Care Quality Commission – A new strategy

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09 May 2013

Care Quality Commission – A new strategy

The Care Quality Commission (CQC) – the regulator for health and social care in England has been subject to a considerable amount of scrutiny by a variety of government and non-government bodies. The Francis inquiry identified many cases of poor care for patients in the Mid Staffordshire NHS trust and made recommendations for the regulator. Previously the Public Accounts Committee had also made remarks about the performance of CQC as a regulator. There have been a number of references to the regulator in the media while identifying poor care and compromise in dignity and privacy in various care settings. One of the criticisms was aimed at the competence of the inspectors in identifying and reporting poor practice for people receiving care for complex conditions – the current knowledge was considered too generic. The CQC launched a consultation and invited comments from public, professionals and people receiving care and their carers and promised that the findings will inform the future regulatory strategy. Subsequent to this exercise a new CQC strategy ‘Making services better, putting people first’ was published on 18th April 2013. The key points of the strategy are as follows:

• Appointing a Chief Inspector of Hospitals, a Chief Inspector of Social Care and Support, and considering the appointment of a Chief Inspector of Primary and Integrated Care.

• Developing new fundamental standards of care including a quality rating system.

• Making sure inspectors specialise in particular areas of care and lead teams that include clinical and other experts, and Experts by experience (people with experience of care).

• Introducing national teams in NHS hospitals that have specialist expertise to carry out in-depth reviews of hospitals with significant or long-standing problems.

• Improving our understanding of how well different care services work together by listening to people’s experiences of moving between different care services.

• Publishing better information for the public, including ratings of services.

• Strengthening the protection of people whose rights are restricted under the Mental Health Act.


These changes will be implemented over 3 years between 2013 and 2016. The new approach will be effective in the NHS and mental health trusts first and will be applied to social care sector between 2014 and 2016.

While these changes are welcome and are aimed at improving the care and welfare of people receiving care in all settings it is important that there is a strong joined up thinking particularly between the Chief inspectors. This is because of the fact that people receiving care suffer from many conditions and need services from health and social care in a joined up way. Otherwise there will still be gaps in how services are provided and this would seriously impact on the quality of outcomes.

The strategy also mentions developing new standards of care which is good news as it aims to target the right areas of care. However it would be interesting to see how this impacts on those providing care in terms of training and systems of maintaining information. A sector that is already strapped for cash may find these changes demanding more resources.

Enabling inspectors to specialise in particular areas of care would certainly silence the critics who have felt that the inspectors don’t know enough about the areas being inspected. It must be noted that many of our older people suffer from complex and multiple conditions and it would be important that the inspectors are able to join up the dots. A recent announcement that the CQC inspectors will be trained by the Alzheimer’s Society in dementia care is a step in the right direction.

Finally the intention to engage better with public and listen to people’s views should certainly be strengthened by the role Healthwatch England and the local Healthwatch can play in giving people a voice to raise concerns when the care of their nearest and dearest falls below the acceptable standards.

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