CQC warned against hospital-centric regulation regime

HSJ has learned the Mental Health Network, which represents both NHS and independent sector providers, has raised concerns about some changes to the CQC’s approach to regulation following the Mid Staffordshire Foundation Trust public inquiry. The regulator has created posts for three chief inspectors – of hospitals, primary care, and social care – and plans to introduce Ofsted-style ratings for providers.

The MHN supports the commission’s plans for longer, more expert inspections; however, it has suggested the new regulatory model may be too focused on the acute sector, and questioned whether the ratings will be useful to the public.

Its response to a recent consultation described applying ratings to large trusts with numerous services as “almost meaningless”, arguing instead for service-level ratings.

The network said the context of mental health services was “not significantly reflected in the revised approach” adding: “The CQC’s leadership has unapologetically focused much of its thinking on the acute hospital sector. We are clear however that we do not want mental health services shoehorned into a regulatory model designed for acute hospital provision.”

The consultation response also highlights doubts about how the CQC will deal with problems which are the result of “system-wide issues.”

Stephen Dalton, chief executive of the Mental Health Network said members were supportive of the CQC and had “empathy” for the task it had been given.

But he added: “There are a number of questions, bordering on concerns, about how this is going to feel when it is delivered.

“If you want to come up with a score to rate a mental health trust you need to look at where the majority of activity is. Ninety four per cent of the people we treat are treated in the community. The CQC’s inspection model has been largely a building-based model.

“If you seriously want to test the quality in mental health we need to work very hard to look at how we are going to inspect community services.”

Mr Dalton said he was “hopeful” given the CQC’s efforts to engage with the mental health sector, but added: “We will have to wait and see how it works out.”

Sussex Partnership Foundation Trust chief executive Lisa Rodrigues told HSJ: “I believe the CQC leadership is very aware of the risk relating to mental health services, but mental health and physical health have never had parity. We have to work together to achieve it.”

A CQC spokesman said it recognised “the concerns raised by the Mental Health Network” and appreciated that “how we regulate providers of specialist mental health services will need to be different to how we regulate other sectors”.

He added: “We are designing sector-specific methodology for mental health with a range of stakeholders, including NHS Confederation’s Mental Health Network. This will include an approach, which brings together our regulatory functions and Mental Health Act monitoring duties in an integrated way.

“We will launch a consultation for this at a later date, so that we can gather wider views on our proposals and ensure that the sector is regulated to the highest standard.”