Former Care Quality Commission executives were “hung out to dry” by a “flawed process” after chief executive David Behan ignored warnings about potential problems with the work of an independent review, it has been alleged.
HSJ has learned a number of senior CQC figures past and present have raised concerns about how the review of its regulation of University Hospitals Morecambe Bay Foundation Trust was carried out.
The report, by consultancy firm Grant Thornton, alleged former deputy chief executive Jill Finney ordered the deletion of an internal report into the CQC’s regulation of the trust. Former chief executive Cynthia Bower, who was also present at the meeting in which the instruction was said to have been made, is alleged to have supported it.
Both Ms Finney and Ms Bower deny the allegations. Speaking exclusively to HSJ, Ms Bower said she was “very angry” at how the CQC had handled the production and publication of the Grant Thornton report.
“I’m angry that the CQC relied on a flawed process to reach wide ranging judgements about our character and our ability to do the job without any acknowledgement of the pressures CQC were under,” she said.
“This was a regulator [that] didn’t follow any of the principles of a decent, transparent legal process in hanging its own staff out to dry.”
Ms Finney, who was dismissed from her new job as chief commercial officer at internet domain name regulator Nominet in the wake of the report’s publication, told HSJ the CQC’s handling of the report amounted to a “brutal discrediting”.
Concerns about the process include the lack of an audio recording or proper note taking of interviews, an aggressive questioning style and a lack of opportunity to prepare for interviews or dispute criticisms ahead of the publication.
HSJ has spoken to sources at the CQC who share concerns that the review − codenamed Project Ambrose by Grant Thornton − was unfair to those involved.
CQC non-executive director Kay Sheldon, whose concerns prompted the review, has also expressed concern about the interview process and questioning. At the regulator’s June board meeting she said parts of the report needed “correction or elaboration” and complained that notes of her interview with Grant Thornton were not checked with her.
A letter to the Commons health committee from former CQC director of governance and legal services Louise Guss in June reveals she and other executives warned Mr Behan about the weaknesses of the work carried out by Grant Thornton while it was ongoing. However, she claimed Mr Behan ignored the warnings, telling her he wanted to “keep out of” the matter because “he did not want it to be said that he had interfered”.
She said: “DB went so far to ensure that he was not accused of tampering with the report, that he exercised or put in place no assurance process over the process of the report. He did not therefore recognise that the report, when delivered to him, was inadequate and not fit for any publication.”
Mr Behan commissioned Grant Thornton to undertake the review when he joined the organisation in August last year. It was tasked with looking into concerns from Ms Sheldon about why the CQC had registered Morecambe Bay without conditions, only for serious concerns to emerge months later.
Grant Thornton pointed to a contemporaneous note of the meeting in which the internal report was allegedly ordered to be destroyed as evidence of a “cover up”. It also highlighted the fact the report had not been shared within the regulator.
Both Ms Finney and Ms Bower maintain the reason the report was not widely circulated was because the weaknesses in the CQC’s registration process it identified were already well known. They had been highlighted in a report from the public accounts committee and in a Department of Health performance and capability review.
Ms Bower said: “To say somehow we were trying to bury this learning was demonstrably not true.”
A report due to go the CQC’s board on Wednesday said the commission would review the evidence used by Grant Thornton, including transcripts of the interviews, to decide whether action should be taken against any current or former employees.
A CQC spokesman said Grant Thornton “was appointed on the basis of its expertise” and it developed its own “methodology” to determine the report was fair.
He said the CQC’s new management had been aware they risked breaking the law in publishing the names of the individuals in the report but the goal was to “be on the side of people who use services”.
A spokeswoman for Grant Thornton said she could not answer specific questions about the process due to client confidentiality but stood by the accuracy of the report.