Several trust leaders mentioned their own experience as specialist advisors on CQC inspection teams in the years before the pandemic and said they had been proud to support their peers and bring in an external, objective contribution to CQC's work. However, interviewees said they would not return to this work now, because they did not support what they perceived to be a fault-finding attitude to inspections. They felt that the regulator had lost the trust of providers, and was no longer seen to be credible.

When asked about the decline in CQC's credibility, trust leaders mentioned perceived changes in CQC's culture and an inability to self-evaluate, to internalise feedback and to act on it. They also believed that CQC's work was often defensive and led by external pressures and government priorities, which made them less willing to trust the regulator's actions, judgements and priorities.

Trust leaders believe CQC could regain providers' trust by exercising a proportionate and consistent approach, and by acting with openness and transparency, in line with the principles of right-touch regulation. They expect the regulator to act as an objective critical friend to providers, holding them to account, but also setting realistic, clear expectations, recognising their achievements, and engaging in trusting, improvement-focused relationships.

They also mentioned the importance of CQC accepting that its new regulatory approach would need to be implemented, reviewed and refined in collaboration with those using services and those regulated. Better alignment with other bodies, including NHSE, was also mentioned as being key, particularly in sharing information and intelligence aimed at reducing duplication and regulatory burden.


Recommendation 10:

We recommend that: It is for CQC to act on feedback about its credibility and work with providers to regain their trust. It should consistently act with openness and transparency, meaningfully collaborate with those it regulates, and display a positive learning attitude.