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CQC duty of candour inspections ‘inconsistent’ and ‘often superficial’

Care Quality Commission (CQC) duty of candour inspections have been branded “inconsistent” and “often superficial” since coming into force.

According to a new study from Action against Medical Accidents (AvMA), a quarter of CQC inspection reports had little or no evidence that the regulator was taking steps to ensure that NHS trusts improved, and 7% of reports did not refer to duty of candour at all.

The research, which analysed 90 reports on CQC inspections of NHS trusts in 2015, also revealed that nearly two-fifths of CQC reports contained criticism of how a trust was implementing the duty of candour, but only 14 of these went on to make a recommendation to improve.

AvMA added that where recommendations had been made to improve, the CQC could not “provide a single example” of a trust having responded about the action they would take to improve.

Peter Walsh, AvMA chief executive, said: “Having fought so hard to get a statutory duty of candour, we are deeply disappointed about how the CQC has regulated this so far.

“We still believe the duty of candour is potentially the biggest breakthrough in patient safety and patient rights in modern times, but we have always said that its success will depend to a large extent not only on the goodwill of providers, but on robust regulation by the CQC.”

Last summer the ‘professional duty of candour’ guidance – jointly developed by the General Medical Council (GMC) and the Nursing and Midwifery Council (NMC) – set out the standards expected of healthcare professionals, including “saying sorry”. The change came about after a 2014 report – carried out by Professor Norman Williams, president of the Royal College of Surgeons, and Sir David Dalton, chief executive at Salford Royal NHS FT – called for the NHS to usher in a new culture of candour so that patients are informed when things go wrong.

Professor Edward Baker, the CQC’s deputy chief inspector of hospitals, said: “AvMA’s review looked at CQC’s assessment of the duty of candour requirement placed on NHS trusts during the first year of the regulation coming into force. During this period we focused on trusts’ awareness of the new duty and the systems and processes they were putting in place to support its implementation.

“From these early inspections we identified the need for a more systematic approach to inspecting how well organisations are embedding the duty as part of their broader approach to learning from incidents and supporting people who use services and their families.

“We have since developed our methodology with input from AvMA, and this is now allowing us to follow a more robust and consistent approach in assessing the regulation as part of our hospital inspections. We will soon be rolling this out across all sectors.”

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Minh Alexander   08/08/2016 at 14:28

CQC is politicised and makes arbitrary decisions. I don't believe CQC is genuinelt interested in its core job of keeping patients safe. CQC has endlessly wriggled to avoid enforcing Regulation 5 Fit & Proper Persons. A summary can be found here: The AvMA report damningly concluded: "We noted that all of the inspections were heavily reliant on comments from the trusts regarding their own implementation of the duty of candour." This is not news to complainants and whistleblowers who see such behaviour by CQC all the time. In a current example, CQC rated Sheffield Teaching Hospitals "Good" despite multiple whistleblowers' concerns, 228 compromise agreements and 22 EXTERNAL whistleblowing disclosures to CQC. Sheffield whistleblowers asked CQC, under FOI, how CQC responded to the 22 disclosures. The CQC reply showed that CQC relied on the trust to investigate 17 of the whistleblowing matters, and only one of the matters was independently investigated. CQC's FOI response can be found uploaded here: CQC remains an integral part of Prof Brian Jarman's NHS "denial machine".

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