Reflections on a challenging week
CQC’s Interim Chief Executive, Kate Terroni, reflects on the last week, and looks to the future.
It’s a week since Dr Penny Dash published her report into our operational effectiveness. It is no overstatement to say it has been the most challenging week in my leadership career.
We have accepted the findings and recommendations of the review, many of which we had identified and were working to address.
Since the report was published, I’ve spent the week talking to my colleagues and meeting with providers, stakeholders and representatives of people who use services. I have appreciated the candour of those conversations.
I’ve heard the frustration of stakeholders who told us repeatedly we were getting things wrong, and that by listening to them we could have avoided many of our mistakes. I’ve heard about the poor experiences some providers have had when working with us, from delays in registration and publication of our reports, to being able to speak to a team member in a timely way or access the provider portal.
All of these conversations have been hard, but the hardest of all has been hearing the impact of the report on our CQC colleagues.
It is right that a leader should take how colleagues are feeling personally. Across all parts of our organisation, from the earliest days of development, concerns were raised about how we were organising ourselves, our new regulatory approach and the technology designed to support our changes. We did not listen well enough and take the actions our people were asking for. The impact of this was that some of our colleagues went out to do their jobs without feeling properly supported. That is on me and the Executive Team, not them.
The basis of good regulation and trusted relationships with the organisations we regulate is having a well engaged, well trained and well supported workforce. I want to be clear that our CQC colleagues asked for all these things, and many of them told us they were not ready to implement our new approach.
They told us they needed good relationships and the time to build them with providers. They told us the way in which we redesigned teams to support our new regulatory approach wouldn’t work. They told us we needed to test more. We all wanted to do the right thing. However, we didn’t act on feedback fast enough and it is right that I, and the Executive Team and Board, take responsibility for that rather than our trusted, valued and professional colleagues.
This is why when I wrote to providers last Friday, I said what the report found about how we’d implemented our approach aligned with what colleagues had been telling us. We were committed to realising a vision — of more responsive regulation — but along the way we stopped listening to the voices of the people who were responsible for delivering that vision, no matter how many times they tried to make us hear.
On the Today programme last Friday, the Secretary of State said “one of the reasons why we’ve got such an authoritative report is that there are courageous people in the Care Quality Commission, expert people, who have sounded the alarm and worked with Dr Dash and given her the ammunition she needs.”
Every day I see around me colleagues who are united by the same things that drive me in my work — the desire for people to have safe, effective and high-quality care. I absolutely believe that is what motivates all of us working in health and care.
I want to thank everyone who raised concerns and continue to raise concerns — and I commit to listening and working with our people and with providers and people who use services to put right the things we got wrong. I’ve been grateful for the many conversations I’ve had over the past week where there has been consensus about our health and care services needing a strong regulator. I know we can be that regulator again, but I am under no illusions of the difficult journey we are on to get there.
I want to keep the meaningful, open, honest conversations we’ve been having going throughout the journey as we develop, co-produce and test the plans and improvements we need to make, together. I have never felt more committed to a goal: putting things right for the future — for all my CQC colleagues, for health and care providers and most importantly for people who use services.
