Grant Thornton report reveals 'delicate' CQC and Monitor debate

Monitor faced questions over its October 2010 decision to authorise the trust after the CQC issued a warning notice about the maternity unit at Furness General Hospital, part of University Hospitals of Morecambe Bay, just nine months after the authorisation.

On 28 March last year HSJ published an interview with Monitor chief executive David Bennett in which he admitted it was “very likely” the trust had “deep seated problems” at the time of its authorisation. However, despite having relied on the CQC’s registration of the trust without conditions as an assurance of quality, he made no mention of their role.

The Grant Thornton report into the CQC’s regulation of the trust, commissioned by the regulator’s new leadership, reveals what it describes as “behind-the-scenes tension” between Monitor and the CQC in the run up to the publication of the article.

Both regulators commissioned “lessons learned” exercises in the wake of the warning notice. However, while Monitor published its findings, the CQC did not share its internal review, even with its own board. The Grant Thorton report alleges CQC senior staff considered deleting it.

The review listed a series of failures, including that the CQC had relied too heavily on assurances from the trust and the North West Strategic Health Authority.

The review was discussed at a meeting on 13 March last year at which it is alleged Ms Finney ordered it be deleted.

However, minutes from a private CQC board meeting the following day record a discussion of the forthcoming HSJ article and an agreement by the board that “it was important for Monitor [to] take responsibility for its judgements”.

Grant Thornton concluded that in light of the “delicate” situation that existed between the regulators the desire to avoid “blame” by Monitor meant “sufficient motive might have existed to result in the ‘delete’ instruction.”

The investigators also questioned in their report whether the CQC board members would have felt so confident in laying the blame for Morecambe Bay’s authorisation on Monitor if they had all been aware of the internal review.

CQC chair David Prior insisted in an interview with HSJ this week that the relationship between the two regulators was now much better.

He said: “In 2010 we let Monitor down because they relied upon our judgement.”