Care bill extends CQC's powers

The bill, published this morning, gives the CQC powers to issue time limited warning notices to NHS trusts requiring significant improvement. If the provider fails to improve within a specified time period the CQC must consider whether to “require” Monitor to appoint a trust special administrator.

Doing so would invoke the same foundation trust administration process as is currently used by Monitor, which includes a public consultation but no right to appeal the decision by the trust.

Announcing the changes, care minster Norman Lamb said the legislation would put performance and quality on the same footing as finance for the “first time”.

“It’s a rather bizarre feature of the old system that it was only finances that could put an organisation into administration. Now quality of care can achieve that as well.”

The bill’s main focus is on changes to the funding of long-term social care, but it is being used to legislate for some of the changes announced by the government in response to the Francis report.

As well as the “single failure regime”, first announced by prime minster David Cameron in February, the bill also makes it a criminal offence for care providers to publish or supply false or misleading information. Organisations found guilty of the offence could face unlimited fines.

The bill allows for minsters to specify through secondary legislation which types of providers and information will be covered by the offence.

Mr Lamb said initially it would cover only mortality rates and secondary providers. The offence will be corporate, but Mr Lamb said the process of bringing a criminal case would necessarily identify the individuals involved, who would also be expected to face disciplinary action.

“The focus is on ensuring the data on mortality rates is absolutely accurate and assured. The main purpose of the new offence is a deterrent… there is no assumption that people will break the law.”

The bill also provides for the CQC to develop and publish ratings of health and care services. The types of providers that will be rated will be specified through secondary legislation but according to the impact assessment published alongside the bill they will include NHS funded acute care, GP practices, care homes and domiciliary care providers.

The CQC plans to begin publishing ratings for hospitals by the end of the current financial year despite the conclusions of the government commissioned ratings review that it could take at least five years to develop the data needed.

Asked about this discrepancy, Mr Lamb said the government had not dictated the timetable.

“We want to get moving but we have got to do it properly and sensibly and heed the warnings in [the ratings review].”