March 27, 2025

Independent review of CQC technology

Dear colleague

We have just published news from CQC’s Board meeting this morning. This includes:

the Independent review of CQC technology
an update on our ICS programme
taking action on your feedback to improve how we work.

Independent review of CQC technology

An independent review of the technology that supported our transformation has found that the primary cause of our technology failure was a failed organisational transformation. It adds that the technology used for our regulatory platform and provider portal are salvageable but require substantial development and rebuilding work.

The review was conducted by Peter Gill, an independent IT expert. It considered how and why we got to the point where the technology is causing such significant organisational disruption. It also explored whether we could continue with the technology as it is.

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The report clearly sets out the scale of the problems that resulted in the failure of our technology, and the impact that transformation had across CQC. They include:

Technical issues with the way the regulatory platform and provider portal function, resulting in multiple challenges including, for example, an overly complex assessment process, a poor user experience in registration, low use of the provider portal for notifications, and challenges with data quality.

Poor decision-making and major failures in governance – including eroding of sector expertise, siloed working, and a lack of adherence to industry standards.

Fundamental cultural issues, as concerns were raised and colleagues did not believe they were listened to. This was reported to have a negative mental and physical health impact on colleagues. Data was also not given the importance it should have.

The total spend on the regulatory transformation programme, which includes the regulatory platform and provider portal, has been £99 million from inception in July 2019 to date. The vast majority of the benefits expected to be delivered have not yet been achieved.
The report also found that parts of the regulatory platform are working well. These relate to the customer contact area and include richer data capture, time-saving automation of some processes, and the ability to connect and view different data and information in one place.

Recommendations 

There are 23 recommendations, which can be grouped in 5 broad areas. They reflect what is needed as part of rebuilding CQC, and redeveloping the regulatory platform and the provider portal:

Culture

Governance

Operating model

Change management
Data and Digital

CQC’s Board welcomes and accepts the recommendations.

The report recommends that CQC “retains Microsoft Dynamics 365 as a strategic asset” and concludes that the regulatory platform and the provider portal are salvageable. It sets out that the systems will require substantial development and rebuilding work and that this should be done by CQC colleagues with some additional support.

The recommendations also cover the need to:

Develop a culture where data is seen as critical and strategically important.

Ensure robust governance and clear roles and responsibilities.

Extensively engage with and involve users, internally and externally. This includes putting in place additional ways to ensure the concerns and feedback of CQC colleagues and external partners are listened to and acted on.
Follow best practice and industry standards.

Integrated care system assessments: Update March 2025

The Health and Care Act 2022 gives us new responsibilities to assess whether integrated care systems (ICSs) are meeting the needs of their local populations. The methodology we will use to carry out our ICS assessments is subject to government approval under the Health and Care Act 2022.

Following successful piloting work in 2024, we initially paused this work in early 2024 to refine our approach to ICS assessments. This delay was further impacted by the General Election in July 2024 and the Dash review in October 2024, which recommended continuing a pause on this work.

Following uncertainty as a result of the recent government announcement that NHS England will be brought back under the Department of Health and Social Care (DHSC) along with reductions planned for ICBs, DHSC has withdrawn its request for a proposal from CQC on the future of ICS assessment activity. This work will pause for at least six months which will allow us to focus on our 4 priorities and 5 foundational improvements. We will continue to engage with DHSC during this period and will review our plans along with the new government reforms including the 10-year health plan.

Considering how systems are working together continues to be a priority for CQC and we will continue to us our independent voice to highlight this. We have also developed in partnership a new self-assessment and improvement framework for ICSs to address health inequalities.

See this news on our website.

Improving how we work: Taking action on your feedback

We are focusing on work that will enable us to be the strong, effective regulator that people who use and work in health and care services need and deserve. A big part of this is ensuring that we provide up-to-date information about services to the public.

To do this, we are continuing to make changes to how we work to:

increase the number of assessments we carry out
clear our backlog of registration applications
act promptly on information of concern cases and notifications.

So far, we have:

Implemented a process that has helped us to publish reports of assessments that we’ve already carried out, which people have been waiting too long for.
Started to clear our registration backlog so new providers can start delivering services and help more people to access the care they need.
Started to reduce our backlog of information of concern cases and notifications.
Engaged with colleagues, providers, people who use services and wider stakeholders to start co-designing a shared understanding of the organisation’s purpose, vision, values, and expected behaviour.

Do get in touch if you have any comments or queries.

Colin Penning

Senior Stakeholder Relations Adviser

Tel: 0191 249 7532 or 07867 156105