Two reports published designed to improve how CQC listens to, learns from, and acts on concerns
Repost from CQC:
We wanted to share two reports we have published today, designed to improve how we listen to, learn from and act on concerns.
Background
In September 2022, CQC lost an employment tribunal brought by My Shyam Kumar, a consultant orthopaedic surgeon who undertook work for us as a Specialist Professional Advisor. The findings of this tribunal, which we accepted in full, were highly critical of CQC, finding that the decision to disengage Mr Kumar was materially influenced by the concerns he raised. During the same period, other concerns were raised around how we listened to and acted on concerns, including from our own staff.
In response, our Executive Team appointed Zoë Leventhal KC of Matrix Chambers to lead an independent review into our handling of the protected disclosures shared by Mr Kumar, alongside a sample of other information of concern shared with us by health and care staff, to determine whether we took appropriate action as a regulator in response to this information.
Alongside this barrister-led review, a second, wider review was commissioned to explore issues of culture and progress which need to be addressed so we are better able to listen and to act when information of concern is shared with us. The Listening, Learning, Responding to Concerns (LLRC) review also has a focus on inclusivity, including understanding whether race or any other protected characteristic has any impact on how we treat information of concern. Scott Durairaj, who at the point the review was commissioned had just joined CQC as Director of Integrated Care, Inequalities, and Improvement, was appointed to lead this review.
Findings
The LLRC review focused on five key areas and found significant areas of improvement were needed across governance, decision making process, and practice. There was clear evidence of a widespread lack of competence and confidence within CQC around understanding and identifying race and racism. There was also evidence – including high levels of unknown ethnicity data or data not being collected; findings from the workforce race equality standard; staff surveys and directly hearing from people – that pointed to the need for more work to actively identify where systemic inequities that affect ethnic minority people could be replicated within the organisation, or in the organisations we regulate. However – acknowledging limitations of time and scope – neither this review nor the barrister-led review was able to identify direct or indirect race discrimination as described in the Equality Act.
While the barrister-led review was an independent process, there is in fact considerable alignment between its findings and the findings of the LLRC review. The recommendations from the barrister-led review are:
A full apology to Mr Kumar (whom the review noted “had always acted in good faith and in the interests of patient safety, and in line with his professional duties”)
Proper integration of the important Specialist Advisor role within CQC
Improved access to appropriate clinical expertise via Specialist Advisors
Improved processes, policies and training for staff dealing with whistleblowing information, and for managers in supporting staff.
Access the report and news story
Both reports are available on our website at: https://www.cqc.org.uk/listening-learning
The report of the independent barrister-led review: https://www.cqc.org.uk/publication/listening-learning-responding-concerns/independent-review
And the report of the Listening, Learning, Responding to Concerns is here: https://www.cqc.org.uk/publications/listening-learning-responding-concerns/listening-learning-responding-concerns-phase-2-report
You can also read the news story: https://www.cqc.org.uk/news/improving-how-we-listen-learn-and-act-concerns-two-reports-published
Next steps
Our Board will now fully consider the reports and their recommendations. They will make a full response at our next public board meeting, including clear implementation plans to make sure the recommendations from both reports are incorporated into the way we work.
We appreciate this is the first time you have seen the reports and due to the independent nature of the reviews, we haven’t been able to provide any advance briefings. We’ll provide further updates through our upcoming meetings, and if you would like to arrange a call to talk anything through, please let me know.
Sarah Cowley-Beadman (she/her)
Provider Improvement Engagement Lead
Provider Engagement Team
Care Quality Commission