CQC asks for views on future of quality regulation

The Care Quality Commission (CQC) has published a discussion paper that sets out some of the choices it faces in responding to changes to how health and social care is delivered, so that regulation continues to help people receive safe, high-quality and compassionate care.

In ‘Building on Strong Foundations’ (BSF), CQC asks for views on how regulation can develop ahead of the next stage of consultation on its new strategy in January 2016.

Two years ago, CQC set out its strategy, A Fresh Start, which made fundamental changes to the way it regulates. These changes have resulted in a more robust way of inspecting and rating providers, which is providing the most comprehensive insight ever into the quality of health and social care and increased transparency for people who use services.

Already these inspections are helping providers improve the quality of their services, as demonstrated in their ratings and in many coming out of special measures. Also, these inspections are leading to the public having clear judgements on the quality of their local services (through ratings of Outstanding, Good, Requires Improvement or Inadequate), which are helping them to make informed choices about their care.

With its strategy for the next five years (2016-21), CQC will develop the way it regulates health and adult social care in England based on what it has learnt from its inspections and as new ‘models of care’ develop, which seek to dissolve the traditional, provider-based boundaries between primary, community, hospital and social care so that they are structured around the needs and experiences of the people who rely on their services.

CQC sets out two objectives in BSF; the first is to become a more efficient and effective organisation by:

• Risk-based registration – handling lower risk applications and changes to registration in a more streamlined and proportionate way
• Smarter monitoring and insight from data – to help CQC develop a more comprehensive surveillance model
• A greater focus on co-regulating with providers – where CQC supports providers to assess and share evidence on their quality of care
• More responsive and tailored inspections – for example, inspecting services previously found to be good or outstanding quality less frequently, or less intensively than other services

CQC’s second objective is to develop its model to ensure that regulation is flexible and responsive enough to adapt with the sectors as they change. It is considering how to continue to encourage improvement in health and social care by:

• Place – assessing how well organisations are working together to provide health and care services for specific populations and in specific local areas
• Pathways – improving information about the quality of care that specific populations  experience as they move between services

The paper also considers the development of an assessment of how NHS hospitals use their resources. This additional assessment is being developed at the Government’s request and could sit alongside CQC’s quality rating.

David Behan, Chief Executive of the Care Quality Commission (CQC), said: “Our last strategy created a more rigorous inspection approach that gives providers and the people who use services a deeper insight into the quality and safety of care. This is crucial to help people using services make informed choices and so that providers know where they need to improve.

“Our next strategy will set out the case for developing our approach – building on the strong foundations we now have in place.

“Since April, we have engaged over 700 members of staff and stakeholders about the future direction of regulation. We will make our current model more efficient and effective by being more risk-based and proportionate; we will also look at the quality of care in a geographical area and across pathways of care.

“Regulation alone cannot drive improvement but it has a crucial role to play alongside the role of commissioners, providers and professionals. This document sets out our thinking about how working with others we can further contribute to the improvement of the quality and safety of health and care in England.”

CQC is encouraging further comments until 22 November, ahead of a consultation on its next strategy in January 2016.

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