Review into CQC's operational effectiveness (2024)

Independent review highlights key areas for improvement at the Care Quality Commission

By Dr Richard Dune

Evaluating CQC's Operational Effectiveness Key Insights and Findings - Dr Richard Dune -

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The Care Quality Commission (CQC), as the primary regulatory body overseeing health and social care providers in England, plays a crucial role in ensuring that services across the sector meet essential standards of care and safety. However, the recent review into the operational effectiveness of the Care Quality Commission, published on 15 October 2024, has highlighted significant concerns regarding the regulator’s current processes and operational performance.

This comprehensive report by Dr Penny Dash outlines several recommendations to improve the CQC’s effectiveness in assessing and regulating health and social care services. This review's findings and recommendations are vital for providers and the public, as they directly impact how the quality of care is monitored, reported, and improved.

A Comprehensive Review of CQC's Operational Effectiveness What You Need to Know - Dr Richard Dune -

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The importance of effective regulation in health and social care

Effective regulation ensures high standards across health and social care settings. In a diverse and complex sector, regulation ensures that services are safe, effective, caring, responsive, and well-led, the five core areas that underpin CQC inspections.

However, recent concerns have arisen about the CQC’s ability to maintain operational effectiveness in an increasingly challenging environment due to ongoing financial pressures, workforce shortages, and the evolving needs of service users. As a result, the Department of Health and Social Care (DHSC) commissioned an independent review to examine the CQC’s performance and propose areas for improvement.

The review's findings are particularly relevant given the recent reforms to the health and social care landscape, including the introduction of Integrated Care Systems (ICSs) and the ongoing challenges posed by an ageing population and stretched resources. The review acknowledges the difficulties facing the CQC and emphasises the need for rapid and substantial reforms to ensure it can effectively fulfil its regulatory role.

One-word ratings - An oversimplification?

One key area of focus in the report is the CQC’s use of one-word ratings (e.g., ‘Good’, ‘Requires Improvement’, ‘Inadequate’) to summarise the quality of care organisations provide. While these ratings offer a clear and accessible overview for service users and the public, they have been criticised for oversimplifying complex issues related to care quality.

The report notes that while the CQC has not extensively reviewed the use of one-word ratings, the debate surrounding their usefulness has gained traction, particularly following the government’s decision to phase out single-word ratings in the Ofsted framework. The recent NHS Providers’ report, A Pivotal Moment for Regulation: Regulation and Oversight Survey 2024, also raised concerns about these ratings, suggesting that they do not always capture the full picture of care quality.

Critics argue that one-word ratings often mask variations in care quality across different services or departments within the same organisation. For instance, a hospital might receive a ‘Good’ rating overall, which may hide critical issues in specific departments, such as maternity or emergency care.

The review recommends that the CQC consider adopting a more nuanced ‘balanced scorecard’ approach, allowing ratings for different domains—such as safety, effectiveness, responsiveness, and leadership—to be displayed more transparently. This approach would provide a clearer, more detailed picture of performance across the key domains that underpin the CQC’s assessment framework.

Such a change could also align the CQC’s approach with that of other regulatory bodies, such as Ofsted, which is moving away from one-word ratings in favour of more descriptive assessments. It would also allow larger providers with multiple service lines and sites to have a more transparent and detailed view of their performance across different areas, giving the public and service users a more informed basis for decision-making.

CQC Operational Effectiveness Analyzing Performance and Accountability - Dr Richard Dune -

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Understanding CQC's Operational Effectiveness Lessons from Recent Reviews - Dr Richard Dune -.jpg__PID:38d2d9b9-cee2-4a9b-874c-4255f1968fc5

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Funding challenges and financial sustainability

Another critical concern raised in the report is the CQC's financial sustainability. The regulator is funded primarily through fees charged to the providers it oversees, a model that has sparked concerns about the cost to providers and the CQC’s ability to deliver services efficiently.

Under the current system, the CQC is required by the HM Treasury’s Managing Public Money guidance to recover the full cost of its regulatory activities through fees paid by registered providers. Any changes to the statutory fee scheme must be consulted on and require the consent of both the Secretary of State for Health and the Treasury.

However, the review highlights the tensions inherent in this model. On one hand, providers—many already facing financial pressures—must bear the costs of regulation. On the other hand, the CQC needs sufficient resources to carry out its regulatory functions effectively. Balancing these competing demands is challenging, and the report calls for re-examining how the CQC is funded.

There is also a broader question of how to ensure that the CQC operates efficiently and effectively while being mindful of the financial constraints faced by the providers it regulates. The DHSC, as the CQC’s sponsoring organisation, will need to play a vital role in addressing these concerns and ensuring that any changes to the funding model are fair and sustainable.

