The CQC has launched a consultation on proposals to improve its assessment of health and care services.
The proposals aim to create a ‘clearer, simpler, and more trusted framework’, according to CQC, as well as improve the timeliness of its inspections and the clarity and impact of its inspection reports.
It comes after CQC’s chief inspector of primary and community care revealed that a ‘revamped’ assessment framework would be launching in mid-2026.
The changes include developing sector specific frameworks, tailored to a specific sector so providers can ‘better understand our expectations’, and more simplified content (see box for details).
Quality statements will also be replaced with assessment questions under the changes, and rating characteristics will be reintroduced to provide clear descriptions of what rating levels look like in practice.
The consultation document also identified the CQC IT systems as a barrier to improvement.
The document said: ‘We know that our current IT systems need to better support our internal colleagues as well as providers and stakeholders.
‘We will develop and roll out replacement functionality to support our regulatory functions, including our assessment process over the coming months.
‘As part of this work, we will redevelop the provider portal functionality and our registration systems, acknowledging feedback about the significant improvements we need to make.’
The CQC has been under scrutiny over the past year, with a review, led by now NHS England chair Dr Penny Dash, finding ‘significant failings’ in the CQC.
The review recommended that it rebuild its expertise, concluding: ‘There is an urgent need to appoint highly regarded senior clinicians as chief inspector of hospitals and chief inspector of primary and community care.’
The Dash review also suggested that ICBs be ‘explicitly’ tested by the CQC on listening to communities and ensuring their plans include this input.
The consultation is open until 5pm on 11 December.
Sir Julian Hartley, chief executive of CQC and Professor Sir Mike Richards, chair of CQC, said in a foreword to the consultation: ‘This consultation, and the engagement that sits alongside it, is a pivotal opportunity for us to listen to you. Every response provides an opportunity for us to deliver better regulation, and we will be carefully considering all responses.
‘We may not be able to act on every element of your feedback, but it is critical that we deliver this change in a way that works for our stakeholders, and we are committed to explaining how we are acting on the feedback we receive.’
What’s changing?
The proposed changes fall into 2 main areas:
Developing our frameworks and guidance for assessing providers
- Re-introducing rating characteristics
These are clear descriptions of what each rating level (such as good or requires improvement) looks like in practice. They will help to provide a better understanding of what each rating means. - Replacing quality statements with assessment questions
These questions will be similar to the previous key lines of enquiry (KLOEs) and will support the rating characteristics by guiding how we assess quality. - Developing sector-specific frameworks
These will include detailed content and guidance tailored to a specific health or care sector, so providers can better understand our expectations for their sector, as well as consistent core content that would be included across all frameworks. - Simplifying the content of the frameworks
We’ll remove duplicate or overlapping content and make the language clearer and easier to apply in practice.
Improving how we assess and rate providers
We are also proposing changes to simplify how we make judgements and award ratings, including strengthening the role of professional judgement.
- Making judgements at the key question level
We propose to make judgements directly at the key question level with reference to the rating characteristics. We will no longer award lower-level scores to drive our key question ratings. - Potential changes to how we rate NHS trusts
Specifically, we are asking for feedback on:- Re-introducing an overall quality rating for each NHS trust
- Introducing trust-level ratings for all 5 key questions
- Whether to remove location-level ratings.
Source: CQC
