The independent regulator of health
and social care in England

Update from CQC

1 August 2024

A regular update for providers and professionals working in healthcare services

Update on our frequency of planned assessments

Latest updates on paper tab

Earlier this year, we said that we intended to publish information in July about our expectations of the frequency of planned assessments, and an indication of a date by when we will have updated all ratings for all providers. Due to the publication of the interim findings of the Dash review, we will not be able to share this information as planned.

The interim findings of the Dash review made clear recommendations for how we need to change how we work with you, and we have committed to making those changes. It is vital that information we share with you and the targets we set are realistic and achievable, and that we have involved providers, the public and our colleagues in our decision making. We will publish an interim statement in August about how frequently we plan to assess each type of service. We will then publish more information on this in September.

We have listened hard to providers in recent weeks, and so we are able to confirm our intention to work with providers, people who use services and our colleagues in the coming months to develop a new CQC handbook for all providers. We will work together to shape this. So far, we have heard that this handbook needs to explain what providers can expect from an inspection, what customer services standards you should expect from CQC, and how we can together reach a shared understanding of what ‘good’ looks like for different service types. Look out for more detail on this soon, including how you can get involved in this work.

A message from Kate Terroni, Interim Chief Executive, CQC

Interim Chief Executive, Kate Terroni, wrote to all providers last month to apologise about the things we have got wrong in the implementation of our new regulatory approach. She also shared her urgent and immediate priorities to address the issues and get back on track.

We'd really like to hear your thoughts on whether this message from Kate adequately reflects your feedback, comments and concerns and whether the actions we are proposing feel like the right ones.

Share your views through this short survey.

Observing and Improving Culture in mental health inpatient services

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As part of our public commitment to respond to the closed cultures identified in some mental health inpatient settings, we are piloting our framework for Observing and Improving Culture at a small number of assessments in mental health services between August and December.  

The purpose of the framework, which was developed through extensive external engagement with clinicians, partners, providers and people with lived experience, is to support the identification of closed cultures through observing and speaking with people.

This work will be carried out as part of the wider CQC assessment in each service and by trained staff with a background in mental health inspection. We will report on the findings within each service report as well as more broadly after completion of the programme.

Notifications

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Registered providers must notify us about certain changes, events and incidents that affect their service or the people who use it. Incidents which must be notified to us are defined in the Care Quality Commission (Registration) Regulations 2009. The regulations and associated guidance can be found on our website.

This means, for example, the recent IT outage will require a notification if you were not able to continue to deliver regulated activities safely. If there are contingency arrangements which mean a notifiable incident has not occurred (there is no evidence of impact or risk of impact on safely providing a Regulated Activity) then a notification is not required as the threshold for what constitutes a notifiable incident will not be met. 

If a notification is made using the Learning from Patient Safety Events (LFPSE) service a separate notification to CQC is not required.  

Testing sites announced for our integrated care systems (ICS) engagement and inequalities improvement framework

Four ICSs have been chosen to test a framework developed by CQC, National Voices and the Point of Care Foundation. The improvement framework will enable ICSs to understand how well their engagement with people and communities is helping to reduce health inequalities.

Work to develop the framework began in February 2024 and is supported by a grant from the Regulators' Pioneers Fund. National Voices and the Point of Care Foundation led the recruitment of ICSs through an open applications process. They received expressions of interest from 11 ICSs and selected 4 for testing:

• Black Country ICS
• Gloucestershire ICS
• Hampshire and Isle of Wight ICS
• Nottingham and Nottinghamshire ICS

The successful ICSs were selected to ensure a mix of demographics, geography, level of deprivation and experience in addressing health inequalities. The testing phase will take place during the autumn.
If you would like more information about the project, or how we are involving ICSs and other stakeholders, please visit our website or contact ICShealthinequalities@cqc.org.uk. 

Other news

• For several years we’ve been using an online platform to engage with the public, providers, and other strategic stakeholders. We use the platform to gather feedback through online surveys and encourage people to share their ideas and experience on a range of topics. Formerly called CitizenLab, this platform has rebranded and is now known as Go Vocal. This is just a visual change – the features and functionality remain as they were – but you may notice a new logo and a change in how we talk about the platform.

• The Equality and Human Rights Commission (EHRC) currently has a focus on health inequalities, including in maternity care. They have published a policy briefing about using equality data to understand and tackle race inequalities in maternity and antenatal care. The briefing examines how collecting and using equality data can promote patient safety and support service improvements, particularly for women and babies from ethnic minority backgrounds, and sets out a range of recommended steps. The EHRC hopes the briefing will be useful for people working in a range of health bodies, whether they are practitioners, service managers, policy makers or they have a strategic focus.

• The Patient Safety Commissioner has launched a public consultation on draft principles which will to act as a guide for senior leaders in how to deliver safer care for patients and reduce avoidable harm.