The case for a unified ‘data lake’ across health and social care

One of the most ambitious proposals in the report is the creation of a single ‘data lake’ for the health and social care sectors—a unified repository of data on care quality that could be used by regulators, providers, and other stakeholders to improve performance and outcomes.

The NHS Federated Data Platform was established to create a “Single Version of the Truth” within the healthcare sector. It combines data from various sources to support better decision-making and performance management. The review suggests that this model could be extended across the health and social care sectors, creating a comprehensive data platform that would streamline regulation and oversight while improving transparency.

Such a platform would provide a common data set on quality of care across all sectors, allowing for more consistent and accurate performance assessments. It would also reduce duplication of effort, as providers would no longer need to submit the same data to multiple regulatory bodies.

Creating a unified data platform would be transformative for healthcare providers, particularly those operating across NHS and social care services. It would allow for better coordination between regulators and a more streamlined approach to data collection and analysis, ultimately leading to better care for patients and service users.

CQC's Operational Effectiveness Challenges, Opportunities, and Strategies for Improvement - Dr Richard Dune -

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Navigating CQC’s Operational Effectiveness A Review of Best Practices - Dr Richard Dune -

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Addressing the regulatory burden - Simplifying the landscape

One of the most significant challenges highlighted in the review is the complexity of the regulatory landscape in the UK’s health and social care sectors. With over 100 organisations exerting some form of regulatory influence over NHS providers, the current system is confusing and burdensome for many providers.

The report points to the example of maternity services, where over 12 different regulatory and inquiry bodies have made over 100 recommendations for a single NHS trust. This level of regulatory scrutiny can overwhelm providers, making it difficult for them to focus on delivering high-quality care.

The review recommends a more coordinated and streamlined approach to regulation, particularly in areas where multiple regulatory bodies are involved. For example, there is significant overlap between the roles of NHS England, Integrated Care Boards (ICBs), and the CQC, all of which oversee different aspects of care quality.

Simplifying this landscape would reduce providers' burdens and improve regulation's efficiency and effectiveness. By reducing duplication and ensuring that regulatory bodies work more closely together, the CQC can focus on its core mission of ensuring that services are safe, effective, and well-led.

Rebuilding trust and credibility

A recurring theme throughout the report is the need for the CQC to rebuild trust and credibility within the sector. The review found that many providers, particularly those in the independent sector, have lost confidence in the CQC’s ability to deliver timely and accurate assessments.

Part of the problem lies in the CQC’s operational performance. The report highlights significant delays in the publication of inspection reports, with some providers waiting months to receive their final ratings. This has created frustration among providers and raised concerns about the CQC’s ability to respond to emerging risks and issues in a timely manner.

The review calls for urgent improvements in the CQC’s operational performance, including fixing the provider portal and regulatory platform to speed up and improve the accuracy of inspections and reports. It is also recommended that the CQC set clear performance targets in collaboration with the DHSC to ensure progress in addressing these issues.

Additionally, the report emphasises the need for the CQC to rebuild relationships with providers. This includes appointing senior clinicians as Chief Inspectors of Hospitals and Primary and Community Care and encouraging greater involvement from top-performing managers, carers, and clinicians in the inspection process. By involving more frontline professionals in its work, the CQC can demonstrate its commitment to understanding the realities of care delivery and building stronger partnerships with providers.

CQC Performance Review Assessing Operational Effectiveness in Healthcare - Dr Richard Dune -

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Key Recommendations for Enhancing CQC's Operational Effectiveness - Dr Richard Dune -

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Enhancing the Single Assessment Framework

The CQC’s new Single Assessment Framework (SAF), introduced in 2023, is designed to provide a more sophisticated and risk-based approach to inspections. However, the review found that the SAF still requires significant improvement to ensure it is fit for purpose.

One of the main criticisms of the SAF is that it lacks explicit descriptors for each quality statement or evidence category, making it difficult for providers to understand how they will be assessed. The review calls for a fundamental overhaul of the SAF to provide greater clarity and transparency, particularly around what constitutes ‘Outstanding’, ‘Good’, ‘Requires Improvement’, and ‘Inadequate’ ratings.

The report also recommends placing a far greater emphasis on effectiveness, outcomes, innovation, and the use of resources in the SAF. By focusing more on these areas, the CQC can ensure that its assessments reflect the realities of modern healthcare delivery and support providers in delivering high-quality, innovative care.

In particular, the report calls for the CQC to build on its work with the Healthcare Quality Improvement Partnership, the Getting It Right First Time (GIRFT) programme, and national clinical audits to expand the range of outcome measures used in its assessments. This would provide a more robust and evidence-based approach to assessing care quality and ensure that the CQC’s ratings are grounded in real-world outcomes. Moreover, greater emphasis should be placed on the efficient use of resources, especially in the context of increasing financial constraints across both health and social care sectors. Ensuring that resources are being used effectively and efficiently is crucial for delivering high-quality care within the limits of available funding.

