Recommendation 32

Immediate steps if suspected risk to patient safety

Where patient safety is believed on reasonable grounds to be at risk, Monitor and any other regulator should be obliged to take whatever action within their powers is necessary to protect patient safety. Such action should include, where necessary, temporary measures to ensure such protection while any investigation required to make a final determination is undertaken.

As part of the overall single failure regime (see recommendation 19) it is important that where the Care Quality Commission, Monitor or the NHS Trust Development Authority identify breaches of fundamental standards that they can act swiftly to resolve those issues.

As such, the Care Quality Commission has retained both its ability to impose enforcement action to ensure that patient safety risks are addressed and to stop the provision of a service where it is putting people at immediate risk of harm as outlined by the Health and Social Care Act 2008.

Subject to the passage of appropriate regulations, the Care Quality Commission will also be able to prosecute a provider for failing to provide fundamental levels of care, without having to issue a formal warning first.  See recommendations 28 and 30 for further details.

Monitor and the NHS Trust Development Authority have retained their powers to intervene at their discretion if urgent action is required.  Details of this are outlined as part of the response to recommendation 31.


Under the new special measures regime, the NHS Trust Development Authority and Monitor are now able to intervene at providers which the Care Quality Commission judge to be providing poor quality care as part of their new inspection programme. This includes partnering the failing provider with a high-performing buddy, the appointment of a dedicated Improvement Director at the trust as well as other targeted interventions to ensure rapid improvements where failings have been identified.