The board of the Care Quality Commission (CQC) considered recruiting a new chief executive without formal government approval after a four-month delay in ministerial sign-off, according to comments made during a recent board meeting. The disclosure highlights tensions around the governance arrangements for England’s health and social care regulator at a time when it is undergoing significant organisational reform and digital transformation. A non-executive director told the board that the regulator had explored the possibility of proceeding with recruitment to replace Sir Julian Hartley if the approval process continued to stall. The delay had left the organisation uncertain about its leadership plans and raised concerns about the regulator’s ability to move forward with strategic priorities.
Leadership gap following Hartley’s departure
Hartley stepped down as CQC chief executive in October 2025 after less than a year in the role. His departure followed concerns about a potential conflict of interest linked to an inquiry into maternity services at Leeds Teaching Hospitals NHS Trust, where he had previously served as chief executive. Following his resignation, the regulator appointed its chief inspector of mental health, Dr Arun Chopra, as interim chief executive while a permanent successor is recruited.
However, appointing a permanent chief executive requires approval from the Department of Health and Social Care because the CQC is a non-departmental public body sponsored by the government. Board members indicated that delays in this approval process had slowed the regulator’s recruitment plans and created uncertainty around leadership continuity. During the board discussion, one non-executive director said the organisation had debated whether it could begin recruiting a successor without waiting for formal ministerial sign-off. The suggestion reflected frustration over the four-month delay, although the board ultimately did not proceed with the idea.
Governance pressures at the national regulator
The episode underscores the governance challenges facing the CQC as it attempts to rebuild confidence among providers and the public. The regulator has been under sustained scrutiny in recent years following criticism of inspection backlogs, inconsistent ratings and problems with its new digital regulatory platform. Leadership stability is widely viewed as essential to addressing these issues. Hartley had been brought in with a mandate to reform the regulator and modernise its approach to oversight. His tenure included a push to reshape the organisation’s culture and improve how it uses data and digital tools to assess health and care services.
However, his abrupt departure meant those reforms were left unfinished, placing additional pressure on the board and interim leadership team to maintain momentum while a permanent chief executive is recruited. The board’s consideration of bypassing ministers illustrates the degree of urgency felt within the organisation to restore stable leadership and continue its reform programme.
Technology transformation and regulatory reform
The leadership uncertainty comes at a time when the CQC is implementing a major transformation of its regulatory model, including a significant shift toward digital oversight and data-driven inspections.
In recent years, the regulator has been developing a new digital platform designed to integrate data from NHS providers, social care services and patient feedback sources. The system is intended to allow inspectors to monitor quality indicators in near real time rather than relying solely on periodic on-site inspections. The digital approach forms a key part of the regulator’s long-term strategy to modernise oversight across England’s health and social care system. By combining analytics, provider-submitted data and intelligence from patients and staff, the CQC aims to identify risks earlier and intervene more effectively.
However, the rollout of the platform has faced technical challenges and criticism from some providers, who say the system has produced inconsistent assessments and increased administrative burden. A permanent chief executive will therefore inherit a complex agenda, balancing organisational reform, technology implementation and the need to rebuild trust with health and care providers.
Recruitment challenge amid ongoing reform
The debate over recruiting a successor without government approval reflects broader questions about the independence and governance of national health regulators. While the CQC operates at arm’s length from government, key appointments and strategic decisions still require ministerial oversight. For board members, the delay in approving recruitment highlighted the practical implications of those governance arrangements during periods of leadership transition.
As the regulator continues its digital transformation and attempts to strengthen its regulatory framework, securing stable leadership is likely to remain a priority. The eventual appointment of a new chief executive will be seen as a critical step in determining whether the CQC can deliver the reforms needed to modernise its oversight of England’s rapidly evolving health and care system.
