Powers to prosecute trusts failing to meet registration standards were watered down in a bid to avoid legal challenges and bad publicity, HSJ has learned.
Emailed documents seen by HSJ reveal powers allowing the Care Quality Commission to treat failures as criminal offences were called “unusual and unexpected” by the Commons joint committee for statutory instruments, which scrutinises legislation.
Email correspondence obtained by HSJ says the CQC opposed the move because it would “make it more difficult to bring prosecutions”
Its concerns meant the draft regulations legally enshrining the registration standards were at risk of not passing through Parliament in time for the 1 April registration deadline.
This would have forced the CQC to issue “draft” registration decisions, leaving it open to challenges from “well informed and difficult” providers, according to the documents.
To avoid this, the Department of Health added an amendment weakening the CQC’s powers by forcing it to issue warning notices before bringing prosecutions. Trusts will also have a right to appeal registration decisions to the CQC and a tribunal.
The email correspondence, obtained by HSJ through freedom of information legislation, says the CQC opposed the move because it would “make it more difficult to bring prosecutions”.
It also reveals the pressure placed on CQC chief executive Cynthia Bower to announce registration decisions in batches, rather than in one go on 1 April, following health secretary Andy Burnham’s pledge to bring the registration process forward in response to the Mid Staffordshire Foundation Trust scandal.
In a letter to the CQC dated 15 February, a DH official notes the regulator was still planning a single announcement for the end of March. The official warned: “I am concerned by this, as Cynthia made a commitment to ministers that CQC would ‘accelerate the benefits of registration’ by announcing the decisions as soon as CQC could during late Feb/March.
“Not batching the announcements could cause you significant handling problems, not least because of all the noise around Mid Staffs, and the imminent Panorama programme.”
A CQC spokeswoman told HSJ: “We made the announcements on registration in batches due to the high volume of data involved in the process and because of the need to inform a wide range of stakeholders.”
All 378 NHS trusts in England have now been registered but 22 had conditions imposed on them. The batches of registrations were announced on 18 and 25 March, and 1 April.