The New Care Quality Commission Strategy for 2021 and Beyond

“We will be smarter in how we regulate. We’ll keep pace with changes in health and care, providing up-to-date, high-quality information and ratings for the public, providers and all our partners.”

A breakdown of how the CQC plans to create smarter regulation can be broken down by their defined sub-categories:

Taking the right action at the right time 

The CQC maintain that on-site inspections will remain vital to their ratings of care providers but acknowledge that they are not the only way to assess performance. Instead, they will move away from a set schedule of inspections and will use “all our regulatory methods, tools and techniques to assess quality.”  Alongside this, visits will only occur when there is a clear need to do so, which could include a response to a risk or when data is limited on the provider.

More work will be put into building relationships with local care systems, allowing them to tailor future approaches based off insights they gain through conversations on care quality. A final point raised is the building of digital platforms that will “better integrate the data we (the CQC) hold”, relying on innovative analysis, artificial intelligence and data science.

More meaningful ratings

 A more ‘dynamic’ approach to rating care providers will mean changes to a provider’s CQC rating can happen without inspections, when there is evidence that shows a change in care quality. Ratings will also see an evolution in what they reflect, with people’s experience with a provider being central to this.

Making it easier to work with us 

Relationships with services will aim to be more ‘collaborative’ with an emphasis on building trust and openness. To save on time, and reduce duplication, data will only be requested when it is needed and can’t be sourced elsewhere. Data will be stored once, and will be used as many times as necessary, without ever having to go back to the original source provider.

Digital improvements will be made so that any service can hand over information and update pre-existing information easier. By storing all this data in one place, services will have an easier time being able to access more of the information then before. When necessary, organisations that represent the CQC or represent those that use the services, will also be given data on services when it will help improve the current quality of care.

Adapting to changes

By keeping pace with the rate of change in the industry, the CQC aims to work with providers to ensure aligned activity. Assessments will be adapted to ensure they focus on what matters to people as they use and ‘move between’ services, and to ensure “equal and appropriate access to good health and care services for everyone. “There will also be an interesting view into how the culture of a service positively effects service quality and a drive-in care improvement.”

Most importantly they state, “We’ll expand our definition of what we consider to be a provider of care and what it means to carry on a regulated activity.” This will mean care providers, especially those responsible for directing and managing must understand fully and adhere to whatever this new definition evolves into, to stay completely compliant.

Relevant for all

By using their new definitions of quality care as reference, it will be easier to see what good and bad care looks like, both for providers of care and people choosing care services.

The CQC end by explaining they will move away from long reports written after inspections and develop more easy and understandable information in ways that suit stakeholders.

What does this mean for care providers?

The key takeaways here are that the CQC are going to maintain a need for onsite inspections but will look for other avenues to assess care providers especially when visits are deemed unnecessary.

Depending on how confident you are in service quality, this could be seen as good or bad news. It means that rather than ratings hinging on rare inspections, where your service could be having an exceptionally good or bad few days, the CQC will be more vigilant with ongoing monitoring of services.

This also means care providers that are also the most vigilant over care quality with ongoing monitoring of their own services will be best placed to benefit from the new approach and less likely to be ‘found out’ for lack of a better term. There are systems available to embed this vigilance and monitoring into your care services, such as Access Care Compliance.

The CQC are aiming to be more open with discussions with stakeholders within care, so ensure you are honest and ready to provide your thoughts when the time comes to do so.

“Having the right organisational culture is crucial to improving safety. This means safety must be a top priority for all – regardless of seniority or role.” CQC update: A new strategy for the changing world of health and social care, 2021

A breakdown of how the CQC defines Safety through learning can be broken down by these sub-categories:

The importance of culture

Through cross-communication within the care sector, the CQC aims to have a definitive definition of what safety is and how it applies to different services. They will also create a better understanding of risk and what is unacceptable within the industry to manage avoidable harm.

A drive to improve learning cultures, where staff will be encouraged to speak up on any concerns they have about safety issues within the work place. The CQC also emphasise that care staff can go directly to them if they have any safety concerns about their workplace, where actions will be taken swiftly.

The CQC will Identity and share insights around learning and exemplary practices that will help services improve their care. Using their position as a regulator the CQC will highlight where a service has made changes and improvements as a result of their “regulatory actions”.

