The Care Quality Commission (CQC) has set out the improvements and changes it will make to help rebuild trust in its regulation.
The care watchdog is aiming to improve the way in which it works in response to two important reviews of its practices.
Dr Penny Dash recently published the final report of her review into the CQC, while Professor Sir Mike Richards has published the first report of his independent review.
The CQC has accepted the high-level recommendations of both these reports and pledged rapid action to fix the “serious organisational failings” identified. This includes commitments to:
- Align the organisation around sector expertise by appointing at least 3 chief inspectors to lead on regulation and improvement of hospitals, primary care, and adult social care services.
- Modify the current assessment framework to make it simpler and ensure it is relevant to each sector.
- Ensure they have the right systems and tools in place to support its regulatory activity, including improved IT systems.
- Improve the experience for providers registering with CQC.
CQC pledges immediate changes to improve regulation
The CQC has pledged immediate changes to deliver:
- A clear and transparent programme of assessment and ratings
- Quicker and more effective registration and assessments of providers
- Simpler and clearer reports
To this end, the regulator is recruiting a new Chief Executive and appointing 3 Chief Inspectors to help strengthen its leadership across the health and social care sectors. They will also be working closely with Professor Sir Mike Richards and Professor Vic Rayner, the Chair of the Care Provider Alliance, to review longer-term improvements to their single assessment framework and how it is implemented.
This work is being informed by discussions with colleagues, providers and stakeholders from the sector as well as insight and feedback from people who use health and care services and the general public.
The CQC is currently running two pilot projects: one is exploring a better way of managing its relationship with health and care providers; the other is looking at how its operation managers can manage teams in specific sectors.
The first pilot project has started with NHS trusts but will expand to involve providers from each sector.
The care watchdog is also making changes to its relatively new single assessment framework to enable it to assess and inspect more services and ensure its ratings are transparent and robust, with clearer reports stating clearer judgments.
It is also recruiting more staff to enable it to increase the number of monthly assessments carried out and will be making improvements to its provider portal.
Co-design will be key to watchdog’s new regulation approach
The CQC pledges that “new approaches will be evaluated to ensure we fulfil our core purpose. This will be through independent evaluation and working with providers and the public if new approaches are rolled out more widely.”
They are still progressing work to assess local authorities on their duties under the Care Act 2014. However, in line with improvements to the single assessment framework, the CQC has agreed to make scoring of evidence more transparent, and strengthen its focus on nationally agreed priorities.
The regulator has also agreed with the Department of Health and Social Care (DHSC) to suspend assessments of integrated care systems (ICSs) for 6 months as it works to improve the single assessment framework and increase assessments of providers.
Importantly, the CQC wants to co-design its approach with health and care providers by engaging with them online and face-to-face. They will focus on working with providers to design what a CQC rating of ‘Good’ looks like and to develop a clear and accessible regulatory handbook.
The care watchdog is expected to announce further details about its drive to improve soon, including information about the frequency of assessments and when it will carry out more assessments.
It is key that the CQC continues to work with the sectors it regulates to make these improvements and rebuild trust.
In a press release, the CQC states:
“It is vital that we have feedback from providers, the public and wider stakeholders about your experiences as we make these changes.
“As well as our Regulatory Approach Advisory Group, we are planning a series of roadshows for providers to enable them to connect with local CQC teams, learn more about specific aspects of our assessment approach and take part in activities to co-design the improvements we’re making. We will share more information on these soon.
“In the meantime, we will continue to engage with providers, the public and wider stakeholders through our established channels, online engagement sessions and our online participation platform.”
CQC will address recommendations “with urgency”
The Chair of the CQC, Ian Dilks, said the watchdog welcomed the final report from Dr Penny Dash’s review and accepted the findings, aiming to “address the recommendations with urgency.”
He added:
“Today also sees the publication of the review we commissioned from Professor Sir Mike Richards – we are extremely grateful to Sir Mike for his helpful work and will be using his recommendations to help us respond to the serious failings identified by Dr Penny Dash. His review also offers additional suggestions for improvement that we will be exploring as part of our wider recovery work.
“Both reviews have reaffirmed the support for a robust health and care regulator and recognised the dedication and experience of CQC staff. We are committed to rebuilding trust in CQC’s regulation and are taking action to make sure we have the right structure, processes, and technology in place to help us fulfil our vital role of helping people get good care and supporting providers to improve.”
Meanwhile, Professor Sir Mike Richards explained simply that “CQC’s transformation programme has not delivered what was intended,” but added that he believed the problems “can be fixed relatively quickly.”
He concluded that the swift changes planned by the CQC “will help the regulator to effectively deliver its crucial work of ensuring that people get high quality, safe care.”
Training to support health and social care services
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