The Care Quality Commission takes a step in the right direction

My despair at reading that the CQC had spent hundreds of thousands of pounds on new spin doctors struck a chord, to judge from the response that my earlier blog on NHS safety culture produced.

However, I’m pleased to report that the CQC has taken a bold step in the right direction, in carrying out and now publishing a highly critical review of their organisation, 'Exploring bullying and harassment at the CQC’

"Exploring bullying and harassment at the CQC"


The review highlights allegations of a culture of bullying and harassment under the previous leadership.  Publishing the results and addressing the issue head-on is the right way to deal with it.

The failings are all too familiar to us both from our work and as summarised in our latest report ‘Deconstructing failure – Insights for boards’.  The report appears to highlight three major problem areas at the CQC: 

• A failure of leadership to create the right ethos and culture
• A dominant leader not welcoming challenge
• Risks arising from incentives/targets set by leaders - in this case with the added fear of penalties for failure

All three are among the top seven risk areas identified in ‘Deconstructing failure’. 

Since the review did not pretend to make a root cause analysis of the problems at the CQC, it does not comment on other fundamental risks that may have been at work at the CQC, such as an ineffective board, a board lacking key skills, poor information flows to the board, organisational complexity and board blindness to key risks to their licence to operate.

Finding a solution

From my experience as a regulatory chief executive, a particularly interesting aspect is the collected views of staff on "What would it be like to work here, if things changed for the better."  It is our experience that when things are not right, insiders still know what “good” would look like – if only someone is prepared to listen to them.

This list of staff aspirations will help the new management team in the cultural change programme that should be the next step. It will not be easy, or quick, but given time and sound leadership, such a programme should ensure dramatic improvement in the work of this much criticised regulator.  Politicians must allow management enough time to bring about the necessary changes.

A better future?

I look forward to a future when the CQC is admired and respected by all its stakeholders, and the NHS has learned that the best way to achieve high standards is to regulate their own organisation to observe the highest standards, and invite the regulator to approve what they have done. This has been the guiding principle for the aviation industry, and has been adopted all around the globe with the result that the flight safety system is not an issue of public concern. Let's hope the CQC and the NHS will learn from best practice wherever it is found.

Mike Bell
Reputability LLP
London
www.reputability.co.uk