On 7 January 2021, CQC published a consultation paper on its proposed strategy for the next five years, “The world of health and social care is changing. So are we.”
What is proposed is a radical change in the way CQC regulates the care sector. To a significant degree, it is informed by the new remote and virtual ways of working that CQC has had to deploy due to the pandemic.
CQC says that it wants “to move away from relying on a set schedule of inspections to a more flexible, targeted approach.” Instead, CQC intends to focus on collecting up-to-date, high-quality information about registered services which will enable regulation to be more dynamic and responsive. For example, continuously assessing quality will enable ratings to be changed more regularly, without the need for a comprehensive or focused inspection.
It is apparent that the typical site visit will take the form of a targeted inspection, given there will be regular contact with each service as part of an ongoing and collaborative relationship. A far greater focus will be placed on “monitoring and analysing data using technology”, including the use of Artificial Intelligence.
CQC adds that it wants to “regulate in a smarter way by providing a clearer definition of quality and standards people can expect, which is based on what people say matters to them.” This would seem to indicate a move away from the current Key Lines of Enquiry which have formed for basis of performance assessing services since 2015.
There is also a reference to the ratings evolving over time to “reflect how people experience care so they’re more meaningful and focus on what matters most to them.” CQC is being deliberately vague here, suggesting its thinking has not crystallised on what a new rating framework might look like. There has been talk at CQC board meetings of rating the culture of a service given its concern about the risk of closed cultures in the care sector.
In addition, CQC proposes taking on a system-wide approach to regulation across local areas, acknowledging “it’s not enough to look at how one service operates in isolation.” There is also a focus on using regulation as a tool to reduce health inequalities.
What is missing from the consultation is any proposal to hold local authority and NHS commissioners to account for the quality of care. It is difficult to see how quality can be improved across systems if commissioners are not the subject of scrutiny by CQC or some other body.
Providers have until 5pm on 4 March to respond to the consultation.
About the Author
Partner & Health and Social Care Solicitor
D.D: 01483 366069
Tel: 01483 451900
Email: neil@gordonsols.co.uk