• “Effectiveness” review finds concerns with the role and function of the CQC’s board
  • Report says although the board is “effective” it should “evolve” to better interrogate its performance and offer focus on each sector it regulates equally
  • Review says board members’ behaviour should be more “consistently” in line with that expected by a corporate director

An “independent effectiveness review” of the Care Quality Commission’s board has said it should “revisit its role and purpose”.

The review found the board to be “effective” but there were significant differences of opinion between executives and non-executives about how well they thought the board was functioning.

As part of the process, an anonymised survey of CQC board members showed the executive team had significant concerns about how well the board operated, which contrasted with the views of non-executive directors.

Five out of eight executives said they disagreed with the statement that the CQC operates a “unitary board” where policy decisions are made on consensus. All eight non-executives that responded agreed that the regulator did operate a unitary board.

Similarly, half of executives agreed with the statement that all board members acted like corporate directors and could think “strategically”, compared to 89 per cent of non-executives who agreed with the statement.

Again, while six non-executives “strongly agreed” with the statement that individual board members “clearly understood” the distinctions in the roles of executives and non-executives, four executive directors “slightly disagreed” or “disagreed” with the same statement.

However despite these differences, the report said: ”Overall, we are of the view that the CQC board is an effective board and with a small number of changes to how it operates could become even more effective.”

The review, carried out by Deloitte at the request of the CQC, said the board “should evolve to provide a greater focus on the CQC as on organisation” after it found “a number of board members, particularly executive directors, who expressed an appetite for greater consideration and debate on CQC ‘operations’, rather than just the external regulatory environment”.

It also called for “board members to behave more consistently with the expectations of a corporate director on a unitary board… and [the review] noted a propensity for board members to confine their contributions largely to their own portfolio or area of expertise”.

The report recommended that the CQC implement a “formal programme of development” to address the concerns. It said the board should “ensure collective understanding” of the need to balance a regulatory focus with examining the performance of the CQC itself, as well as the need for board members to contribute outside of their own portfolios and to collective decision making.

It also said there should be a “more equitable focus” on each sector the organisation regulates. The hospital directorate was singled out as one that receives a lot of the regulator’s “energy”.

The report, included in April’s CQC board papers, also praised board members and found them to be “deeply committed to the CQC’s purpose and vision” and of “high calibre”.

“The non-executive directors demonstrate high levels of engagement and motivation beyond what we would typically expect to find. Relationships among board colleagues appear positive and constructive,” it said.

The review was commissioned in December and research included the board effectiveness survey; one hour, non-attributable interviews with board members; and observation of board meetings in December, January and February.

A CQC spokeswoman said a response to the report is expected to be made at the next board meeting on Wednesday.

This article was updated at 10.10am on 25 April to include additional information.