Strengthening sponsorship and governance

A significant recommendation of the report is the need for stronger sponsorship and governance arrangements between the DHSC and the CQC. Given that the CQC plays such a vital role in the safety and quality of care across England, the DHSC’s sponsorship of the regulator must be robust, efficient, and clear. The report advocates for a more structured and formalised relationship between the DHSC and the CQC, with regular performance reviews and the setting of clear performance targets for the CQC.

These reviews should take place at the highest levels, involving senior civil servants at the DHSC and the CQC’s leadership. They should focus on tracking progress against the recommendations outlined in the report. By introducing more formal sponsorship arrangements, the DHSC can ensure that the CQC is held accountable for its performance while also providing the support necessary to enable the regulator to meet its objectives.

Operational Effectiveness of CQC A Critical Analysis of Findings - Dr Richard Dune -

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Insights into CQC’s Operational Effectiveness A Review for Stakeholders - Dr Richard Dune -

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The need for a stronger focus on patient safety and innovation

One of the most pressing concerns raised by the review is the need for a stronger focus on patient safety within the CQC’s regulatory framework. While the CQC has historically prioritised patient safety as a core component of its assessments, the review found that there is still room for improvement in how safety is monitored, measured, and enforced.

The report calls for the CQC to enhance its focus on patient safety by expanding the range of outcome measures it uses in its assessments. This could involve building on existing frameworks, such as the National Patient Safety Strategy, and incorporating lessons learned from high-profile incidents like the Mid Staffordshire NHS Foundation Trust scandal.

Additionally, the review highlights the need for the CQC to become more agile and forward-thinking in its approach to innovation. In today’s rapidly changing health and social care landscape, providers are increasingly adopting new models of care, digital solutions, and innovative practices to improve outcomes for patients and service users. The CQC must ensure that its regulatory framework supports, rather than stifle innovation.

The report suggests that the CQC should work closely with providers and other stakeholders to build a deeper understanding of emerging trends in healthcare and social care. This could involve establishing specialist teams within the CQC to focus on innovation and providing more targeted guidance on how innovative models of care will be assessed within the Single Assessment Framework.

Addressing the workforce challenge

The review also illuminates one of the most significant challenges facing the CQC and the wider health and social care sectors: workforce shortages. A lack of skilled professionals in key areas, including nursing, social care, and clinical leadership, has placed immense pressure on providers and raised concerns about the ability to deliver safe and effective care.

The report calls for urgent action to address these workforce challenges, including ensuring that the CQC has the expertise required to carry out inspections effectively. The review highlights the importance of rebuilding sector expertise within the CQC by appointing highly regarded clinicians and professionals to leadership positions, particularly in the roles of Chief Inspector of Hospitals and Chief Inspector of Primary and Community Care.

Additionally, the report recommends creating a programme that incentivises top-performing managers, clinicians, and carers from across the sector to take part in CQC inspections. By bringing in frontline professionals for short periods of time to assist with inspections, the CQC can ensure that its assessments are grounded in real-world experience and that providers feel more confident in the regulator’s understanding of the challenges they face.

CQC's Impact on Healthcare Reviewing Operational Effectiveness - Dr Richard Dune -

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Operational Effectiveness in Regulation An In-Depth Review of CQC - Dr Richard Dune -

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A path forward - Implementing the recommendations

The findings of this independent review mark a pivotal moment for the CQC and the future of regulation in the health and social care sectors. While the challenges facing the regulator are significant, the report outlines a clear path forward, with a series of practical and actionable recommendations designed to improve operational performance, rebuild trust, and enhance the regulatory framework.

The next steps outlined in the review call for rapid improvements within the CQC over the coming months. These include urgent action to improve the provider portal and regulatory platform, rebuild relationships with providers, and strengthen the CQC’s capacity to respond to emerging risks and serious incidents.

Over the next six months, significant progress must be made towards rebuilding expertise within the CQC and fostering stronger relationships with providers. By involving more clinicians and frontline professionals in the inspection process, the CQC can begin to restore credibility and trust within the sector.

Looking further ahead, the next 12 months will be critical in ensuring that the Single Assessment Framework is enhanced and improved to meet the needs of a modern, innovative, and outcome-focused health and social care system. This includes reviewing the quality statements, emphasising effectiveness and outcomes more, and ensuring that the framework supports innovation and the use of resources.

By implementing these recommendations, the CQC has the opportunity to strengthen its role as a regulator and play a pivotal role in improving the quality and safety of care across England. The road ahead will be challenging, but with the right leadership, governance, and support from the DHSC, the CQC can rise to the challenge and deliver the changes needed to build a safer, more effective health and social care system.

Moving forward with confidence - How ComplyPlus™ can help

As the health and social care sectors continue to navigate the challenges of regulatory compliance, innovation, and workforce shortages, the role of regulatory compliance management software has never been more critical. ComplyPlus™ is designed to support providers in meeting regulatory requirements, improving performance, and driving innovation.

