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Assessing local health systems key focus of new CQC strategy

28 May 2021

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The Care Quality Commission (CQC) will focus on assessing local systems’ ability to improve outcomes and reduce inequalities as part of its new 2021 regulation strategy.

Launched today (27 May), the new strategy will aim to give the public independent assurance about the quality of care in their area by assessing how well local health systems are working and addressing local challenges and against ‘the things that matter to people in that community,’ it said.

The CQC added that the work in this area will likely be underpinned by legislation outlined in the Health and Social Care Bill, and that it will align with other regulators to encourage a shift towards more integrated services.

In its published strategy, it said: ‘We’ll look at how the care provided in a local system is improving outcomes for people and reducing inequalities in their care. This means looking at how services are working together within an integrated system, as well as how systems are performing as a whole.’

Looking at how services work together in a local system is a change in its approach that better reflects how people experience care, it said.

This will include working with service providers and partners to make sure its regulatory model keeps pace, in addition to gathering information to ‘better understand the risks of inequalities in people’s experiences of their pathway’ through care and their outcomes.

Supporting while regulating

The CQC said that while it will enable access to support, it will ‘retain our core regulatory role, which means using our powers to act where we see poor care’.

Services and local systems will need to demonstrate a ‘culture of improvement’, with an expectation for them to address inequalities in access, experiences and outcomes, it said.

To support this, the regulator said it will play an ‘active part’ in making improvement happen.

This includes offering services and systems analysis and benchmarking data to help them self-assess how they perform against similar services and areas, which will in turn show the regulatory body ‘where we need to focus our work to drive improvement’.

It will also identify the national and local areas that need to improve as a priority, it said.

Listening to service users

Additionally, it said it will make it easier for people, their families and advocates to give feedback about their care.

The regulator outlined its intention to gather experiences from a ‘wider range’ of people, including ‘people with a learning disability, people with communication needs, people living in poverty, those whose voices are not often heard, those who are detained under the Mental Health Act, and people who are at risk of abuse or other human rights breaches’.

It intends to increase scrutiny of how providers encourage and enable people to feedback, and will focus on how they act on this to improve their service, it said.

It added that it will ‘proactively raise public awareness’ of the CQC and be clear about its role as a regulator.

Regulation driven by patient need

Danny Mortimer, chief executive of the NHS Confederation, said the organisation welcomes the ‘shift away’ from organisations and ‘towards service improvement and whole patient pathways’.

The strategy intends to foster a culture to support quality improvement which will be ‘crucial’ to successful system working, he said.

‘The CQC plays a significant role in creating the right regulatory environment for system working to flourish and our members support the move to a more open, iterative and partnership-based approach to regulation adopted by the CQC since the onset of the pandemic,’ he said.

‘The strategy rightly places people and communities front and centre and we support a regulatory environment that is driven by people’s needs being met in the places where they live.’

He added that as the NHS moves toward system working and statutory ICSs, all regulators will need to maintain ‘a better balance between national consistency and the enormous possibilities of local flexibility and innovation, rather than assuming that ‘one size fits all’’.