A major public consultation has revealed that trust in the Care Quality Commission (CQC) is “pervasive and deeply felt”, with widespread criticism of its inspectors and regulatory approach. The findings, published as part of the CQC’s “Better regulation, better care” consultation response in March 2026, highlight a significant credibility challenge for the organisation at a critical moment for NHS oversight.
Respondents across the health and social care sector, including NHS providers, GPs and care organisations, reported a lack of confidence in the regulator’s ability to deliver consistent, fair and accurate assessments. The strength of feeling suggests that concerns are not isolated but systemic, reinforcing warnings from earlier reviews that the regulator must undergo substantial reform to rebuild trust.
Criticism of inspectors and inspection quality
A central theme emerging from the consultation is dissatisfaction with the performance and consistency of CQC inspectors. Stakeholders reported concerns about variability in inspector expertise, with some questioning whether inspectors have sufficient clinical knowledge or frontline experience to assess services effectively.
There were also complaints about inconsistency in inspection outcomes, with providers reporting that similar services can receive markedly different ratings depending on the inspection team involved. These concerns echo findings from earlier independent reviews, which identified gaps in clinical expertise and inconsistencies in assessments as key weaknesses within the regulator. In some cases, providers described inspections as overly bureaucratic or disconnected from the realities of delivering care, raising questions about whether the current model is fit for purpose in a modern, digitally enabled NHS.
Legacy of IT failures and delayed inspections
The consultation findings build on a series of high-profile issues that have undermined confidence in the CQC in recent years. Problems with a new internal IT system led to delays in publishing inspection reports and, in some cases, the loss of data, contributing to a backlog of assessments and outdated ratings.
Delays in inspections have also been a persistent concern, with some providers going years without a visit from the regulator. These issues have had a direct impact on public trust, with health leaders warning that outdated or inconsistent ratings may not provide an accurate picture of service quality. The consultation suggests that, despite efforts to address these problems, their effects are still being felt across the sector.
Streeting signals urgency of reform
Health Secretary Wes Streeting has previously been highly critical of the regulator, and the latest findings are likely to reinforce calls for reform. In an official statement following earlier reviews, Streeting said: “The CQC is not fit for purpose and has lost the confidence of the sector it is meant to regulate.” He also highlighted the need to restore credibility, adding: “Patients and families must be able to trust the information they are given about the safety and quality of care.”
Streeting has committed to a programme of reform aimed at improving transparency, strengthening inspection processes and ensuring greater accountability. His comments reflect a broader recognition within government that effective regulation is essential to maintaining standards and public confidence in the NHS.
Implications for digital regulation and data use
The consultation also raises important questions about how regulation should evolve in a more digital healthcare environment. The CQC has been moving towards a more data-driven approach, using real-time information and analytics to complement traditional inspections. However, respondents expressed concern about the reliability and interpretation of data, particularly where it is used to inform ratings without sufficient context.
There are also challenges around integrating data from different sources, including NHS systems, social care providers and digital platforms. Health technology experts argue that while data-driven regulation has significant potential, it must be underpinned by robust governance, transparency and clear communication. Without this, there is a risk that digital tools could exacerbate, rather than resolve, existing trust issues.
Rebuilding trust in a critical institution
The findings of the consultation underline the scale of the challenge facing the CQC as it seeks to rebuild trust and modernise its approach. For providers, confidence in the regulator is essential to ensuring constructive engagement and continuous improvement.
For patients and the public, it underpins trust in the safety and quality of care. Addressing the issues identified will require not only technical fixes, such as improved IT systems and clearer processes, but also cultural change within the organisation. Greater consistency, transparency and engagement with stakeholders will be key to restoring credibility.
A pivotal moment for NHS oversight
The consultation marks a pivotal moment for the future of health and care regulation in England. As the NHS undergoes wider transformation, including greater integration and digitalisation, the role of the regulator must evolve accordingly.
The challenge for the CQC, and for policymakers is to create a system that is both rigorous and trusted, capable of supporting improvement while maintaining accountability. With confidence described as “deeply felt” and concerns widespread, the pressure is now on to deliver meaningful reform.
