'Regulating healthcare - experience and lessons' report

The Healthcare Commission published a 'lessons learnt' document in the month leading to its abolition. Its legacy report suggested that the government's decision to establish an independent regulator was an important and, in some respects, brave step. As the system became more devolved, there was a case for effective regulation to provide strong guidance to people using services.

The report considered that the word 'regulation' had not been commonly used in health and social care at an organisational level until the establishment of the Healthcare Commission and the National Care Standards Commission.

The report noted the relationship with an independent regulator could be uncomfortable, as the regulator would inevitably highlight concerns about the services that ministers were politically accountable for. It also noted that the role of a regulator in promoting 'improvement' would create tension with those whose job it was to manage the service.

The report highlighted a range of common themes across the trusts that had been investigated:

• while patient satisfaction levels were high, further progress was needed to ensure person-centred care
• many of the concerns about poor performance and investigations into service failures had highlighted poor leadership and governance, particularly in relation to the safety of care
• information on outcomes of care had not been routinely reported, analysed or actioned at board level
• more attention needed to be given to patient safety, including the development of surveillance mechanisms, reporting and better comparative information
• more attention needed to be given to the continued professional development and training of staff
• in all of the commission's major investigations, the boards of the organisations were not receiving adequate information about the quality of care that their organisations were providing
• there had been a lack of clarity on what 'good services' meant: the commission felt that the government had been too focused on processes rather than outcomes
• there had been a lack of attention to areas such as mental health, learning disabilities, equalities and the integration of health and social care in the national priorities set by the government.

In parallel, the Commission for Social Care inspection published a legacy report outlining actions it had taken against its core objectives.