New health secretary Wes Streeting has echoed what many in the health and social care sector have believed for a long time: the UK’s health and care regulator the Care Quality Commission (CQC) is “not fit for purpose”.

Commenting on the results of a new independent, government-commissioned review into the CQC, the long-time Labour MP did not mince words, saying: “When I joined the department, it was already clear that the NHS was broken and the social care system in crisis.

“I have been stunned by the extent of the failings of the institution that is supposed to identify and act on failings.

“It’s clear to me the CQC is not fit for purpose.

“We cannot wait to act on these findings so I have ordered publication of this interim report so action can begin immediately to improve regulation and ensure transparency for patients.

“I know this will be a worrying development for patients and families who rely on CQC assessments when making choices about their care. I want to reassure them that I am determined to grip this crisis and give people the confidence that the care they’re receiving has been assessed. This government will never turn a blind eye to failure.”

This will come as a relief to many in the health and social care sector who have been saying just this for months or even years.

Complaints range from the poor implementation of the watchdog’s much-maligned single assessment framework – for which interim CEO Kate Terroni apologised only days ago – to its lack of communication with providers.

Many of the same criticisms the CQC is known to hand to health and care providers in inspection reports – staff shortages, poor communication and ‘closed cultures’ – have also been levelled at the regulator, while others have noted the long waits between inspections.

Some had speculated whether the CQC would be on the chopping block post-election, but despite Streeting’s comments the government seems intent on improving rather than replacing the body.

Meanwhile, the BBC has reported that the regulator has “accepted the [report’s] findings in full”.

The government has published online initial findings from the review of the CQC.

A post reads: “An independent review of the Care Quality Commission has identified significant internal failings which is hampering its ability to identify poor performance at hospitals, care homes and GP practices.”

Findings included:

• Inspection levels “still well below where they were pre-Covid”;
• A “lack of clinical expertise among inspectors”;
• A “lack of consistency in assessments”;
• Issues with its IT system;

The government noted the regulator’s inability “to consistently and effectively judge the quality of health and care services”, and said that it “will now take immediate steps to restore public confidence in the effectiveness of health and social care regulation”.

Perhaps disappointing to some who had been hoping that the CQC would be axed and replaced, the gov.uk post also said that its first step to improve health and care regulation would be to increase “oversight” of the CQC.

The government’s four initial steps to improve health and care regulation are set out as follows:

• The appointment of former physician and ex-CQC chief inspector of hospitals Mike Richards to review CQC assessment frameworks;
• Improving transparency in terms of how the CQC determines its ratings for health and social care provider;
• Increased government oversight of the CQC, with the CQC regularly updating the department on progress, to ensure that the recommendations in the final review (scheduled to be published later this year) are implemented;
• Asking the report’s author, Penny Dash, chair of the North West London Integrated Care Board, to review the effectiveness of all patient safety organisations.

Dash said: “The contents of my interim report underscore the urgent need for comprehensive reform within the CQC.

“By addressing these failings together, we can enhance the regulator’s ability to inspect and rate the safety and quality of health and social care services across England.

“Our ultimate goal is to build a robust, effective regulator that can support a sustainable and high-performing NHS and social care system which the general public deserves.”

She also revealed some concerning findings, including: one in five health and care settings under the CQC’s watch have never received an inspection rating; many others have gone several years between inspections; and reports of inexperienced CQC staff who claimed to have never set foot in a hospital before the job, or else “never met a person with dementia”.

Martin Green, chief executive of Care England, said: “It is clear that [Dash] has listened to the voices of care providers, resulting in a clear set of recommendations. This report acknowledges the severe and systemic problems that sit at the very heart of the CQC and gives a specific set of steps that the regulator must take to improve performance and re-establish the sector’s long-eroded trust.

“This is going to be a long and difficult journey for the CQC, but one that is entirely necessary. Care England stands ready to work with the regulator to help them deliver an effective and supportive regulatory system that will be the cornerstone of public protection and delivers fair judgements across health and social care.

“The CQC must embark on a radical improvement programme that should not only include some tangible improvements in their performance, but also needs to move away from a culture of blame. We all want proportionate and effective regulation, and the challenge now is for [the] CQC to take action and work with organisations across the sector to deliver it.”