Health care regulation a struggle for Care Quality Commission

The Commission had to merge three existing regulators to establish a new organisation and implement a new regulatory approach, integrating health and social care for the first time.

The Commission's budget is less than the combined budget of its predecessor bodies, even though it has more responsibilities. Even so, it spent less than budgeted in both 2009-10 and 2010-11. This was partly because it had a significant number of staff vacancies.

The process for registering care providers did not go smoothly. Although 21,600 providers are now registered, the timetable for two of the three tranches of registrations was not met. The Commission diverted inspectors from compliance activity to registration work in a bid to meet the timetable. As a result of this and the number of inspector vacancies, the Commission completed only 47% of the target number of compliance reviews between October 2010 and April 2011.

Although clearly defined, the Commission's role as a regulator has not always been communicated effectively to the public and providers. In addition, proposals to extend the Commission's role risks distracting the Commission from its core work of regulating health and social care.

In the absence of measures of impact, the National Audit Office assessed value for money in terms of whether the Commission delivered what it set out to.

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