• CQC has seen a small increase in the proportion of inspections which result in enforcement action
  • It says inspectors “increasingly used the breadth of our enforcement powers”
  • The regulator underspent its 2017-18 budget by £6.3m
  • The share of hospital inspection reports published within 50 working days increased

There has been a small increase in the share of Care Quality Commission inspections resulting in enforcement action, which it has put down to its staff “increasingly used the breadth of our enforcement powers”. 

A performance report to the CQC’s May board says that in 2017-18, 8 per cent of its total inspections resulted in an enforcement action - 2,283 in total. In 2016-17, the figure was 6 per cent, it said.

The paper said: “Our inspectors have increasingly used the breadth of our enforcement powers, including taking more complex actions, such as criminal prosecution…

“A significant programme of work has been carried out over the last two years in particular and our processes and systems around enforcement are in a stronger place as a result.”

Of the 2,283 enforcement actions, 1,343 were warning notices and 781 civil actions against providers. During 2017-18, the CQC closed 141 locations, of which 103 were social care settings. It has pursued 159 criminal actions and five criminal prosecutions. The balance between health and social care providers in these categories is not known.

The tougher approach was despite an overall improvement in ratings with the CQC recording fewer inadequate and requires improvement ratings.

The report said the CQC had underspent its 2017-18 budget by £6.3m – spending £8.6m lower than planned but recovering £2.3m less in fee income from providers.

The CQC is required to find substantial savings by 2020 when its budget will be £217m, although this will be £53m up on its £164m for 2012.

A persistent complaint from providers about the CQC is the time it takes to publish reports following inspections.

It has a target of publishing 90 per cent in 50 working days. In 2017-18, the regulator managed this in 81 per cent of cases compared to 72 per cent in 2016-17.

The regulator has struggled with workforce shortages but its move to an “always-on” recruitment policy has seen it fill all roles for hospital and primary care divisions with social care at 93 per cent of planned establishment.

A CQC spokeswoman told HSJ: “While there has been some improvement in the timeliness of hospital inspection reports, there is still work to be done: 30 per cent of inspection reports on trusts with two core services or less are published within 50 days, and 49 per cent within the planned 65 days where three or more core services were inspected.”