CQC launches discussion in to the future of regulations

The Care Quality Commission (CQC) has published a new discussion paper detailing the decisions it is faced with, when changes are to make to ensure that high-quality health and social care is delivered to those who need it.

The ‘Building on Strong Foundations’ (BSF) document, asks for opinions on how regulations can be developed ahead of the next stage of the consultation on the CQC's new strategy in January 2016.

In 2013, the CQC established the ‘A Fresh Start’ strategy which saw fundamental changes made to the way it regulates health and care providers. Subsequently, these changes have resulted in a more thorough way of carrying out inspections and awarding ratings to providers and is providing a clear insight into the quality and delivery of social care, as well as increasing transparency for service users.

’Regulation alone cannot drive improvement but it has a crucial role to play’

Chief executive of the Care Quality Commission (CQC), 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. 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."

Since launching the current inspection model, providers have been helped to improve the quality of their services, which is demonstrated in their ratings with many providers coming out of special measures.

In addition, the new inspections have resulted in members of the public having access to clear judgements on the quality of their local services, through the ratings: Outstanding, Good, Requires Improvement or Inadequate. These ratings are helping people make informed decisions about their care.

Becoming more efficient, effective, flexible and responsive

The CQC has laid out two main 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 the CQC develop a more comprehensive surveillance model

• A greater focus on co-regulating with providers – where the 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

The CQC’s second objective is to create a model to ensure that regulation is both flexible and responsive enough to adapt to changes within the sectors and it is considering how to encourage improvements 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 the resources available to them. This assessments is being developed following a request by the Government and could work alongside the CQC’s quality rating systems.

Care England welcomed the CQC’s BSF paper but stressed the need to encourage a climate where providers are encouraged to improve quality and co-regulate.

'The CQC must deliver their new regulatory approach within the current budgets'

Chief executive of Care England, Professor Martin Green, said: "We are pleased to see CQC’s recognition of the need to adapt its strategy to the changing health and care landscape, and we will be issuing a full and considered response to this initial discussion paper within the stated timeline.

“Crucially, the CQC must assure local authorities of its strength as a regulator and improve communication with councils to avoid excessive and duplicative regulation. By better co-working, as the discussion paper states, we agree that regulation could be made proportionate. We are initially open to sensible suggestions such as a risks-based approach and better differentiation which promise to reduce unnecessary regulation.”

He added: "The social care sector is not able to afford any increase in regulation fees and the CQC must deliver their new regulatory approach within the current budgets.”

The CQC has already established its strategy for the next five years (2016-21) and is working to develop and improve the way in which it inspects and regulates adult health and social care in England, based on what it has learnt from previous inspection models and as new ‘models of care’ are developed.

Furthermore, the CQC is working to dissolve traditional, provider-based boundaries faced between primary, community, hospital and social care, ensuring they are structured around the needs and experiences of those using their services.

The CQC is encouraging further comments until 22 November ahead of its next consultation in January 2016.

For more information on ‘Building on Strong Foundations’ paper, and to respond, visit: http://www.cqc.org.uk/strongfoundations