The CQC is making ‘urgent changes’ to its assessment approach from today, and will no longer be scoring providers or reporting on them at evidence category level.
The watchdog will only produce scores at quality statement level using the five key questions (safe, effective, caring, responsive and well-led) and the four-point ratings scale (outstanding, good, requires improvement and inadequate), it announced last week.
It said that the changes will mean that it will be able to ‘deliver more assessments, at a faster pace’.
An overhaul of the assessment model was introduced by the CQC earlier this year, with six new evidence categories created to use for gathering information and scoring.
However, in an update on its website, the CQC said assessments using the current scoring approach ‘take too long’, preventing it from completing enough of them ‘to give an up-to-date view of quality for the public and providers’.
‘We have also heard that our scoring model is too complex and hard to understand,’ it added.
The evidence categories will still be used to guide what the CQC looks at during assessments and ‘direct’ how it assesses individual quality statements, the organisation further explained. But no scores will be given at evidence category level.
It will update its guidance to provide more information on what this change means, it said.
The CQC has also set out other changes for 2025, including:
- Providing clearer descriptions of what it looks for at different levels of quality under each of the 4 ratings
- Developing a new guidance handbook for providers
- Developing ways to produce an accurate rating while using a selected number of quality statements
- Stopping the use of existing ratings to produce new scores
- Developing how it uses professional judgement when rating services.
It said it will develop these changes in ‘partnership’ with providers and the public, and be looking at these areas in detail over the next three months as well as hold a consultation next year.
Meanwhile, the RCGP has called for a temporary pause of CQC routine inspections of GP practices due to concerns about the current regulation system.
The college’s governing council also called for an end to ‘simplistic’ one-word ratings currently used in CQC inspections, during a meeting on Saturday (30 November).
The proposed pause would only be for routine inspections, as the college said it is ‘clear’ that inspections of practices where patient safety concerns have been raised should continue.
The CQC should also explore alternatives to the one-word ratings that would provide ‘greater nuance, support and transparency’, according to the council. This view echoes that of the Institute of General Practice Management (IGPM), which wrote to the Department of Health and Social Care (DHSC) in September asking that ‘unfair’ single word grades be scrapped.
RCGP chair Professor Kamila Hawthorne said that continuing to apply the current inspection regime would be ‘harmful’, diverting resources and attention away from patient care and perpetuating a ‘distorted and inconsistent’ picture of GP services.
‘We regularly hear reports that preparing for CQC inspections is highly and unnecessarily stressful at a time when GP teams are already working under intense pressure, and that the CQC’s processes are ineffective and, in some cases, discriminatory against practices run by GPs from ethnic minorities,’ she said.
‘We are therefore calling for a temporary suspension of routine CQC inspections until an improved, cost-effective and evidence-based approach to assessments and inspections has been agreed and implemented.
‘Of course, patient safety is our number one priority, and inspections of practices where patient safety concerns have been raised should continue.’
Earlier this year, two reviews identified serious organisational failings at the CQC, with one saying it had ‘lost its credibility’.
