The CQC is changing how it regulates care services, with longer more thorough inspections planned. This briefing outlines our response to its proposals.
The Care Quality Commission’s (CQC) consultation document A New Start implies a determination from the CQC to return to the more targeted scrutiny of its earlier incarnations, as well as to refine and improve its surveillance and inspection methods.
In part the plans are informed by the Nuffield Trust’s report: Rating providers for quality: a policy worth pursuing? published in March 2013 at the request of the Secretary of State for Health.
We welcome the CQC’s decision to continue investigating whole systems and care pathways. Very often the most important areas to address for good quality care are at the interface between care providers
Our response endorses the emphasis on specialist inspection, but we note that the process of defining standards of care and tightly assessing providers for whether they deliver could well increase the number of NHS organisations perceived to be at risk of failing.
Recent furores surrounding Bruce Keogh’s review in the media and parliament demonstrated that the findings from inspections can be used by politicians seeking electoral advantage. If it is to command trust in such a fraught climate the CQC will need to be prepared to stand by its assessments, as well as be open in cases where the process of inspection fails to unearth failures of care.
We also point out that in the context of a new single failure regime, the stakes for trusts deemed to be inadequate will be high. The first wave of trusts will be going into their inspections blind and this risks a protected debate about process and methodology.
In the interest of fairness, there should be an opportunity for stakeholders to craft and comment on inspection standards before providers are issued with ratings (albeit shadow ones) that could unduly influence their reputation for years to come.
Nuffield Trust (2013) Changes to the way the CQC inspects, regulates and monitors care. Briefing.