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CQC's strategy is reactive, board member tells inquiry

The Care Quality Commission’s strategy is “reactive” and driven by “reputation management and personal survival”, a board member has told the Mid Staffordshire Foundation Trust public inquiry.

Kay Sheldon – who was described by chairman Robert Francis QC as a “whistleblower” - said in evidence to the inquiry this afternoon that the organisation had been under pressure to show that it was making a difference.

She told the inquiry she had been at a board level meeting where it was suggested it would be good to have a few “high profile cases” to pre-empt reports from the inquiry, the Department of Health and the Public Accounts Committee into the effectiveness of the CQC.

Ms Sheldon said the first the non-executives heard about the CQC’s move to annual inspections was when they read it in HSJ.

Asked why she had contacted the inquiry, Ms Sheldon said her concerns about the leadership had been growing and had increased recently as she had begun challenging the executive team.

“My main concern is the organisation is badly led with no clear strategy. The chair and the chief executive do not have the leadership or strategic capabilities required,” she said.

She told the inquiry the board had never voted on anything but only endorsed or commented on items, adding that challenge was seen as “disloyal”. The regulator’s chair Dame Jo Williams blamed the egos of board members when a revised strategy document was rejected by non-executives at a recent meeting, she said.

At one meeting to discuss the revised strategy, Ms Sheldon raised issues and left the meeting after becoming upset. Following the meeting Dame Jo suggested Ms Sheldon, who has a history of depression, was suffering mental health problems and insisted she see an occupational health nurse before she attended the next board meeting.

Ms Sheldon, who was on the board of the Mental Health Commission, one of the three organisations that merged to form the CQC, told the inquiry she was concerned that the CQC kept repeating the same mistakes and did not consider whether it had sufficient capacity to do what it proposed, such as moving to annual inspections.

She told the inquiry she had emailed chief executive Cynthia Bower with her concerns about the culture of the organisation. In response, she received a phone call from a “quite angry” Dame Jo, asking her whether she “knew what impact this email would have on Cynthia”.

“She said this sort of email was unhelpful because things were very delicate,” Ms Sheldon said.

Inquiry counsel Tom Kark read an extract from a letter signed by the other non-executives declaring their support for Dame Jo.

There was no mention of Ms Bower in their letter. However, speaking to HSJ this evening, Dame Jo said the chief executive “absolutely” had the confidence of the board.

She said she did not recognise Ms Sheldon’s description of the culture of the board or the wider organisation and some of Ms Sheldon’s criticisms of her personally had been taken out of context.

She said: “There is no doubt in my mind that the executive team, of which Cynthia is part, and the staff have performed well given the external forces that they have had to deal with.

Asked about evidence to the morning session from inspector Amanda Pollard that inspectors would not spot another Mid Staffs, she said the regulator had employed more inspectors.

“I spend a lot of time out and about meeting with people in a variety of different settings and what I hear from people is their enthusiasm and commitment to make a difference,” she said.

Readers' comments (5)


  • I seem to recall that Sir Winston Churchill suffered from depression and had been known to be moved to tears.

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  • Absolutely disgusting that this person's mental health condition has been used against her- suggesting that she was ill just because she did not like what was going on and had the guts to say so. So anyone who does not like how the CQC is being run (including the whistleblowing inspector from the morning's session) is mentally ill? Appalling.
    And the reason that Jo Williams "does not recognise the description of the culture of the board"? She does not want to.

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  • As the CQC now incorporates the Mental Health Commission, in merging the 3 organisations, has there been a loss of focus on quality of Mental Health services, also Learning Difficulties (ref Winterbourne View)? It is vital that non-execs can promote effective quality of services for vulnerable people with mental health needs. Someone with real understanding of mental health needs can bring valuable perspectives to the non-exec role.

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  • Blair Mcpherson

    I am a bit surprised to hear a board member described as a whistle blower. Surely a whistle blower is a member of staff whose position in the organisation means they don't have direct access to senior managers or the board and feel their position in the organisation makes them vulnerable if they make criticisms. Would it not be more accurate to describe Ms Sheldon as a dissenting possibly disgruntled member of the board.


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  • some what odd but totally believable that the CQC board would behave in exactly the way they would severely criticise an organisation they were investigating for,green houses come to mind.

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