- In our 2023 regulation survey, and in subsequent discussions with us, trust leaders shared a range of concerns they had about the approach the Care Quality Commission (CQC) has taken to quality regulation in recent years.
- In response, we set out to identify the characteristics of good quality and safety regulation, and to explore how CQC’s approach could become more supportive and constructive in the future.
- Our research has identified that by focusing on the right-touch regulation principles of proportionality, consistency, targeted nature, transparency, accountability and agility, and the concept of responsive regulation, CQC could build its credibility with the provider sector and regain its trust.
- Trust leaders fully support CQC’s role in assuring the quality and safety of services, and believe regulation is an essential element of a high-performing health and care sector.
- However, they believe CQC could be doing more to support providers to improve and innovate, by sharing good practice, focusing conversations on improvement and even by helping trusts build connections with their peers.
- Our interactions with members highlighted the importance of consistent, stable and trusting relationships between the regulator and providers at a local level.
- Unfortunately, trust leaders flagged variable quality of these relationships, and variable experiences of CQC’s regulatory activities, including its inspections, reports and ratings. They also reflected on the negative impact that these sometimes had on their staff’s morale, recruitment and retention, as well as on public perceptions.
- Overall, providers support the changes CQC is introducing to its regulatory approach, with the launch of its new single assessment framework and the potential of its new system assessments. However, trust leaders are keen to see how this potential will be realised in practice.
- This report makes 10 recommendations for how CQC could modify its approach, or build on progress currently being made. Taken as a whole, these recommendations could help CQC add value to trusts and the services they provide, and may also improve CQC’s relationship with providers, and enhance their confidence in its activities and outputs.