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CQC could ditch annual inspections following U-turn

The Care Quality Commission could move away from regular inspections of all regulated organisations and back towards a more risk-based model, under plans being put out for consultation today.

The proposal, which forms part of the regulator’s strategy for 2013-16, comes just over a year after former chief executive Cynthia Bower announced the CQC would introduce annual inspections of all NHS providers and move away from a risk-based approach.

However, the new strategy is clear there are no extra resources available, meaning the CQC needs to improve its efficiency if it is to operate within its current budget.

New chief executive David Behan developed the strategy. It sets out a vision for “differentiated regulation” which will approach regulation of the three different sectors the CQC is responsible for – health, social care and mental health - in different ways.

It proposes moving towards a more “evidence-based” model which the consultation document says is likely to mean revisiting the current frequency of inspections.

Mr Behan said this “differentiated” approach was perhaps the “most significant” of the changes being proposed.

He added: “[The] CQC is now in its fourth year. As we enter the next stage of our development I am clear that our role is to check that health and care services meet national standards and in that way drive improvements in the quality and safety of services.”

The strategy also sets out plans to be “more ambitious” with the use of the information the CQC collects, publishing performance data and reports aimed at driving improvement in the provision and commissioning of services.

Inspectors will start to highlight where things are working well, not just where things are going badly, and also begin to consider the culture of the organisations they regulate by assessing how providers listen to the views of patients and their families and staff.

The proposed changes appear to mark a shift in thinking at the top of the beleaguered regulator. At an event hosted by the King’s Fund earlier this week, former chief executive Ms Bower said the CQC could not be “an improvement agency and a control agency” and had to settle for “policing the bottom line”.

She said the problem with a risk-based approach, where not all providers were subject to regular inspections, was working out “who the good guys are”.

Asked her biggest regret in her three years at the CQC, Ms Bower said if she had her time again she would have had a much more open political debate about where the role of the regulator sits and what it could achieve.

She added: “My biggest mistake was assuming that people would understand it would take a while to get going.”

A key part of the new strategy is to work more closely with strategic partners such as the Health and Social Care Information Centre and local authorities in a bid to avoid duplication.

The consultation runs until 6 December and will take into account any relevant recommendations from the report of the Mid Staffordshire Foundation Trust Public Inquiry which is due to be published in late October or early November.

Readers' comments (6)

  • A significant part of governance is to anticipate risk based on intelligence. Real-time feedback from patients will be a key factor. But it will only work if the CQC is listening closely. The 'risk' of not doing that is clear from the recent past and the consequencies for patients pretty dior.

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  • Apologiies for 'haute couture' reference. Had just ordered present for my wife!

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  • One of the biggest problems the CQC faces is in insulating itself from political pressure. It is not acceptable for it to suddenly find its budget hijacked by a Minister's personal hobby horse or what happens to be in the latest redtops' headlines.

    The CQC needs to establish a firm strategy and stick to it. One of the NHS's most persistent problems is constant political meddling, and the CQC needs to be immune to this - the first and only priority is patient care.

    If, by any budgetting means, the CQC finds itself unable to police patient care adequately, it needs to speak up and demand the extra funds it needs, and to continue to embarrass politicians who deny it the facilities it needs to provide adequate protection for the public - the people the Ministers are elected to serve.

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  • Differentiated regulation: a system of regulation intended to look substantially different to what hasn't worked in the past. #NHSLexicon

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  • U-Turn!
    CQC delivery strategies are more like a series of hairpin bends
    A five-year strategy that last lest than two, five key priorities reduced to three. Increased inspection, reduced inspection.
    When are they going to make up their mind exactly what it is they are supposed to be doing. I feel very sorry for the staff whose objectives must be continually changed.

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  • I disagree with the notion of patient surveys being the basis for measuring quality. They might be OK for say 5% of service quality, but the other 95% will be factors that the patient will not have a clue about. Neither do many acute managers.

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