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NHS Improvement and CQC outline how they will work together

NHS Improvement and the CQC will be teaming up in drafting a single national framework under which both bodies will operate, their chiefs have said in a letter to the leaders of trusts and foundation trusts today (15 January).

The letter, signed by NHS Improvement boss Jim Mackey and chief inspector of hospitals Prof Sir Mike Richards, said the organisations will base their framework and inspection regime on the principle of balancing quality with cash savings.

“We want to start off by being clear that, from our perspective, quality and financial objectives cannot trump one another. We know that, in the past, there was a perception that delivering financial targets was more important than delivering the right quality outcomes; and that, more recently, improving quality was more important than staying in financial surplus,” the letter said.

“We want to clearly and unequivocally state, with the full support of our other arms’ length body colleagues, that your task as provider leaders is to deliver the right quality outcomes within the resources available.

“That is how we will both measure success and that is how the NHS Improvement regulatory framework and the CQC inspection regime will be framed going forward.”

To build on this shared principle, the two bodies will aim to deliver a “single clear, consistent message”, moving away from past perceptions that they had “greater focuses on different sides of the quality/finance balance, potentially creating unhelpful mixed messages”.

They will jointly design the approach the CQC will use to evaluate trusts’ use of resources, as well as look at how the inspectorate can use financial data held by NHS Improvement and the expertise of its staff to judge this use.

NHS Improvement’s view of the role of quality in its new single provider regulatory framework will also be created jointly with the inspectorate and NHS England. As they come together, both bodies will start using a new metric looking at care hours per patient, to be used in assessing how trusts manage staffing resources.

“In practical terms, we want regulators and commissioners to rely on each other’s work, rather than duplicating effort, and we want to create a single unified framework with a single way of measuring success that we all use,” Mackey and Sir Mike added.

“We want this to bring greater clarity and consistency and reduce the regulatory burden, as you have asked for.”

The two organisations will also be working together on turnarounds, with NHS Improvement beginning to work with organisations deeply in the red to help them stabilise their cash pots. Alongside the CQC, it will strive to show trusts that, even for those facing “some of the biggest financial challenges”, it is still possible to find a balance between money and quality.

The letter also asks that its recipients – including the CEOs, financial directors, medical directors and directors of nursing across providers – inform NHS Improvement and the CQC of what the bodies must do differently to “secure the right finance/quality balance that we all need” during times of greater economic rigour.