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CQC should adopt new role as ‘primary enforcer’ of innovation transformation, says think tank

by Awil Mohamoud
26 June 2020

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NHS England should make innovation a part of its framework, as it will be ‘central to the Covid-19 recovery’, and the CQC should adopt a new role as the ‘primary enforcer’ of that change, according to a leading think tank. 

An Institute for Public Policy Research (IPPR) report into spreading innovation in the NHS found that technology, including automation, could ‘help alleviate pressure’ for health workers responding to the backlog of treatment caused by the pandemic. 

A university of Oxford report, published last week, said half of all administration tasks carried out in general practice could be automated to help the sector manage post-Covid-19

Matching the innovation undertaken by the UK’s international peers would also save an estimated 20,000 avoidable deaths each year, by, for example, improving access to treatment for those suffering with long-term conditions, according to the report. It could also save the NHS £10 billion by reducing costs. 

To achieve this, NHS England would need to set ‘ambitious’ and ‘time bound’ targets for innovation in the form of guidance. The CQC would, therefore, need to take on a new role, and ‘regulate on the basis of innovation’, the IPPR researchers said. 

The CQC ‘should act’ where the minimum standard for innovation is not met by GP practices or care homes. It should include progress as part of its inspection rating system and make consistently missing those targets grounds for desertification, the report suggested. However, it should give regulators clarity on how innovation will be judged beforehand. 

The regulator does not currently give significant enough focus to innovation. ‘Far more bearing is given to doing something wrong, rather than failing to do something better. Yet, the consequences for patient safety or patients’ outcomes could be just as detrimentally impacted by a missed opportunity as by negligence,’ the report said.

The BMA last week called on the CQC to ‘overhaul’ its inspections model rather than restart it, following the regulator’s announcement that it will do so starting this summer. 

The NHS also needs to shift direction before any of this could come into effect. It is ‘risk averse’ and does not give enough attention to long-term transformation goals, the report concludes. 

An NHS trust director of innovation told the researchers that ‘being innovative and allowing people to try and fail is quite challenging in structures when you have a lot of governance around the system’.

‘We need to start to give freedom and permission,’ he added.

An unattributed senior NHS England leader also said: ‘We have a blame culture; things go wrong and people get fired. That needs to be changed.’

The report said that leaders and clinicians also need the time to focus on innovation, and that workforce funding streams should include bespoke hours for this purpose.

The Government should also introduce a £10 billion transformation fund, to be implemented over four years, recommended IPPR.