Building expertise

Here the CQC will do two things; look at how systems assure themselves that they have the right knowledge and expertise to ensure safety and if they are investing in improving safety. Alongside this, the CQC will also ensure they increase their own expertise to ensure their “approach is in line with the latest safety thinking”.

Involving everybody

The CQC will use a more collaborative approach to transform safety and uphold human rights within care.

“We’ll check that services actively take into account people’s rights and their unique perspectives on what matters to them in the way they choose to live their lives and manage risk.”

Regulating safety

The CQC will start to target services with poorer cultures that are going undetected. The aim is to understand what is happening to cause the poor culture within these services and why. There will be a review into how effectively safety is measured and monitored and how data is gathered to ensure improved consistency across the board.

The need to learn and improve is what the CQC are calling on to be the ‘primary response’ to any  safety concerns a provider may have. Through the publishing of public data, the CQC aims to see further accountability from services regarding safety. Where safety concerns exist, services will be made responsible to show what action they’ll take to learn and improve to both the regulator and the people using the service.

The CQC states an intention to encourage “meaningful change” when safety issues are identified.

“We’ll share the learning from our insight on themes, trends, and best practice to help services and local systems improve their safety. We’ll also share with regional organisations our data and information about safety in local systems, to support their oversight of safety in their area”

Consistent oversight and support

Support and Guidance is a key theme of our final subgroup, with an aim to ensure that all care providers have access to the right support. Using insights and their own “independent voice” the CQC will address the national conversation on safety within the sector.

What does this mean for care providers?

“We will do more with what we know to drive improvements across individual services and systems of care. We’ll use our unique position to spotlight the priority areas that need to improve and enable access to support where it’s needed most.” CQC update: A new strategy for the changing world of health and social care, 2021

A breakdown of how the CQC plans to accelerate improvement can be broken down by their defined sub-categories:

Collaborating for improvement 

Through collaboration, the CQC will facilitate ‘national improvement coalitions ‘within health and social care. These coalitions will be built upon existing partnerships and will not seek to duplicate current efforts through new partnerships. The CQC will support all locally driven improvement efforts and assess how well people have access to care. From these local levels they aim to improve relationships to promote collaboration between national partners.

Making improvement happen

“We want to see improvements that benefit people.” By setting a higher bar, the CQC want to see improvements in quality supported by clearer standards of what they expect from providers of care. Services can expect the CQC to be more collaborative, building relationships to help providers find their own routes to improvement. The CQC will offer out resources to support services to improve, this will include facilitating conversations to drive change organically, rather then just telling services what to do. This will include the hosting of events and workshops, and by publishing resources and guidance to support them

Through collaboration, the CQC will identify areas that need the most improvement as a priority, at a local and national level. As well as this, they seek to “empower” local care systems to improve themselves by offering analysis and data. This access to data will enable services to self-assess and focus on how they can improve.

Encouraging innovation and research

Here the CQC state a need for accelerated improvement in innovative and technological change.

“We’ll encourage and champion innovation and technology-enabled services where they benefit people and where the innovation results in more effective and efficient services.”

Through advice and guidance, services will find support that they need to innovate and create a safer environment of care. Alongside this the CQC will keep abreast of technological change, to ensure they understand new ways that technology can be used to improve quality of care and help care providers overcome resourcing and staffing challenges.

In partnership with other stakeholders, the CQC wishes to see a coordinated approach to regulating new innovations and technologies within the sector.

An approach based on evidence 

Based on evidence the CQC will identify and investigate the factors that ensure good quality care. Through investments into research, the CQC will be able to understand external evidence of “conditions that drive quality improvement”. Research will investigate best practises including evidence from other industries that might help drive improvement.

What does this mean for care providers?

The CQC have clearly set precedence that they want to see change, and they want it start happening as soon as possible.

An intriguing area of conversation is that the CQC want to help facilitate care providers in utilising innovation and technology through a conversation and advisory role. It has been demonstrated conclusively that software helps improve care, by easing the burden of administrative tasks, improving processes and workflows, creating a better trained workforce and using data to drive up quality across services of all shapes and sizes.

Read case studies detailing the use of software to help care providers improve financial sustainability, organisational efficiency and care quality.