Exclusive: CQC to get new powers through Health and Care Bill amendment

The pledge is made in a letter from the health and social care secretary to Health and Social Care Committee chair Jeremy Hunt.

The letter, seen exclusively by HSJ, said: “The committee proposed that [integrated care systems] should be held accountable for the quality and safety of care through transparent CQC assessments. My officials have been working closely with the CQC and NHS England to develop detailed proposals to include in the bill as an amendment.

“These new powers for the CQC are an opportunity not only to inform the public about the quality of health and care in their area, but also a way to review progress against our aspirations for delivering better, more joined-up care across ICSs.”

Currently the CQC can only review systems with permission from the health secretary and does not have the power to rate them.

Mr Javid also said his “officials are examining options” to implement the health select committee’s proposed creation of a UK-wide register of people who have sat on NHS boards, with the intention “to update the committee in due course”. The proposal was made partly in response to the scandal at Leicester City Hospitals, where the CQC could not take any action under its “fit and proper person” regulations as the people involved had already resigned.

New powers

Mr Javid also seemed to suggest he is willing to listen to wide-ranging concerns about the new powers to intervene in any local reconfiguration proposal at any time the health secretary deems fit.

He said: “Whilst the scope of the power as drafted is broad, we intend to set out further detail of how the process will work in practice and what is expected of all parties.”

On the power to direct NHS England, Mr Javid said it was needed to “ensure is NHSE is working effectively with other parts of the system,including social care and public health, to support integration and tackle broader priorities such as health inequalities.”

He added that the power could be used, “for example”, to request to see guidance developed by NHSE before it is published to ensure effective working.

Workforce shortages

Mr Javid knocked back proposals by the committee to include a duty in the bill that would require Health Education England to publish independent annual reports on workforce shortages.

He said: “We do not agree that a requirement in primary legislation to publish long-term workforce projections is needed in order to continue to invest [in workforce]”.

Instead, he confirmed a new duty would be introduced in the upcoming bill that would provide “clarity on the purpose and role of each organisation in the system on workforce planning” which would be set out in ”one document… to provide… accountability for actions”.

He also said the Department of Health and Social Care are working NHS England to “develop a set of criteria for… appointments [to the Integrated care boards].

The letter also said:

• Further guidance is expected on new discharge rules, which will protect the rights of carers when patients are being discharged to hospitals as well as outline which health and social care partners are responsible for which discharge roles.
• A framework setting out the roles and responsibilities of the integrated care board and the integrated care partnership will be include in statutory guidance.
• The new provider selection regime that is due to replace the current finance rules on competition will set out what information providers need to publish each year about the contracts they hold. This was in response to a request from the health select committee to establish a new DHSC framework to monitor new contracts on an annual basis.