This review, commissioned by the government, has laid bare significant failings within the CQC’s operational framework, with grave implications for patient safety across the healthcare sector.
The findings are stark: delayed inspections, poor-quality reports, and a lack of expertise have left the regulator struggling to fulfil its core duty of ensuring the safety and quality of care. Health and Social Care Secretary Wes Streeting has made it clear in his response that patient safety is non-negotiable and that the CQC’s shortcomings cannot be allowed to continue. In this blog, Dr Richard Dune will explore the key findings of the review and their impact on health and social care in England.
Image by NomadSoul1 via Envato Elements
A regulator in crisis - what went wrong?
Dr Dash's review paints a troubling picture of the CQC’s operational inefficiencies, describing a regulator that is failing to keep pace with its responsibilities. The number of inspections has plummeted, from 15,800 in 2019 to just 6,700 in 2023. Hospitals and care homes awaiting re-inspection following ‘requires improvement’ or ‘inadequate’ ratings are left languishing in a backlog, some waiting years for a re-assessment.
The impact of these delays is profound. Without timely inspections, organisations providing substandard care can continue to operate unchecked, with patients and service users suffering the consequences. Dr Dash's report highlights that approximately 20% of locations under the CQC's jurisdiction have never been rated, a shocking statistic for an organisation tasked with safeguarding patient safety.
Moreover, new IT systems introduced in 2021, intended to streamline the inspection process, have instead added complexity and delays. The CQC’s regulatory platform has been criticised as cumbersome, with inspectors and providers facing difficulties navigating the system. This, combined with delays in producing inspection reports, has created a toxic environment in which both transparency and accountability have been eroded.
Loss of expertise and trust in the system
One of the most alarming aspects of the review is the loss of expertise within the CQC. The regulator’s internal restructuring has left inspection teams without the sector-specific knowledge needed to assess healthcare providers effectively. This has led to inconsistent ratings and a lack of trust from both providers and the public.
Dr Dash’s report also pointed to significant confusion over how ratings are calculated. Providers described the process as opaque, with some likening it to a "magic box" where outcomes seem arbitrary. This lack of clarity has further undermined confidence in the CQC's ability to regulate effectively.
The single assessment framework (SAF), introduced in 2021 to create a unified standard for health and social care providers, has been particularly criticised. The review found that the SAF uses vague language, offers little guidance on what constitutes high-quality care, and fails to measure outcomes adequately. This has made it difficult for providers to understand how to improve and for patients to have confidence in their care.
Image by gpointstudio via Envato Elements
Image by monkeybusiness via Envato Elements
ICS inspections paused as CQC reforms begin
In response to these criticisms, the CQC has been ordered to formally pause its Integrated Care Systems (ICS) inspections for six months. This pause will allow the regulator to focus on fixing its internal issues and address the backlog of inspections for hospitals, care homes, and GP practices. Dr Dash’s report recommended the pause after finding that the CQC’s assessment process for ICSs lacked focus on the core objectives of improving healthcare outcomes and reducing inequalities.
The CQC, in agreement with the Department of Health and Social Care (DHSC), will use this time to review its single assessment framework and modify its inspection processes to ensure they are fit for purpose. The organisation has already appointed Sir Julian Hartley as its new chief executive, tasked with steering the CQC through this period of reform.
A system in need of overhaul
The findings of Dr Dash’s review make one thing abundantly clear: the CQC’s operating model is not fit for purpose. With delayed inspections, poor-quality reports, and a loss of trust across the healthcare sector, immediate and decisive action is required to restore credibility.
Health Secretary Wes Streeting has promised to overhaul the system, stating, “An overly complex system of healthcare regulation and oversight is no good for patients or providers. We will overhaul the system to make it effective and efficient and protect patient safety.”
In tandem with the Dash review, Professor Sir Mike Richards’ internal review of the single assessment framework has also recommended a "fundamental reset" of the CQC’s regulatory approach. The reviews underscore the urgent need for a transparent, efficient regulator that supports the organisations it oversees.
Image by DC_Studio via Envato Elements
Image by YuriArcursPeopleimages via Envato Elements
Restoring faith in the CQC and the future of patient safety
The reforms at the CQC are critical to restoring faith in the regulatory system and ensuring that patient safety remains the bedrock of healthcare in England. While the findings of these reviews are sobering, they offer a roadmap for recovery. The appointment of Sir Julian Hartley and the commitment to overhaul the CQC’s inspection processes are positive first steps, but the road ahead will be long.
As the healthcare sector awaits the implementation of these reforms, the priority must remain on providing safe, effective, and compassionate care. Both providers and regulators must work together to ensure that the CQC can fulfil its vital role in safeguarding patient safety.
Is your organisation ready for the new CQC reforms?
Reach out today to discover how ComplyPlus™ can help your organisation navigate these regulatory changes and ensure compliance with the latest CQC standards.
