An independent review into the Care Quality Commission (CQC) has revealed "significant internal failings" that are hampering its ability to keep a check on health and social care institutions.
An interim report from Dr Penny Dash found the CQC's ability to identify poor performance at hospitals, care homes and GP practices had been impeded by its own issues, including low levels of inspections, a lack of clinical expertise amongst those carrying them out, a lack of consistency in assessments and IT issues.
The report found the watchdog was unable to effectively judge the quality of health and care services, including those in need of urgent improvement.
It also said social care providers were left waiting too long for registration and ratings to be updated, leading to an impact on local capacity.
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Health Secretary Wes Streeting, who ordered the report to be published ahead of a full assessment due in the autumn, said he was "stunned" by the findings, which showed the organisation was "not fit for purpose".
He added: "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."
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The CQC said it accepted the full findings and was "working at pace" to "rebuild that trust and become the strong, credible, and effective regulator of health and care services that the public and providers need and deserve".
In her report, Dr Dash revealed one in five health and social care providers had not received a rating from the CQC, despite its power to assess them.
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She also said some providers had not been re-inspected in "several years" - pointing to the oldest rating of a hospital being from 10 years ago, and the oldest social care assessment taking place in 2015.
Dr Dash also heard evidence that some inspectors of hospitals had never been to one before, while a social care inspector had never met a person with dementia.
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Mr Streeting promised immediate action and increased oversight of the CQC, announcing the appointment of former chief inspector of hospitals Professor Sir Mike Richards to review its assessment frameworks.
The government also promised to improve transparency over the watchdog's ratings for health and social care providers and ensure the CQC regularly updates the Department of Health on its progress.
Meanwhile, Dr Dash has been asked to review all patient safety organisations for any of their own issues.
She 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."
Dr Dash has called for urgent action from the CQC to overhaul its inspection and assessment system, as well as fixing its IT issues.
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The CQC's interim chief executive Kate Terroni said: "We accept in full the findings and recommendations in this interim review, which identifies clear areas where improvement is urgently needed.
"Many of these align with areas we have prioritised as part of our work to restore trust with the public and providers by listening better, working together more collaboratively and being honest about what we've got wrong.
"We are working at pace and in consultation with our stakeholders to rebuild that trust and become the strong, credible, and effective regulator of health and care services that the public and providers need and deserve."
Ms Terroni also said the organisation had committed to increasing the number of inspections, increasing the number of people working on registrations, and working on a "new approach to relationship management that enables a closer and more consistent contact point for providers".
