An independent review of the technology that supported our transformation has found that the primary cause of our technology failure was a failed organisational transformation. It adds that the technology used for our regulatory platform and provider portal are salvageable but require substantial development and rebuilding work.
The review was conducted by Peter Gill, an independent IT expert. It considered how and why we got to the point where the technology is causing such significant organisational disruption. It also explored whether we could continue with the technology as it is.
Findings
The report clearly sets out the scale of the problems that resulted in the failure of our technology, and the impact that transformation had across CQC. They include:
- Technical issues with the way the regulatory platform and provider portal function, resulting in multiple challenges including, for example, an overly complex assessment process, a poor user experience in registration, low use of the provider portal for notifications, and challenges with data quality.
- Fundamental cultural issues, as concerns were raised and colleagues did not believe they were listened to. This was reported to have a negative mental and physical health impact on colleagues. Data was also not given the importance it should have.
- The total spend on the regulatory transformation programme, which includes the regulatory platform and provider portal, has been £99 million from inception in July 2019 to date. The vast majority of the benefits expected to be delivered have not yet been achieved.
- The report also found that parts of the regulatory platform are working well. These relate to the customer contact area and include richer data capture, time-saving automation of some processes, and the ability to connect and view different data and information in one place.
Recommendations
There are 23 recommendations, which can be grouped in 5 broad areas. They reflect what is needed as part of rebuilding CQC, and redeveloping the regulatory platform and the provider portal:
- Culture
- Governance
- Operating model
- Change management
- Data and Digital
CQC's Board welcomes and accepts the recommendations.
The report recommends that CQC “retains Microsoft Dynamics 365 as a strategic asset” and concludes that the regulatory platform and the provider portal are salvageable. It sets out that the systems will require substantial development and rebuilding work and that this should be done by CQC colleagues with some additional support.
The recommendations also cover the need to:
- Develop a culture where data is seen as critical and strategically important.
- Ensure robust governance and clear roles and responsibilities.
- Extensively engage with and involve users, internally and externally. This includes putting in place additional ways to ensure the concerns and feedback of CQC colleagues and external partners are listened to and acted on.
- Follow best practice and industry standards.
The full recommendations can be found in the report on our website.
Julian Hartley, Chief Executive said:
“The findings in this report evidence that the way the digital transformation programme was carried out was completely unacceptable. It marks a critical moment in terms of where we are, what’s gone wrong and where we’re going and I want to thank the colleagues who have given their time and expertise to help inform it.
“The report praises colleagues for their diligence and determination to move forward and bring CQC back to being a fully effective organisation. I would like to echo those thanks. It starkly highlights the cultural issues and the fact that colleagues were not listened to. I am focused on putting this right.
“I have already started to take steps to address these issues to get us back to delivering our purpose and protecting people from poor care. This includes a focus on re-setting our culture through the CQC Way, working in partnership with CQC colleagues, providers, the public and wider stakeholders. I have also established strong digital transformation and change management executive leadership at CQC and I will be recommending to the new chair that we commission an independent review of organisational governance.
“It is clear we have a journey ahead of us, but we are committed to ensuring the regulation we carry out meets its core purpose — to keep people safe and ensure they receive the care they deserve.”
Esther Provins, Interim Chief Digital and Data Officer added:
“I know colleagues, providers and wider stakeholders have been waiting to read this review. Peter Gill’s findings are indeed sobering however I believe they appropriately represent the voice of all who were, and continue to be, impacted by the challenges in our historic transformation programme and associated digital systems.
“The recommendations are fundamental to rebuilding CQC and getting back to delivering our purpose and speak to much wider issues than just challenges with technology. There is much to do to make this right, and I have already started to work with colleagues and stakeholders to develop an action plan that will deliver the recommendations in the report.”
An action plan that responds in full to this report will be shared at a future CQC Board meeting.