Biased CQC inspections found in High Court decision
In the recent decision in Cygnet Health Care v Care Quality Commission [2025], the court held that the Care Quality Commission (“CQC”), England’s health and care regulator, made decisions with apparent bias.
The claim was brought by a healthcare provider, Cygnet Health Care (“Cygnet”), and centred around the CQC’s failure to comply with its own ‘Declaration of Interest and Resolution of Conflicts policy’ (the “Conflicts Policy”). The Court also found that it was not only in this case that the CQC did not follow its conflicts policy, but that there were also other cases.
What happened?
As outlined in the Judgment, it is the CQC’s policy that an Inspector should not take part in an inspection of a care provider if there has been a ‘relevant connection’ with that care provider within the past 5 years.
In this case, the Inspector assigned to inspect a number of Cygnet’s hospitals had previously been an inpatient at Cygnet’s Blackheath and Stevenage Hospitals, where he was detained under the Mental Health Act 1983. The Inspector had since recovered, and only later went on to become a CQC inspector, but during his detention he had made complaints about the care and treatment he received at both Cygnet hospitals.
The CQC’s Conflict Policy stated that the Inspector’s allocation to inspect Cygnet hospitals should have been escalated to the Deputy Chief Inspector of Chief Inspector, but that this was not done. It was found by the court that it was not common practice to escalate such decisions, and that the way in which the CQC considered conflicted before each inspection did not accord with the Conflict Policy.
What did the court find?
The Court held that whilst the Inspector’s reports themselves were cogent and balanced, and therefore could not be criticised, it was the CQC’s failure to follow its own conflicts policy which meant that there was a real possibility of bias.
The Judgment sets out that the legal test for apparent bias was established in Porter v Magill [2002] 2 AC 35, and is
“whether a fair-minded and informed observer, having considered all the relevant facts, would conclude that there existed a real possibility of bias”
In this case, it was established that there was apparent bias, due to the fact that the Inspector had a previous history of being an inpatient at two Cygnet hospitals.
As a result of the Court’s findings, the CQC has been ordered to review and reconsider one of its decisions.
How can Ellis Jones help?
Our Healthcare Team can provide support and advice on challenging CQC inspection reports as detailed in our previous article ‘Factual Accuracy – challenging CQC draft inspection reports’, and on making a formal complaint to CQC if you are concerned that you may have been affected by apparent bias during an inspection.
If you do feel that an inspector may be conducting themselves in breach of CQC’s conflict policy, it is important to seek advice and make a complaint to CQC before you receive the draft inspection report, in case any apparent bias negatively feeds into the draft report. Once you receive the draft inspection report, you are limited to responding on a factual accuracy basis only.
If you would like to discuss a potential matter, please contact Henrietta Frew by email at Henrietta.Frew@ellisjones.co.uk or phone 01202 525333, to discuss your matter further.
About the authors
Henrietta is a Senior Associate Solicitor in our Banking & Finance Litigation department and is based in the Bournemouth office. Henrietta specialises in various forms of commercial litigation, including claims in Banking & Finance Litigation, Commercial Disputes and Healthcare Disputes.
Leah is a Solicitor in our Banking & Finance Litigation team and is based in the Bournemouth office. Leah has experience in acting on a vast range of matters, such as Gambling Disputes, Financial product mis-selling, Consequential loss claims and Financial disputes.
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