By Dr Minh Alexander retired consultant psychiatrist 25 May 2022
There have been questions about how the Care Quality Commission manages conflicts of interest arising from its proximity to providers.
There is a revolving door between the regulator and providers.
High profile examples are that of David Behan former CQC chief executive hopping off to the private care giant HCOne upon his retirement from CQC, and Steve Field former CQC Chief Inspector of Primary Care taking up the Chair of the Royal Wolverhampton NHS Trust.
CQC also uses “specialist advisors” in its inspections who are current NHS staff, including managers who review the Well Led domain of inspections.
There has been an extraordinary local media report – by Leicestershire Live on 21 May 2022. This was about a former CQC specialist advisor, Shaun Chadwick. Colleagues and ex colleagues have accused Chadwick of abusive comments and social media posts.
Despite Leicestershire Live obtaining apparent evidence of the social media posts, which it has shared, Chadwick has reportedly denied the allegations:
“A manager working for the NHS has been accused of telling a former colleague Karma is a b****’ after she was diagnosed with multiple sclerosis – before calling her a “pathetic woman” and a “fat cow”.
Shaun Chadwick, senior executive partner at Spectrum Health in Oadby, has also been accused of regularly ‘fat shaming’ another former colleague. It has also been alleged he shared confidential questions with practice staff that CQC inspectors planned to ask during a visit – and telling them to be ready with the right answers.
Mr Chadwick has robustly denied the allegations in a statement issued by his current employers Spectrum Health. It says: “We can all confirm that such allegations are grossly inaccurate and insulting.”
Readers can take a look at the Leicestershire Live original article and related images of the social media posts to make up their own minds:
A comment on this article alleged that concerns had been raised with the CCG and NHS England, who failed to act:
“The repeat theme on these posts is that the Leicester/Leicestershire CCG, LMC and NHSE are continually failing in their duty to act despite suggestions of patients and staff raising concerns and it being their position to bring all those responsible to account.”
Chadwick is a GP practice manager.
According to Leicestershire Live, he is also accused of abusing his position as a CQC specialist advisor by sharing questions that CQC inspectors were due to ask with one of his own practices, whilst he was employed as a CQC specialist advisor:
“Mr Chadwick has also been accused of sharing questions that Care Quality Commission inspectors were due to ask staff at one of his practices during a forthcoming inspection, which is a breach of the CQC rules on confidentiality.
He was a specialist advisor for the CQC at the time, while he was also executive manager at nine practices across Leicestershire. But he told LeicestershireLivein 2020 that he was stepping down from his role due to his concerns within the CQC.
The email sharing the questions asks colleagues to treat the documents “in the strictest of confidence” and instructs them not to have them on the day of the inspection. He goes on to tell staff to familiarise themselves with the questions the inspectors will be asking and to approach him if anyone was “unsure of the answers.”
“…A CQC spokesperson said they would not be investigating the allegations because Mr Chadwick is no longer a specialist advisor.
The spokesperson added: “Shaun Chadwick used to work at the CQC as a specialist advisor in primary medical services, however he is no longer employed by the CQC. We are not aware that he sent an email to a GP practice including details about the CQC inspection framework.”
All of the above accusations have also been put to Mr Chadwick, Spectrum Health, NHS England and Leicestershire and Rutland CCG. Mr Chadwick has denied the allegations to LeicestershireLive.
A Spectrum Health spokesman said: “Mr Chadwick denies allegations made and legal proceedings via our solicitor and Leicestershire Police have commenced. Mr Chadwick takes such allegations extremely seriously and therefore ordered an external facilitator to investigate working culture at Spectrum Health.
“We can confirm that such allegations are grossly inaccurate and insulting.”
A joint statement from NHS England and LLR CCGs said: “We cannot comment on ongoing individual cases, but we are aware of concerns which have been raised and we are working to investigate following the appropriate NHS complaint processes.”
I can understand that CQC would not investigate Chadwick as an employee, now that his employment with his CQC has ended.
But surely CQC has grounds to investigate his service as a provider that allegedly abused the inspection process?
How many CQC specialist advisors use their insider inspector knowledge to benefit their own provider services? How does CQC manage the risk of such breaches?
The CQC’s handbook for primary care specialist advisors states:
“CQC recognises that in the course of your regular work outside of CQC, you may be asked to speak at conferences or make presentations to various groups. In these presentations you may wish to use your experiences of participating in CQC inspections to illustrate your talk. In such circumstances you must:
• notify the conference organisers that you are not speaking on behalf of CQC
• not imply that you are appearing and/or speaking for or on behalf of CQC;
• anonymise any data from which an individual could be identified; and
• not breach the confidentiality provisions as set out in this Agreement or any relevant CQC policy on confidentiality.
We advise you to seek guidance from CQC if you are unsure about your obligations around this and how they apply to a given set of circumstances. “
This is Chadwick’s CV according to his LinkedIn profile:
Chadwick previously came to public attention in 2020 when he resigned from the CQC claiming disillusionment:
This article for Open Democracy reported on how CQC uses NHS directors to rate their own peers:
Some CQC specialist advisors have been known to sell regulatory compliance services to provider organisations.
The current National Freedom To Speak Up Guardian was a CQC specialist advisor and she also advertised consultancy services including CQC inspection advice:
Multi-skilling is so useful.