Conclusion

Despite visible green shoots, the CQC still has a long way to go to rebuild its credibility and regain the sector’s confidence.

There are clear signs of progress. Some leaders report improvements in inspection quality, more stable relationships with local teams, better informal engagement, and a much-needed focus on rebuilding sector expertise. Proposed policy changes have been broadly welcomed, as has the CQC’s commitment to consult widely.

But these positive experiences remain too isolated. Across many of the measures examined in this report, leaders are experiencing little improvement or further deterioration. Concerns persist about inspector expertise, slow reporting, inconsistent judgments, poor understanding of local context, regulatory burden and a punitive inspection culture.

The overall message is not that nothing is improving, but that progress is not yet sufficiently widespread, consistent or visible to rebuild confidence. A gap remains between the direction of policy nationally and the day-to-day experience of most trusts.

The challenge for the CQC’s new leadership is to turn promising reforms and pockets of better practice into consistent improvements across the organisation. The challenges and destination are well understood. The priority now must be delivery.

At a time of significant operational and financial pressure, the NHSE needs an effective and trusted regulator that can identify risks, provide meaningful independent challenge and support improvement. The green shoots identified in this report provide grounds for cautious optimism, but rebuilding credibility will ultimately depend on providers seeing tangible and sustained improvement in their experience of regulation.