CQC Commissioners' statement on Kay Sheldon’s statement

In her statement to the Mid Staffordshire NHS Trust inquiry, Kay Sheldon, one of our fellow commissioners, makes criticisms of various aspects of CQC’s management.

This statement is not an accurate representation of CQC, its leadership or its culture. In addition, it contains a number of factual inaccuracies relating to the functioning of the Board and the operational aspects of CQC. These have been addressed in CQC’s most recent statement to the inquiry, which we endorse.

Kay made a number of statements about the leadership provided by Dame Jo Williams. All three of us (Deirdre Kelly, Martin Marshall, John Harwood) have been proud to serve under Jo’s leadership. She has led the Board with determination, sensitivity, foresight and energy and has been a key driver behind the progress that CQC has made in identifying and tackling poor care. We unreservedly support her ongoing Chairmanship.

We are disappointed that Kay believes that the Board lacks rigour in its governance, decision-making and direction. We are fully confident that we are able to effectively fulfil our governance role. All three of us are experienced board members with extensive knowledge of setting up, running and overseeing the operation of major organisations and we do not recognise the criticisms Kay is referring to.

Over the past two years the Board has overseen:

• a continuous review of the strategic direction, governance and risk framework
• a thorough review and updating of the regulatory model in order to strengthen and simplify the tools available to our inspectors to identify poor care
• improved collaboration with other bodies in the sector, including other regulators, patient advocacy bodies and clinical stakeholders
• the development of the world-leading Quality and Risk Profile (QRP) model
• the development of our new website to help people make informed choices about their providers – developed with the public and designed around their needs
• registration of over 24,000 social care locations, nearly 2,500 independent healthcare locations and, for the first time, of over 2,500 NHS locations and over 8000 dental providers
• an ongoing compliance monitoring regime based on unannounced inspections which identifies poor care and forces providers to take action
• development and implementation of a targeted inspection programme, looking at dignity and nutrition for older people in 100 acute hospitals.

At the core of everything we do is the focus on people who use services and on compliance with the essential standards of health and safety set out in law. We have adapted and refined our strategic approach when necessary, but this central focus remains unchanged. The most important driver is, and has always been, the need to ensure the most effective system possible to protect people who use services from poor care.

Not every aspect of running a highly complex and multifaceted organisation can run smoothly - CQC has made mistakes, which it has acknowledged and from which it has learned. But the direction of travel on what has been a steep learning curve, has overwhelmingly been one of steady improvement and delivery.

CQC’s Executive Team and staff have performed well, given the many external factors with which they have had to contend. This is an organisation that has learned much in a short time and is increasingly delivering real benefits to people who use services, with over 1,400 unannounced inspections last month alone.

CQC’s full response to today's evidence will be made to the Mid Staffordshire Inquiry on Tuesday and we are limited in what we can say in advance of this. However, we are very clear that the evidence heard today does not represent a true picture of our organisation.

While it is extremely disappointing that Kay Sheldon has chosen to raise her concerns in this way, the other members of our Board have made their support for our Chair, Chief Executive and our Executive Team absolutely clear. We welcome their support, and that of the other parts of the health and social care system who have worked closely with us and will continue to do so while we deliver what the Secretary of State described recently as a 'proactive and tough' inspection regime. Our priority now is – as it has always been – to identify and tackle poor care and protect people who use services. We will not be distracted from this task.

CQC has faced major challenges in merging three existing regulators, setting up an entirely new regulatory system and registering over 40,000 provider locations – including previously unregulated sectors – against aggressive Parliamentary deadlines and with a 30% budget reduction.

The speed required to design and implement this new regulatory model and to complete registration has demanded constant re-evaluation of processes and methodologies. Rapid change has frequently been necessary to ensure our staff have the best tools to identify poor care. Many of the criticisms in these evidence refer to earlier points in the development of our model, which we have now strengthened and simplified to make more effective.

This process of evolution has been a difficult one for everyone involved. Our staff have been placed under enormous pressure to deliver and, understandably, some have found the pace of change challenging. However, we completely refute the charge that CQC tolerates a culture which does not support its employees. Our Executive Team is committed to driving the organisation forward, but only with the engagement of our most valuable resource - our staff.

We have made mistakes, and we have worked hard to learn from these and build a stronger organisation as a result. We think we are now firmly on the right track, and the vast majority of our 2,000 staff have contributed to this journey and are proud to be part of an organisation that has achieved much in a short time and is delivering real benefits to people who use services.