Do we need the inspector to call?BMJ 2018; 363 doi: https://doi.org/10.1136/bmj.k4491 (Published 30 October 2018) Cite this as: BMJ 2018;363:k4491
All rapid responses
There is a lot of sense in Helen Crisp's article, which also contains links to some useful references. However, one key reference readers should be aware of - published after she submitted her piece for publication - is a major review of the impact of CQC inspections carried out by Manchester Alliance Business School and The Kings Fund . It concludes, among other things, that the industry that is CQC inspections and ratings had only shown "small or mixed effects" on improving quality. So the current and historical approach may not be the right one at all if we are really interested in improvement as opposed to attempting public reassurance.
Conversely, there have been a number of examples of care "scandals" in organisations which the CQC had rated at least adequate.
FInally, when poor care is often the result of serious gaps in workforce funding and local health and social care economies around organisations, it seems unfair to be criticising leadership of organisations for factors largely outside their control. After all, so called "turnaround" directors, often expensively parachuted in, often do no bettter than the incumbents for precisely that reason.
Perhaps we would be better off focussing on doing everything we can to support, engage, retain and motivate the existing NHS workforce (including senior managers) and ensure we have them in adequate numbers and equip them with skills around quality, safety and improvement.
You don't fatten a pig by weighing it
 The Kings Fund . Impact of the Care Quality Commission on Provider Performance. 2018 https://www.kingsfund.org.uk/publications/impact-cqc-provider-performance
Competing interests: No competing interests