COVID-19 new phase of regulatory activity
Colleagues
I wanted to let you know that from today we have decided to begin a new phase of our regulatory activity in response to COVID-19. Subject to the Secretary of State's approval, we will move from conducting routine inspections to focusing on more responsive and targeted ways of supporting providers to keep people safe.
We have a responsibility to make sure that all services across health and social care are safe – but we are also acutely aware of the requirement to balance this duty with the need to allow providers to focus on delivering care and not add to the pressure they are already facing.
Our primary objectives during the period of the COVID-19 pandemic will to be to support providers to keep people safe, and to provide government, decision-makers, and local and national partners with an accurate picture of pressures being faced on the ground to inform national response and planning.
Routine inspections to cease
As a result, we will be stopping routine inspections from today Monday 16 March. Instead we will be moving towards a new way of providing assurance to the public, government and parliament on the safety of services. It may be necessary to still use some of our inspection powers in a very small number of cases when we have clear reports of harm, such as allegations of abuse. However, inspections (and provider information requests for health services) will not be conducted in their present form during the period of the pandemic.
In adult social care, in the absence of a single national oversight body, CQC will act as a support for registered managers – our inspection team will be there to provide advice and guidance to the providers throughout this period, and will be implementing the following:
- Continuing the use of provider information returns (PIRs). However, we will not penalise providers for the late return of PIRs
- Sharing the information we collect with local authorities and clinical commissioning groups in order to reduce reporting burden
- Using PIRs as a key way to learn about the impact of COVID-19 on providers’ operational business and using this information to raise concerns and prompt action from government.
Developing our interim regulatory methodology
We are urgently developing an interim targeted methodology which will enable us to provide assurance on safety and risk during the outbreak, and for a period of time afterwards. This revised methodology will shift the emphasis from inspection to a broader regulatory approach which can be delivered remotely if necessary.
We are developing this at pace and will be talking to providers, stakeholders and the public to ensure that we can continue to use our unique oversight of the health and social care system to help government target support most effectively. The role of regulation will change fundamentally during this period – acting as a source of intelligence and conduit between health and social care will be an important part of what we do for the next few months.
How will the new methodology work?
At two full-day workshops last week, over 70 colleagues from all directorates met to answer a fundamental question: How do we ensure we can continue to deliver our purpose in light of COVID-19 if we have:
- A reduction in our own capacity due to colleagues being absent or seconded out to health and care services?
- A reduction in the capacity of providers to provide information?
- A commitment to ensure the safety of our own people, and of service users, by not being a conduit for the spread of the virus?
The answer, developed by colleagues, was that we should focus our efforts on safe care, infection control and governance and develop a set of questions around Regulation 12: safe care and treatment and Regulation 17: good governance. (And the decision framework developed in Registration for COVID-19 applications aligns well with this as the focus is on safe and well led.)
Work is progressing to develop the questions and how we score against them. The intention is that we will develop an application that will allow us to ask the questions of providers, primarily over the phone, but, if necessary, face-to-face. The answers would be captured in a database that would provide us with a regulatory response that we would be able to share with providers quickly. We would not be producing a written report and it would not affect their rating. However, if we have concerns, it may trigger an inspection or we would work with local authorities if there was a safeguarding concern.
The voice of people who use services will still be important and will still be captured in our existing system. This information would be used alongside the information from the new streamlined methodology to give us a picture of a provider.
We are also developing risk-based measures so we can prioritise inspection activity.
Due to our unique oversight of both adult social care and independent health sectors, we are also developing a separate tool to pull the information from the new database so we can share an overview both with the sectors and also across the health and social care system.
We see this as a positive step towards developing a new, more responsive approach that helps us maintain oversight of the safety of health and social care services, while acknowledging that we are all operating in exceptional circumstances. We are also seeing this as an opportunity for learning to influence longer term development of our regulatory approach.
What will this mean for operational colleagues?
As I have said above, our ASC inspection teams will be there to provide advice and guidance to providers throughout this period. Ted Baker, Chief Inspector of Hospitals, is leading work to look at the impact on all our teams and how we deploy the skills and experience we have to best effect, working with colleagues across the sectors and those involved in other CQC work.
We will provide further information on the intranet and our daily COVID-19 bulletins as this work develops. We are also holding twice weekly calls with our Leadership Group (heads of inspection/function and above) and weekly with all leaders and team leaders. Please raise issues in your teams so that these can be escalated through these calls.
Thank you
I also want to briefly outline what other support we are offering the system. Clinically qualified CQC special advisors have already returned to the front line to help with the wider national response; colleagues have come forward to support DHSC, Public Health England and NHS England where they have relevant skills and a number have been seconded already. We expect to be using our customer contact team in Newcastle to start taking non-clinical COVID-19 calls from next week in support of 111. In addition, we are asking our teams to stand ready to help any other part of the national effort, whether that be in the public or private sector.
I wanted to say a big thank you for the hard work and commitment you are already putting in to offer the health and care system all the support possible to ensure that people – those who use services and those who work in them – are kept safe during this global health emergency. Please also continue to help each other out whenever you can – our own health and wellbeing is vitally important.
And no message during this period from me is going to be complete without me saying – keep washing your hands.
Ian Trenholm
Chief Executive
|