A regulator in crisis - what went wrong?
Image by NomadSoul1 via Envato Elements
Dr Dash's review paints a troubling picture of the CQC’s operational inefficiencies, describing a regulator that is failing to keep pace with its responsibilities. The number of inspections has plummeted, from 15,800 in 2019 to just 6,700 in 2023. Hospitals and care homes awaiting re-inspection following ‘requires improvement’ or ‘inadequate’ ratings are left languishing in a backlog, some waiting years for a re-assessment.
The impact of these delays is profound. Without timely inspections, organisations providing substandard care can continue to operate unchecked, with patients and service users suffering the consequences. Dr Dash's report highlights that approximately 20% of locations under the CQC's jurisdiction have never been rated, a shocking statistic for an organisation tasked with safeguarding patient safety.
Moreover, new IT systems introduced in 2021, intended to streamline the inspection process, have instead added complexity and delays. The CQC’s regulatory platform has been criticised as cumbersome, with inspectors and providers facing difficulties navigating the system. This, combined with delays in producing inspection reports, has created a toxic environment in which both transparency and accountability have been eroded.
Loss of expertise and trust in the system
Image by gpointstudio via Envato Elements
One of the most alarming aspects of the review is the loss of expertise within the CQC. The regulator’s internal restructuring has left inspection teams without the sector-specific knowledge needed to assess healthcare providers effectively. This has led to inconsistent ratings and a lack of trust from both providers and the public.
Dr Dash’s report also pointed to significant confusion over how ratings are calculated. Providers described the process as opaque, with some likening it to a "magic box" where outcomes seem arbitrary. This lack of clarity has further undermined confidence in the CQC's ability to regulate effectively.
The single assessment framework (SAF), introduced in 2021 to create a unified standard for health and social care providers, has been particularly criticised. The review found that the SAF uses vague language, offers little guidance on what constitutes high-quality care, and fails to measure outcomes adequately. This has made it difficult for providers to understand how to improve and for patients to have confidence in their care.
ICS inspections paused as CQC reforms begin
Image by monkeybusiness via Envato Elements
In response to these criticisms, the CQC has been ordered to formally pause its Integrated Care Systems (ICS) inspections for six months. This pause will allow the regulator to focus on fixing its internal issues and address the backlog of inspections for hospitals, care homes, and GP practices. Dr Dash’s report recommended the pause after finding that the CQC’s assessment process for ICSs lacked focus on the core objectives of improving healthcare outcomes and reducing inequalities.
The CQC, in agreement with the Department of Health and Social Care (DHSC), will use this time to review its single assessment framework and modify its inspection processes to ensure they are fit for purpose. The organisation has already appointed Sir Julian Hartley as its new chief executive, tasked with steering the CQC through this period of reform.
A system in need of overhaul
Image by DC_Studio via Envato Elements
The findings of Dr Dash’s review make one thing abundantly clear: the CQC’s operating model is not fit for purpose. With delayed inspections, poor-quality reports, and a loss of trust across the healthcare sector, immediate and decisive action is required to restore credibility.
Health Secretary Wes Streeting has promised to overhaul the system, stating, “An overly complex system of healthcare regulation and oversight is no good for patients or providers. We will overhaul the system to make it effective and efficient and protect patient safety.”
In tandem with the Dash review, Professor Sir Mike Richards’ internal review of the single assessment framework has also recommended a "fundamental reset" of the CQC’s regulatory approach. The reviews underscore the urgent need for a transparent, efficient regulator that supports the organisations it oversees.
Restoring faith in the CQC and the future of patient safety
Image by YuriArcursPeopleimages via Envato Elements
The reforms at the CQC are critical to restoring faith in the regulatory system and ensuring that patient safety remains the bedrock of healthcare in England. While the findings of these reviews are sobering, they offer a roadmap for recovery. The appointment of Sir Julian Hartley and the commitment to overhaul the CQC’s inspection processes are positive first steps, but the road ahead will be long.
As the healthcare sector awaits the implementation of these reforms, the priority must remain on providing safe, effective, and compassionate care. Both providers and regulators must work together to ensure that the CQC can fulfil its vital role in safeguarding patient safety.
Is your organisation ready for the new CQC reforms?
Reach out today to discover how ComplyPlus™ can help your organisation navigate these regulatory changes and ensure compliance with the latest CQC standards.
About the author
Dr Richard Dune
With over 20 years of experience, Richard blends a rich background in NHS, the private sector, academia, and research settings. His forte lies in clinical R&D, advancing healthcare tech, workforce development and governance. His leadership ensures regulatory compliance and innovation align seamlessly.
About the author
Dr Richard Dune
With over 20 years of experience, Richard blends a rich background in NHS, the private sector, academia, and research settings. His forte lies in clinical R&D, advancing healthcare tech, workforce development and governance. His leadership ensures regulatory compliance and innovation align seamlessly.
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