Between December 2016 and February 2017, we consulted on how we should develop and evolve our approach as we implement our strategy and move into the next phase of our regulatory approach.
This was the first of three Next Phase consultations and focused on our principles for regulating new models of care; changes to our assessment frameworks; strengthening our guidance on registering services for people with a learning disability and/or autism; and changes to the way we regulate NHS trusts.
Alongside our response to the first consultation, we are providing information and guidance relevant to your sector including:
What did respondents tell us?
Overall, respondents to the consultation were supportive of our proposals. There was general confidence that our proposed changes could improve the regulation of care services, and ultimately the quality of care. The feedback from respondents produced a number of themes across the consultation:
- the need to ensure clarity, consistency and transparency in implementing the change
- the need for flexibility in our approach, avoiding a one-size-fits-all approach in our processes and methods
- the need for proportionate regulation and closer and more collaborative working with other organisations at local and national level.
What changes should providers be aware of?
Changes to our assessment frameworks for NHS trusts
We have simplified our assessment frameworks to help complex providers and those with more than one type of service. The 11 separate frameworks for healthcare services have been merged into one, and the two frameworks for adult social care have also been merged into one. We have also aligned, as much as possible, the wording of our Key Lines of Enquiry and prompts between the two assessment frameworks.
We include new content to strengthen specific areas and reflect current practice, and we have improved the wording to simplify the language to aid clarity and understanding. We have also highlighted the changes to help providers who use the frameworks for their own internal assessment and training purposes.
Implementation of assessment frameworks and new approach for NHS trusts
We will introduce our new assessment framework and approach for NHS trusts from the second half of June 2017. This means that the first new provider information requests (PIRs) will be sent at that point, the first internal regulatory planning meetings will take place from August, the first next phase inspections will take place between September and November 2017, and the first next phase ratings and inspection reports will be published in early 2018.
We plan to roll out our approach slowly to help us evaluate, improve and refine our approach and we intend to fully embed the approach by spring 2019, by which all trusts can expect to have an assessment of the well-led key question and at least one core service inspection approximately once each year.
Updated guidance for providers online
We have restructured the Guidance for Providers section of our website in response to feedback we’ve received over the past two years. Choose your sector from the main Guidance for Providers page to see the information that’s relevant to you.
Today, 12 June 2017, we have launched the second consultation on our proposed changes, which seeks views on specific proposals for how we will:
- improve the structure of registration and clarify our definition of registered providers
- monitor, inspect and rate new models of care and large or complex providers
- use our unique knowledge to encourage improvements in the quality of care in local areas
- regulate primary medical services and adult social care services
- carry out our role in relation to the fit and proper persons requirement.
We want to keep the elements that we know people value, and to improve what people tell us we can do better. We will continue to work with people who use services, providers, professionals and our other local and national partners to co-produce what we do.
You can respond to this consultation until Tuesday 8 August via this online web form.
What proposed changes are we seeking views on?
The structure of registration, and clarifying how we define providers
We propose to:
- develop our register so that it properly informs the public about ownership of providers, what services are provided, to whom and where to find these services
- clarify who is required to register with us, so that we can hold to account all of those who are accountable for quality and make sure they improve quality across their services
- improve our understanding of large and complex organisations so that we can take a more targeted and responsive approach to regulation
- re-structure our approach to registration so that we hold more information about different types of services and so that we can make it easier to register new organisational forms and innovative types of services.
How we monitor, inspect and rate new models of care and large or complex providers
We propose to:
- identify a single CQC relationship-holder for each complex provider, who will work alongside named leads for each type of service to coordinate our regulatory activity for that provider
- align the way we collect information from providers and combine our monitoring information to inform a single regulatory plan
- coordinate our inspection activity within a defined period, except for any focused inspections in response to concerns about quality in individual services
- assess leadership and governance across all services when we assess the well-led key question in NHS trusts, and in any future provider-level assessments in other sectors
- test this approach, including with a small number of accountable care organisations and systems.
How we use our unique knowledge to encourage improvements in the quality of care in local areas
We propose to:
- use our monitoring and inspections of individual providers to assess how well services are working together and to understand the impact on people’s experiences
- use our insight about quality in a place to help us understand the context in which providers are working
- use our independent voice and relationships with national, regional and local partners to share our view of quality across health and social care and to highlight cross-system issues
- undertake a small number of targeted local area reviews to help system partners identify opportunities to overcome barriers to improvement.
How we carry out our role in relation to the fit and proper persons requirement
We propose to:
- send all information of concern that we receive from a third party to the provider and ask them to set out their current processes. We will assess the information and, where necessary carry out an investigation and assessment.
Get in touch with us
You can share your views with us by responding to the consultation via the online webform on our website.
If you have any questions about this consultation, please contact us via email.
Keep up with our work on the next phase by following us on Twitter @CareQualityComm and #CQCNextPhase.