CQC could be given ‘enhanced’ role following Hewitt review

The review, led by former health secretary and current integrated care system chair Patricia Hewitt, was commissioned as part of the autumn statement by chancellor Jeremy Hunt and health and social care secretary Steve Barclay last month.

The terms of reference for the review were issued today. 

They confirm the rapid timetable revealed by HSJ last month. “Interim findings” will be delivered in just 10 days – on 16 December – with a “first draft” of the full report completed by 31 January 2023 and a final report submitted no later than 15 March 2023”. 

The first recommendations will inform NHS England’s planning guidance for 2023-24, normally published just before Christmas.

 The ToR say the review will cover:

• “how to empower local leaders to focus on improving outcomes for their populations, giving them greater control while making them more accountable for performance and spending”; 
• “the scope and options for a significantly smaller number of national targets for which NHS [integrated care boards] should be both held accountable for and supported to improve by NHSE and other national bodies, alongside local priorities reflecting the particular needs of communities”;
• “How the role of the [Care Quality Commission] can be enhanced in system oversight”.

HSJ understands the review arose from former Mr Hunt’s “unfinished business” with the NHS, which includes a more prominent role for the CQC. 

The CQC is already expected to issue ICS ratings, but no details have been set out on how or when. It is so far unclear how its regulation and ratings will link to NHS England’s system oversight framework, which gives ICSs a one-to-four score.

The ToR add: “The review will consider how the oversight and governance of integrated care systems can best enable them to succeed, balancing greater autonomy and robust accountability with a particular focus on real-time data shared digitally with the Department of Health and Social Care, and on the availability and use of data across the health and care system for transparency and improvement.

“It will cover ICSs in England and the NHS targets and priorities for which integrated care boards are accountable, including those set out in the government’s mandate to NHSE.”

The review’s secretariat will be provided by Department of Health and Social Care.