CQC to target struggling providers with more unannounced inspections

Providers struggling to deliver good-quality care will be subjected to more targeted unannounced inspections as part of the CQC’s five-year strategy, launched today.

The regulator also said inspections will become “smaller and more frequent”, with the interval between them based on previous inspection findings – while newly registered providers will still be subject to comprehensive inspections.

The strategy, relevant from 2016 to 2021, seeks to make better use of intelligence from the public, providers, other regulators and oversight bodies in order to focus more tailored inspections where needed. For example, if there is a sudden spike in complaints or reports of poor care from a particular service, the CQC will target that provider for more unannounced visits.

Ratings will then be updated if the regulator identifies any changes in quality.

Similarly, this will also translate to longer intervals between inspections of services consistently rated as good or outstanding, as long as they continue to demonstrate good quality of care.

The body’s chief executive, David Behan, said: “We’re developing our approach to reflect changes in the sectors we regulate – effective regulation doesn’t occur in a vacuum.

“Inspection will always be crucial to our understanding of quality but we’ll increasingly be getting more and better information from the public and providers and using it alongside inspections to provide a trusted, responsive, independent view of quality that is regularly updated and that will be invaluable to people who provide services as well as those who use them.”

The regulator will also do more to help providers monitor and report their own quality, Behan said – a point initially floated in October when the CQC suggested moving to a co-regulation regime, where providers proactively self-assess care and report back on changes. This includes making it easier for providers to work with the CQC through online systems, for example.

The CQC boss also promised to work with national and local partners to “formalise the definition of quality and agree how we should measure it”, as well as develop a shared data set to ensure providers are only asked for information once.

“This will make it easier for health and care services to know what is expected of them and to report on it - and easier for people to know what to expect from their care,” Behan added.

Peter Wyman, the regulator’s chair, said this new and more streamlined way of working would help in reducing the CQC’s budget by £32m over the next four years.

In its strategy document, the inspectorate said it is currently piloting its approach to regulating independent doctors, and will publish its approach to regulating these types of services during 2016-17. It is also currently developing an approach to regulating digital healthcare.

Overall, the CQC aims to begin implementing aspects of its new approach from April 2017 after it completes its current programme of comprehensive inspections, which has been running behind target for some time.

The revised strategy has been welcome so far, with Miriam Deakin, head of policy at NHS Providers, saying the changes will “greatly improve confidence in the quality of care”.

“NHS Providers has long called for a more proportionate and risk-based approach to regulation,” she added. “Trusts will also recognise changes prompted by their feedback about improving the use of data to target the CQC’s resources. We are particularly pleased to be engaging with trusts and the CQC as it develops its ‘single shared view of quality’ and the new use of resources measure with NHS Improvement.

“The CQC will no doubt wish to focus its energies on translating the principles set out in the strategy into actions which feel different at the frontline for providers – and ultimately for patients. In line with its strong tradition of engagement with the provider sector, we look forward to working with the CQC as it makes this strategy reality.” 

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