High Court finds apparent bias in CQC inspections

A landmark judicial review challenge against England’s health and care regulator on issues of apparent bias and the terms and application of the Care Quality Commission’s conflicts policy will be of interest to health and care providers.

The judge commented on the CQC’s failure to follow its conflicts policy:

“The Conflicts Policy was not followed in full. The potential for conflict arising from the use of a service by an inspector was one which CQC identified and thought about. It was of such obvious relevance that the decision to allow inspection by a former service-user was to be taken at a senior level, but it was not. It is the role of those in senior leadership to deploy long experience, overview and insight which might not be evident to those who do not have that level of responsibility. For those who should have referred the matter to senior leadership to have failed to do so is indicative of the Conflicts Policy not being taken as seriously as it should have been. Equally, the failure of senior leaders to ask and check whether the correct decision-making process was being implemented also indicates that senior leadership was not taking sufficient interest in potential conflicts. For an organisation which is entirely focussed on assessing compliance with methods, procedures and policies, these are striking features of the case.”

It was also found that while the CQC’s conflicts policy was not followed in this case it was also not followed in other cases. 

Cygnet Health Care, a mental health provider challenged the legality of CQC’s inspection reports and enforcement action taken by the regulator against various Cygnet sites on the basis of apparent bias resulting from an inspector’s historic connection to Cygnet’s hospitals.

The case has run for over a year with the final hearing on 4th and 5th December 2024. Judgment was delivered on 21 January 2025. 

You can read the decision Cygnet Health Care v Care Quality Commission here. 

Partner Amanda Narkiewicz and Principal Associate Samuel Lindsay represented Christian Young, General Counsel at Cygnet Health Care while Patrick Green KC and Jack Castle of Henderson Chambers acted as Counsel.

The Claimant’s application for judicial review was allowed and the High Court declared that:

• The Inspector was “apparently biased”
• The CQC’s decision that its “Impugned Decisions” were not affected by apparent bias was therefore unlawful
• A number of reports, decisions and/or actions taken by the CQC were affected by the apparent bias of the inspector

The CQC’s decision not to withdraw “the Acer Decision” has been quashed and the CQC has been ordered to reconsider that decision.

Permission to appeal was sought but refused.