It said that the CQC’s budget is less than the combined budget of its predecessor bodies, although it has more responsibilities. The budget for health and adult social care regulation fell from £175m in 2008/9 to £164m in 2010/11, a reduction of 6.3%, it said.
But it added: ‘Although regulation is being delivered more cheaply, the CQC has not so far achieved value for money in regulating the quality and safety of health and adult social care.
‘It is not clear to us exactly where the balance of responsibility lies between the CQC and the DoH for failing to achieve value for money, but it is clear that responsibility is shared.’
The NAO also found that the timetable for registering health and adult social care providers set by the DoH did not allow time for the registration process to be tested properly and meant the process has ‘not run smoothly’.
It said the decision to postpone CQC registration of general practice has allowed the CQC time to engage with GPs at an early stage, streamline the application process, and develop online services to make registration quicker and more efficient.
But the NAO also recommended that the DoH and CQC should review the GP registration progress regularly and have a contingency plan in place if GP registration ‘does not go to plan’.
CQC chief executive Cynthia Bower agreed that the CQC faced a ‘difficult task’.
She said: ‘Not everything has gone smoothly, but we have learned, reviewed what we do and made changes – often with support of others involved in health and social care.
‘We are a young organisation and we are still evolving - but I firmly believe that we are making real progress.'