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CQC considers move to more ‘proportionate’ regulation

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The Care Quality Commission may in future inspect organisations considered to be low risk in a more “proportionate way” and visit less frequently those services previously judged to be performing well.

The CQC has today published a discussion paper setting out potential changes to the way it inspects health and social care organisations in future.

The document – titled Building on Strong Foundations – asks for views on how regulation can develop, as part of a consultation on a new five-year strategy.

“We will make our current model more efficient and effective by being more risk-based and proportionate”

David Behan

The strategy, which will cover the period 2016-21, requires the CQC to become a “more efficient and effective” organisation.

To achieve this initial objective, the CQC has suggested it moves to a more “risk-based registration” system, in which lower risk applications and changes to registration are handled in a “more streamlined and proportionate way”. 

More “responsive and tailored” inspections are also been mooted by the regulator. For example, this might involve inspecting services previously found to be “good” or “outstanding” quality less frequently, or less intensively than other services, said the CQC.

It has also proposed using “smarter monitoring and insight” from data to help it develop a more “comprehensive surveillance model”

In addition, it suggested a greater focus on co-regulating with providers, where the CQC would support providers to assess and share evidence on their quality of care.

Meanwhile, the CQC’s second strategic objective is to ensure its regulation model is “flexible and responsive enough” to adapt to major changes in the health and social care sectors themselves – notably more integrated working.

It said it was considering how to assess how well organisations were working together to provide services for specific populations and in local areas, as well as improving information about the quality of care that populations experienced as they moved between services.

In addition, the discussion paper covers the development of an additional CQC assessment, which will provide a check on how NHS hospitals use their resources. It is being developed at the government’s request and could sit alongside CQC’s quality rating. 

The commission described the paper as outlining 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”.

Two years ago, the CQC set out its A Fresh Start strategy, which made fundamental changes to the way it regulated the health and care sector. It covered the period 2013-16.

Care Quality Commission

David Behan

The changes resulted in a more robust way of inspecting and rating providers, but which have also been criticised by some nursing directors for being too heavy-handed, with busloads of inspectors turning up on the day of the CQC’s visit.

However, the CQC said the new-style inspections were helping providers improve and aiding the public with clear judgements on the quality of services through its ratings systems.

CQC chief executive David Behan 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.

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

“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,” added Mr Behan.

The CQC said it was “encouraging further comments” on the ideas set out in the discussion paper until 22 November. A formal consultation on the new strategy will begin in January.  

  • 4 Comments

Readers' comments (4)

  • "In addition, the discussion paper covers the development of an additional CQC assessment, which will provide a check on how NHS hospitals use their resources. It is being developed at the government’s request and could sit alongside CQC’s quality rating. "
    Long overdue, it will,hopefully result in massive savings from cutting out a multitude of duplications present in the existing sytem.

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  • "a check on how NHS hospitals use their resources"

    Will there be more manpower hours then for the CQC to provide this service? Already there seem to be too few hours to assess the quality of pressure relief, toileting and hydration, especially in care homes and these things are absolutely fundamental.

    How about channelling some resources into a publicity drive for Experts by Experience to bridge the gap David Behan?

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  • Good heavens! Sense at last.

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  • Anonymous | 29-Oct-2015 5:44 am

    "channelling some resources into a publicity drive for Experts by Experience"

    Please elaborate, this sounds interesting

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