DH banned CQC from recruiting inspectors

The Department of Health must share responsibility for the failings of the Care Quality Commission, a report by the National Audit Office has found.

The report concluded the CQC had not provided value for money, as it underspent by a total of £14.9m during 2009-10 and 2010-11, but said it was not clear “exactly where the balance of responsibility lies” between the DH and CQC.



Most of the underspent £9.8m was due to the government-wide ban on recruiting non-frontline staff, while the remainder was due to restrictions on spending on consultants.

The DH ruled compliance inspectors and registration assessors were not frontline staff but agreed they were business critical. In September 2010 it gave permission for the CQC to recruit from within a “redeployment pool” of staff being made redundant from arm’s-length bodies, the NHS and the Audit Commission.

However, the CQC attempted to fill the posts from an internal restructuring and did not advertise the posts until March 2011. When it was still unable to fill them with suitable applicants in June 2011 the DH gave permission to recruit on the open market.
Labour MP Margaret Hodge, chair of the Public Accounts Committee, said it was “shocking” the CQC had been prevented from recruiting.

“The findings are deeply worrying and highlight significant failures that put patient care at risk,” she added.
The also report warns changes proposed in the Health Bill, including the CQC taking on responsibility for HealthWatch England and working with Monitor to operate a joint licensing and registration system, risked distracting the regulator from its core business, especially as it was not clear whether more resources would be available.

It criticises the regulator for pulling compliance inspectors away from their role to work on registering providers during 2010 and highlights that even as vacancies were increasing the CQC made 250 staff redundant at a cost of £16m.

The NAO found the regulator had faced challenges in staff morale due to the four different sets of pay and terms and conditions operating across the organisation that was formed from a merger of three previous regulators.
In October 2010 the commission made contacted the Treasury for permission to align pay scales which would have involved some pay increases but this was rejected and the DH refused to make further representation for an exemption to the public sector pay freeze.

The CQC welcomed the report for recognising the challenges the regulator faced in establishing a system of health and social care regulation.

Chief executive Cynthia Bower said: “As the NAO report makes clear, we faced a difficult task. We had to bring together the work of three organisations and bring in a new model of regulating health and adult social care.
“Not everything has gone smoothly, but we have learned, reviewed what we do and made changes – often with support of others involved in health and social care.”