A Deep Dive Into the Past, Present & Future of the CQC
The Care Quality Commission (CQC) is one of the most important regulatory bodies in England’s health and social care system. For individuals and families seeking ADHD or autism assessments, the CQC plays a critical role in ensuring that services meet essential standards of safety, effectiveness, and compassion. Yet in recent years, the CQC has been subject to increasing criticism, culminating in the resignation of its Chief Executive and a period of considerable uncertainty.
This article aims to provide a clear and authoritative overview of the CQC, its purpose, its recent controversies and shortcomings, the circumstances surrounding its previous leadership’s resignation, the government’s stance, and the challenges and opportunities facing its new leadership.
What Is the CQC?
The Care Quality Commission was established in 2009 as the independent regulator of health and adult social care in England. Its primary remit is to ensure that hospitals, clinics, GP practices, care homes, and community-based services provide care that is safe, effective, compassionate, and of high quality.
The CQC’s main functions include:
- Registering care providers.
- Monitoring, inspecting, and rating services.
- Taking action to protect people who use services.
- Publishing reports to help people make informed choices.
- Speaking with care users, their families, and carers to understand their experiences.
In practice, the CQC carries out regular inspections and rates services as Outstanding, Good, Requires Improvement, or Inadequate. For services such as ADHD and autism assessments, a good CQC rating can be a marker of trustworthiness, whereas a poor rating may prompt families to look elsewhere.
For further details about ADHD and autism assessments, please see our services page.
Recent Controversies and Shortcomings
In recent years, the CQC has faced mounting criticism across several areas.
1. Slow Response to Complaints
Families and whistleblowers have reported long delays when raising concerns about unsafe care. Some have argued that vulnerable individuals were left at risk while the CQC failed to act promptly.
2. Inadequate Inspection Processes
A number of high-profile failures have highlighted weaknesses in the inspection process. Critics argue that some inspections have been too superficial, missing serious failings, while others have been overly bureaucratic, focusing on paperwork rather than frontline care.
3. Workforce and Culture Issues
A 2023 independent review reported a “toxic culture” within the CQC, with claims of bullying, discrimination, and poor internal governance. Staff turnover has been high, which some believe has undermined the regulator’s effectiveness.
4. Lack of Specialist Knowledge
Particularly relevant to ADHD and autism services, many providers have noted that inspectors often lack the specialist knowledge required to understand the complexities of neurodevelopmental care. This has led to inconsistent ratings and confusion among service providers and families alike.
For families navigating ADHD or autism diagnoses, the implications are profound. When regulatory oversight falters, the risk to vulnerable individuals increases. For guidance on accessing trusted ADHD and autism services, visit our assessment process page.
Resignation of the Previous CEO
In October 2024, Ian Trenholm, who had served as Chief Executive since 2018, resigned amidst growing criticism. His departure followed months of negative media coverage, including allegations that the CQC had failed to respond adequately to reports of abuse in some care settings.
Although Mr Trenholm cited personal reasons, insiders reported that his position had become increasingly untenable. He faced criticism both from within the organisation and externally from the public, healthcare professionals, and Parliament.
His resignation marked the end of a turbulent period for the CQC, but it also raised pressing questions about the regulator’s ability to reform and rebuild public trust.
The Health Secretary’s View
The Secretary of State for Health and Social Care has acknowledged the seriousness of the situation. In recent statements, the Health Secretary described the CQC as “vital to patient safety” but admitted that the regulator had “lost sight of its core mission.”
The government has called for a “root and branch review” of the CQC’s processes, culture, and leadership. There is particular concern about the regulator’s ability to oversee mental health and neurodevelopmental services effectively, areas where the needs of patients are often complex and easily overlooked.
Families and clinicians alike will watch carefully to see whether the government’s promises of reform translate into real improvements on the ground.
New Leadership and the Road Ahead
In October 2024 it was announced that Sir Julian Hartley would be appointed as the new Chief Executive of the CQC. Sir Julian is a respected healthcare leader with extensive experience, including his prior role as Chief Executive of NHS Providers. His appointment has been widely welcomed as a signal of the government’s commitment to reform.
Sir Julian has pledged to address the regulator’s shortcomings, rebuild morale among staff, and improve relationships with healthcare providers and the public.
His priorities include:
- Cultural Change: Tackling reports of bullying and discrimination within the organisation.
- Improved Inspection Processes: Streamlining inspections to focus on outcomes for patients, not merely compliance with paperwork.
- Enhanced Specialist Knowledge: Ensuring that inspection teams include professionals with expertise in areas such as ADHD, autism, and mental health.
- Restoring Public Trust: Engaging with service users and carers to understand their needs and expectations.
Sir Julian has acknowledged that “rebuilding confidence will take time” but has emphasised his determination to lead a “modern, transparent, and accountable regulator.”
For individuals and families navigating ADHD or autism care, this leadership change holds particular importance. Improved regulatory oversight can help ensure that services are safe, effective, and centred on patient needs.
What Does This Mean for ADHD and Autism Services?
The CQC plays a critical role in safeguarding the quality of ADHD and autism services across England. However, its recent difficulties have created uncertainty.
Key concerns for families include:
- Are services meeting standards of care?
- Do inspectors understand the needs of neurodivergent individuals?
- Will ratings accurately reflect the quality of services?
There is hope that the new leadership will address these issues, but families must remain informed and vigilant. When choosing an ADHD or autism service, it is advisable to check the provider’s CQC rating and to seek recommendations from trusted sources such as the National Autistic Society and the UK Adult ADHD Network.
Our own clinic is committed to upholding the highest standards of care.
Conclusion
The CQC remains a cornerstone of healthcare regulation in England, but it faces significant challenges as it seeks to restore public trust. The recent controversies, CEO resignation, and government scrutiny have highlighted the need for cultural change and improved specialist oversight.
Families seeking ADHD or autism assessments should stay informed, ask questions, and consult reputable sources when selecting services.
If you or your family are seeking ADHD or autism assessments, we invite you to contact the ADHD and Autism Clinic for expert care and support.