At the end of October, Sir Julian Hartley stepped down as Chief Executive at CQC with immediate effect. Dr Arun Chopra, Chief Inspector of Mental Health, has assumed the role of Interim Chief Executive until a permanent successor is appointed. Explaining his decision, Sir Julian said, ‘This has been an incredibly difficult decision. However, I feel that my current role as Chief Executive at CQC has become incompatible with the important conversations happening about care at Leeds Teaching Hospitals NHS Trust, including during the time I was Chief Executive there. I am so sorry for the fact that some families suffered harm and loss during this time.
‘I will be giving whatever support I can to the inquiry into maternity services at Leeds, so families get the transparency and answers that they need and deserve – and I want to avoid my connection with the Trust impacting on CQC’s work to rebuild people’s confidence in the regulator. I know that the four outstanding Chief Inspectors appointed to lead on our specialist regulation, alongside our compassionate and dedicated staff, will ensure that we continue on our journey to being a strong effective regulator that people can trust to improve health and social care. I will miss being a part of the journey, but I believe the decision I have made is the right one to help CQC reach that destination.’
Commenting on the announcement, Professor Sir Mike Richards, Chair at CQC, said, ‘While Sir Julian’s departure will be a huge loss to CQC, I understand his concerns that his previous role at Leeds Teaching Hospital NHS Trust may undermine trust and confidence in CQC’s regulation. I am grateful to him for making this unselfish decision in recognition of the need for the regulator to be visibly held to the highest standards.’
Why CQC continues to face scrutiny
The underlying factors contributing to continued criticism of CQC include the backlog in inspections/re-inspections and the delays to the implementation of the single assessment framework (SAF). DHSC’s Review into the Operational Effectiveness of the Care Quality Commission: Full report found that the time taken to re-inspect services rated Inadequate or Requires improvement grew significantly from 87 days in 2015 to 136 days in 2024 for Inadequate, and from 142 days to 360 days for Requires improvement in the same timeframe.
The SAF, introduced to unify inspection/assessment across sectors, has been widely criticised for being too complex and poorly adapted to the diversity of services (hospitals, social care, homecare). A review by CQC itself stated, ‘One size does not fit all. Some elements of the quality statements are causing confusion both to CQC inspectors and to providers. In addition, the evidence categories and scores are causing major delays to report writing.’
Sector reaction
Professor Martin Green OBE, Chief Executive at Care England, said, ‘…Care England will continue to work closely with CQC to help it build back better and stronger than before, ensuring that the regulator delivers meaningful outcomes for providers and, most importantly, for the people who rely on care and support every day. While this is an unexpected setback, it must not be allowed to halt the momentum for positive change that Sir Julian and his team have started. We stand ready to work alongside Chris [Badger], the Board and the next Chief Executive in driving forward the transformation that will shape a fairer, more effective regulator for the future.’
The Chief Executive at NHS Providers, Daniel Elkeles, said, ‘We thank Sir Julian for his work with CQC. We understand and respect his decision to step down. We look forward to a close dialogue with Arun Chopra in his new interim role, as we work with CQC to support high-quality care for patients with fair, proportionate and constructive regulation.’
As Honorary President of the Independent Care Group, I was very sorry to see Sir Julian Hartley step down as Chief Executive at CQC. I understand the immense pressures he inherited and the challenges facing the organisation, but I genuinely believe he would have been a strong and steady hand to lead CQC forward at a crucial time for our sector. As the search begins for a new Chief Executive, what the social care sector needs most is leadership grounded in understanding – understanding of the realities providers face every day and the pressures that continue to build across all types of services. CQC cannot operate effectively without appreciating the scale of those pressures or the impact that prolonged uncertainty and regulatory change have had on providers already struggling to meet rising demand. It would also go a long way for CQC to acknowledge – and apologise for – the difficulties and disruption caused in recent years. Many providers feel bruised by inconsistent processes, unclear expectations and a relationship that has too often felt adversarial rather than collaborative. Recognising this openly would be an important step in resetting the tone. Looking ahead, inspections must not simply be more frequent or more digital – they must be more constructive. We share the same aims – better care, safe care and higher standards. But too often, providers approach inspections with a fear factor rather than a sense of partnership. Ofsted has demonstrated that regulatory reform, clearer frameworks and a more supportive tone are possible. CQC should be prepared to follow that example. Finally, any new Chief Executive must also be prepared to promote positivity around the sector – not just policing providers, but championing the context we operate in, including how commissioning practices directly shape quality. We need a regulator that works with us, not against us. This leadership change is an opportunity to reset, rebuild trust and strengthen the shared mission of delivering outstanding care. Mike Padgham, Honorary President, Independent Care Group X: @Mike_Padgham Email: [email protected]
Following a period of significant internal and operational challenges, confidence in the regulator has been tested amongst the sector and the public. Independent reviews have highlighted issues that have affected CQC’s ability to deliver timely inspections and consistent oversight. The result has been frustration for many providers striving to maintain high standards, and concern that delayed assessments may not always reflect the quality of care being delivered today. Sir Julian Hartley’s resignation presents another transition point for the organisation. Yet it also provides an important opportunity for renewal. To strengthen systems, rebuild trust and reaffirm CQC’s vital role in championing safety and quality across health and social care. The next permanent Chief Executive faces a significant challenge, but also a unique chance to lead transformation and set a new tone for collaboration, transparency and improvement. To achieve this, the next Chief Executive could focus on: Historic ratings pose a safety risk to residents, meaning inspections are currently prioritised on a risk-based methodology. CQC should continue working to build out its workforce to ensure the inspection demand be met. By working with providers and CQC openly and with shared purpose, we can ensure that regulation not only protects people but also enables innovation, improvement and the delivery of outstanding care. Scott McMurray, Director, Delphi Care Solutions. LinkedIn: @Delphi-Care-Solutions-Ltd Email: [email protected]