- New CQC assessment frameworks to be rolled out immediately with first new style inspections beginning in September
- Consultation responses reveal concerns that financial and commissioning pressures are limiting providers’ “ability to improve”
- CQC said it “cannot compromise” care quality standards but will use place based reviews to see how health and social care can better work together
The Care Quality Commission will roll out its new inspection regime immediately despite concerns from providers that “scarce” resources are effecting their “ability to improve”.
The regulator received 500 responses, the bulk of which came from health and social care providers, as well as members of the public.
A summary analysis report commissioned by the CQC and produced by consultancy firm OPM Group said: “Consultation responses often mention the funding and commissioning context, which they argue affects providers’ ability to improve. Respondents highlight the pressures experienced by local authorities and care providers to deliver sufficient care, while resources are often scarce, and ask the CQC to be mindful of this when requiring providers to change”.
It added: “Some respondents emphasise that decisions about funding and commissioning are outside their control, as well as outside the CQC’s reach”
The CQC’s response said: “While we understand the pressures that providers face, the CQC’s focus is on the quality of care for people who use services, and we cannot, and will not, compromise our standards on this.”
The report also found less than half of respondents (45 per cent) felt the CQC’s new inspection methods would “enable the development of new models of care and complex provider”. But only 11 per cent explicitly thought it would prevent them from doing so, with the rest neither agreeing or disagreeing.
The document said: “Above all, respondents urge the CQC to increase its efforts to work with local authorities and their commissioning groups, as they perceive the commissioning of health and social care to be instrumental to the sector’s potential to improve care quality.”
While the CQC’s plan to have only two assessment frameworks – one for healthcare and one for adult social care – was welcomed by 71 per cent of respondents, questions were raised about how the separate frameworks will enable greater alignment between health and social care and fit in with new care models.
The regulator said it will use its 20 placed based reviews, due to begin this year, to “look at how health and social care work together, and what improvements could be made to benefit people who use services”, and ease “continued pressures in the health and social care system”.
The CQC also revealed its timetable for rolling out the new inspection regime and provided details about its data collection plans. The consultation report said:
- The CQC will inspect each organisation on how well led it is each year along with an inspection of at last one core service.
- The new approach to inspections will be “fully embedded by spring 2019” with the first of the new inspections taking place between September and November 2018, and new shorter reports being published by early 2018.
- Revised inspection frameworks with changes to key lines of enquiry will be used from this month for NHS acute, community and ambulance trusts. From November, they will be rolled out for NHS GP practices, out of hours and 111 services.
- The CQC will only inspect all core services offered by the provider once a year if the provider is rated inadequate. It will rate half of those at providers rated requires improvement; a third of services at providers rated good; and a fifth at outstanding providers. The consultation said the “selection of core services to inspect will also reflect areas where we or the trust have identified new risks or improvements”.
- The CQC Insight data tool for acute trusts was piloted earlier this year but the CQC is yet to reveal the metrics used. A pilot for a mental health data tool is due to finish soon.
- CQC Insight will track risk in providers and initially only collect existing national data. “Over time” additional data will include “qualitative analysis” of information from staff and patients. The CQC is in talks with NHS Improvement and the Department of Health about how to align or reduce the cost of new data collections.
- Between June 2017 and autumn 2018 providers will receive their first new “provider information request”, which will include a self-assessment of how well the provider believes it is doing alongside data requests. Thereafter updates will be requested yearly. Inspections will normally be scheduled within six months of each new request, though the majority will be unannounced.
- The CQC will report on whistleblowing disclosures from April 2017 onwards with the first disclosures being reported in its annual report and accounts for 2017-18.
The CQC also announced two new consultations yesterday. One looks at how it will regulate primary care, inspect new care models and review its role in the fit and proper person regulations.
The other is due out later this financial year and will discuss proposals on how the CQC will regulate and rate independent healthcare services from 2018-19.
The CQC and NHS Improvement’s joint response to the consultation on its approach to assessing leadership and use of resources by trusts will be available later in the summer.