The Care Quality Commission (CQC) introduced a new approach to inspecting and rating health and social care providers starting in 2013. The change was triggered by numerous prominent failures of care that raised questions about the CQC’s aptitude and skill to identify and act on poor performance. The new approach appears more in-depth and carried out by specialist, expert teams and produces ratings and an inspection report for each provider. The new approach was extended to other parts of the health and social care system in 2015 and continues to progress. The CQC’s amended strategy for 2016–21 plans for further developments to their model.

An interesting and major evaluation of this approach has recently been published by the Alliance Manchester Business School and The King’s Fund. The evaluation was funded in whole by the department of health’s policy research programme.

One of the outcomes of the evaluation, was the creation of a new framework for understanding the impact of regulation. The framework outlines 8 ways in which CQC regulation directly impacts on a provider’s performance. These impacts have been highlighted to occur before ,during and after interactions between the CQC and providers. The 8 impacts are described below.

The evaluation looked at the inspection and ratings model over 4 different sectors within health and social care, within a 3-year period(2015-2018).

What was found is examples of all 8 types of impact with higher prevalence in some areas and some differences across the 4 sectors. With the new approach of inspection finishing its first cycle in 2017 CQC are now implementing a revised approach. The evaluation highlights some key issues to consider as the development of the regulatory model continues.

The research used both quantitative and qualitative methods .This included 170 interviews with a wide range of staff from health and social care organisations, CQC, service-user groups as well as other key stakeholders.Intelligent Monitoring (IM) datasets (a large set of routine performance indicators that CQC used to risk assess organisations and to help them decide when to inspect a provider and what to focus on) were also used.

Key Suggestions/Outcomes

• There needs to be greater emphasis on relational and systemic elements to the inspection and regulatory approach.
  
• The relationships between CQC staff and health and social care professionals and managers profoundly affect the way regulation works .The relational element contributes significantly to the variation in providers’ experience of inspection. New developments planned for 2016-2021 will provide more emphasis on the relational impact.
  
• It was generally accepted and supported, that there is a need for regulation and the new approach has been an improvement on the previous system of regulation and inspection.
  
• Inspections and subsequent ratings have governed the CQC’s model, consumed most of its resources and possibly thwarted other potential activities that may have more impact.
  
• The inspection model evaluated focussed heavily on individual providers. As health and social care becomes more integrated the need to adapt the approach will inevitably have to follow.
  

Read the full report here……….

https://www.kingsfund.org.uk/sites/default/files/2018-09/cqc-provider-performance-report-september2018.pdf

Josie Winter Clinical Director
josie@advancedclinicalsolution.co.uk
01633 415 427


Advanced Clinical Solutions

We support health & social care providers to create an environment for success by empowering the whole care team and developing health and social care quality improvement skills and capabilities. We encourage collaboration across the team and the increased use and sharing of established improvement tools, techniques and knowledge