A review of the Care Quality Commission’s failures in a high-profile whistleblowing case says it needs to ensure clinicians with the “correct expertise” are placed on its inspection teams.
Barrister Zoe Leventhal said the regulator should set up a new management structure for part-time specialist advisers, who are a key part of its local inspection system, as they are “not properly utilised”, and can be called to work outside their expertise.
Her report, published today alongside a wider review, confirmed the Care Quality Comission “did not respond appropriately” to concerns raised by Shyam Kumar, a consultant orthopaedic surgeon in the North West, who was also a CQC specialist professional adviser.
Last year, Mr Kumar won a tribunal against the CQC, with judges ruling he had been unfairly dismissed as an adviser, after raising concerns about the adequacy of inspection teams.
The CQC subsequently launched the probe into how it handled the protected disclosures he made, which has made four recommendations, one of which focuses on the role of specialist advisers.
Mr Kumar had raised concerns around a lack of staff on inspections and said he was expected to act beyond his expertise.
In an email to CQC chiefs, he had commented on the irony of the regulator criticising the trusts it inspects, while failing to ensure it had adequate inspection teams.
Ms Leventhal’s review said: “The role of [specialist advisers] is vital to enable CQC to meet its regulatory functions by providing the right clinical expertise. This case shows that, in many cases, SpAs are not properly utilised and are unlikely to feel valued or properly involved within CQC…
“There were no standard procedures governing their [SpAs’] deployment. There was no central management of engagements, leading to inconsistent matching of skills to required tasks…
“Although some individuals had been registered as specialist workers for several years, some had never been contacted to make use of their specialist area of knowledge [though they had been utilised more generally to support inspections].”
She called for “appropriate clinicians with the correct expertise” to be made available for inspections, and said there should also be better training for SpAs and inspectors to ensure their role is understood.
Other recommendations from her review included that the CQC should issue a full apology to Mr Kumar, and improved processes and training for staff dealing with whistleblowing information. She also said staff should receive training around handling issues around racism, as there was a lack of confidence in dealing with these issues when they were raised by whistleblowers.
At today’s board meeting discussing the two reports, several CQC leaders thanked Mr Kumar for raising the issues and contributing to the reviews. CQC chair Ian Dilks said: “Frankly he had a single-minded focus on patient safety. If everybody in the health system had that focus, probably many of the issues we face, we wouldn’t be facing.”
Mr Kumar was contacted for comment by HSJ and said he was still examining the report’s findings. But he said the regulator “will be judged on their next actions”.
The Leventhal review formed the first phase of the CQC’s probe into how well it listens when people share concerns.
The parallel internal review, led by CQC director Scott Durairaj, concluded there was “clear evidence of a widespread lack of competence and confidence” within CQC in understanding and identifying racism.
It also found evidence of high levels of “unknown” ethnicity data, or data not being collected, as well as findings from the NHS workforce race equality standard and staff surveys that required the CQC’s attention.