CQC quality ratings should be adopted across NHS to improve care

The CQC has proposed that its ratings system should be adopted system-wide across health and social care providers and management organisations, including by NHS England, the GMC, practices and CCGs, ahead of another overhaul to its regulation processes.

The CQC's Shaping the Future report proposes how it will overhaul its regulation process over the coming five years to adapt to rapid change in the UK’s health and social care system – including new models of care and GP federations.

The watchdog said it will develop a more flexible, broader approach to registration to accommodate these new and varied models of care when it launches its new approach this May, 19 months after it implemented its Ofsted-style regime in October 2014.

The CQC plans to achieve this with ‘fewer resources’ as the DH prepares to pull the grant-in-aid it currently relies on. The CQC has announced that it will hike up provider fees to mitigate this loss of funding, triggering a seven-fold fee increase over the next two to four years for GP practices.

CQC ratings system

A key element of the proposals is to ‘implement a single shared view of quality’ across the healthcare system as a whole.

The CQC hopes to have its framework of quality – centred on the five key questions it asks about every service: Is it safe? Is it effective? Is it caring? Is it responsive? Is it well-led? – implemented across the whole healthcare system by all providers and oversight bodies, including NHS England, CCGs, local authorities and the GMC.

Such a move will support providers to ‘understand their own quality and identify necessary improvements’, reduce duplication and make the oversight system more efficient, it claimed.

It would also help pave the way for providers to play a more active role in assessing their own quality alongside the CQC, as previously alluded to by chief inspector Professor Steve Field. He told GPonline that high-performing practices would be visited less often by inspectors, instead providing the CQC with information ‘in a form of co-regulation’.

NHS quality data

With this approach, information from across the healthcare system gathered by different organisations could be better compared and shared by CQC and others.

GPC deputy chairman Dr Richard Vautrey said adopting a common system of quality across the system was ‘sensible in principle’, but it must not be allowed to put an extra burden on GPs.

‘It’s very clear that the profession has concerns about the current arrangements,’ he said. ‘There is huge bureaucracy and cost burdens on GPs – we really need to see a reduction in all of those things so practices can concentrate on looking after patients.

‘I think having a common system so everyone knows what is expected is sensible in principle. But we’ve seen some examples of practices being visited or asked for information on top of inspections, which just puts more of a burden on practices.’

CQC chief executive David Behan said: ‘We’ve radically changed the way we regulate over the last three years – these changes are driving improvement in the quality and safety of care, highlighting "good" and "outstanding" care and protecting people from poor care.

‘Now we need to further develop our approach, adapting to changes in the way health and care services will be provided in the future, while improving our efficiency and effectiveness. The landscape is changing – and we can’t stand still.’

The watchdog is now seeking feedback on this ‘proposed vision’ for the future of regulating health and social care. The consultation will run until midday on 14 March 2016, with the final strategy to be published in May.

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