Professor Sir Mike Richards, Former Chief inspector of Hospitals at CQC (2013 to 2017), has conducted a review of the Care Quality Commission’s single assessment framework.
CQC commissioned the review to complement the report by Dr Penny Dash, which looked at changes CQC made following the publication of its new strategy in 2021 and their impact.
The transformation programme that followed the 2021 strategy had 3 key elements:
- An organisational structure
- Introducing the single assessment framework across all the sectors that the CQC regulates
- And the development of a new IT system.
In his review, Professor Richards stated: “These 3 initiatives are clearly interlinked, but this review has shown that all 3 have failed to deliver the benefits that were intended, despite being initially welcomed by providers.”
In turn, this has meant CQC has been unable to fulfil its primary purpose “to ensure health and care services provide people with safe, effective, compassionate high-quality care and to encourage these services to improve.”
Key recommendations are as followed;
- Organisational Reset:
- Fundamental reset of the organisation, similar to 2012/13
- Reinstate previous organisational structure
- Disband current Operations directorate, reform into sector-based inspection directorates
- Leadership and Staffing:
- Appoint at least 3 permanent Chief Inspectors for sector-based inspection directorates
- Consider appointing a fourth Chief Inspector for mental health services
- Review staffing levels and pay scales in inspection directorates
- Address staffing shortages, especially in hospital and primary care inspection programs
- Inspection and Assessment:
- Reinstate ongoing relationships between inspection staff and providers
- Modify aspects of the single assessment framework
- Suspend and potentially scrap evidence categories and scoring system
- Prioritise use of data to inform judgments
- Incorporate existing datasets from NHS England and associated bodies
- Review priorities for inspection within healthcare sectors
- Collaboration and Improvement:
- Work closely with adult social care leaders and healthcare providers to improve assessment approaches
- Reintroduce more peer review in the process
- Address registration backlogs urgently
- Reconsider the use of "one-word ratings" and their relevance to service users
- IT and Data:
- Simplify assessment framework to potentially resolve IT system issues
- Establish new data sharing agreements between national bodies.
These recommendations aim to improve the organisation's effectiveness, enhance inspection processes, and better align with the needs of both providers and service users.
Read and download the full report here:
