The Care Quality Commission (CQC) has published its interim guidance for assessing integrated care systems (ICSs), with ICSs set to receive ‘outstanding’ or ‘requires improvement’ ratings.
The new framework – which is yet to be approved by the health secretary Steve Barclay – has set out the regulatory body’s key areas of focus and means of evidence gathering.
Overall ratings will also use the CQC’s 4-point rating scale, from ‘outstanding’ to ‘requires improvement’.
However, the score will offer more detail, indicating if an ICS is in the ‘lower or higher threshold’ of its band.
In its framework, it said: ‘For example, if an integrated care system was rated as good, the score will tell us if this is in the upper threshold of good, nearing outstanding. Similarly, if an integrated care system was rated as requires improvement, the score would tell us if it was at the lower or higher threshold, so nearer to inadequate or good.’
From April, the CQC will begin to form a ‘national view of performance’ focusing initially on equity in access, intended to show how ICSs are acting on health inequalities and improving patient access to services.
The CQC has also said it intends to pilot its approach in a handful of ICSs before it formally rolls out assessments for all systems.
According to its latest update, the CQC will consider an ICSs’ effectiveness in its:
- Arrangements for place-level working within the system
- Variations in service quality
- People’s experiences
- Health inequalities and population health outcomes, and wider determinants of health across the system.
It will also consider the quality and integration of health care and adult social care – as required by the Health and Care Act 2022 – and the ‘core purpose’ of ICSs, including value for money.
The CQC will also look at six evidence categories, including:
- People’s experiences using services, sourced form interviews, feedback forms and surveys
- Staff and leader feedback, pulled from interviews, concerns raised and self-assessments
- Partner feedback, offered by commissioners, providers, royal colleges, and those involved in wider detriments of health such as housing
- Observation, including case tracking
- Processes, or the steps taken to deliver care
- And outcomes, with a particular focus on impact on individual people and communities.
The CQC said in its framework: ‘As part of our assessments, we will consider evidence of the quality of health and care services provided across the area of each integrated care system alongside other evidence of the outcomes of system working. Ratings of individual providers will not directly determine the outcome of an integrated care system assessment, but will form part of the evidence we use for assessments.’