If you would like more information on how ComplyPlus™ can help your organisation navigate the evolving regulatory landscape, contact us today. Let’s work together to build a safer, more effective health and social care system.

The importance of effective regulation in health and social care

A Comprehensive Review of CQC's Operational Effectiveness What You Need to Know - Dr Richard Dune -

Image by maxxyustas via Envato Elements

Effective regulation ensures high standards across health and social care settings. In a diverse and complex sector, regulation ensures that services are safe, effective, caring, responsive, and well-led, the five core areas that underpin CQC inspections.

However, recent concerns have arisen about the CQC’s ability to maintain operational effectiveness in an increasingly challenging environment due to ongoing financial pressures, workforce shortages, and the evolving needs of service users. As a result, the Department of Health and Social Care (DHSC) commissioned an independent review to examine the CQC’s performance and propose areas for improvement.

The review's findings are particularly relevant given the recent reforms to the health and social care landscape, including the introduction of Integrated Care Systems (ICSs) and the ongoing challenges posed by an ageing population and stretched resources. The review acknowledges the difficulties facing the CQC and emphasises the need for rapid and substantial reforms to ensure it can effectively fulfil its regulatory role.

One-word ratings - An oversimplification?

CQC Operational Effectiveness Analyzing Performance and Accountability - Dr Richard Dune -

Image by leungchopan via Envato Elements

One key area of focus in the report is the CQC’s use of one-word ratings (e.g., ‘Good’, ‘Requires Improvement’, ‘Inadequate’) to summarise the quality of care organisations provide. While these ratings offer a clear and accessible overview for service users and the public, they have been criticised for oversimplifying complex issues related to care quality.

The report notes that while the CQC has not extensively reviewed the use of one-word ratings, the debate surrounding their usefulness has gained traction, particularly following the government’s decision to phase out single-word ratings in the Ofsted framework. The recent NHS Providers’ report, A Pivotal Moment for Regulation: Regulation and Oversight Survey 2024, also raised concerns about these ratings, suggesting that they do not always capture the full picture of care quality.

Critics argue that one-word ratings often mask variations in care quality across different services or departments within the same organisation. For instance, a hospital might receive a ‘Good’ rating overall, which may hide critical issues in specific departments, such as maternity or emergency care.

The review recommends that the CQC consider adopting a more nuanced ‘balanced scorecard’ approach, allowing ratings for different domains—such as safety, effectiveness, responsiveness, and leadership—to be displayed more transparently. This approach would provide a clearer, more detailed picture of performance across the key domains that underpin the CQC’s assessment framework.

Such a change could also align the CQC’s approach with that of other regulatory bodies, such as Ofsted, which is moving away from one-word ratings in favour of more descriptive assessments. It would also allow larger providers with multiple service lines and sites to have a more transparent and detailed view of their performance across different areas, giving the public and service users a more informed basis for decision-making.

Funding challenges and financial sustainability

Understanding CQC's Operational Effectiveness Lessons from Recent Reviews - Dr Richard Dune -

Image by MPPLLC45 via Envato Elements

Another critical concern raised in the report is the CQC's financial sustainability. The regulator is funded primarily through fees charged to the providers it oversees, a model that has sparked concerns about the cost to providers and the CQC’s ability to deliver services efficiently.

Under the current system, the CQC is required by the HM Treasury’s Managing Public Money guidance to recover the full cost of its regulatory activities through fees paid by registered providers. Any changes to the statutory fee scheme must be consulted on and require the consent of both the Secretary of State for Health and the Treasury.

However, the review highlights the tensions inherent in this model. On one hand, providers—many already facing financial pressures—must bear the costs of regulation. On the other hand, the CQC needs sufficient resources to carry out its regulatory functions effectively. Balancing these competing demands is challenging, and the report calls for re-examining how the CQC is funded.

There is also a broader question of how to ensure that the CQC operates efficiently and effectively while being mindful of the financial constraints faced by the providers it regulates. The DHSC, as the CQC’s sponsoring organisation, will need to play a vital role in addressing these concerns and ensuring that any changes to the funding model are fair and sustainable.

The case for a unified ‘data lake’ across health and social care

CQC's Operational Effectiveness Challenges, Opportunities, and Strategies for Improvement - Dr Richard Dune -

Image by FoToArtist_1 via Envato Elements

One of the most ambitious proposals in the report is the creation of a single ‘data lake’ for the health and social care sectors—a unified repository of data on care quality that could be used by regulators, providers, and other stakeholders to improve performance and outcomes.

The NHS Federated Data Platform was established to create a “Single Version of the Truth” within the healthcare sector. It combines data from various sources to support better decision-making and performance management. The review suggests that this model could be extended across the health and social care sectors, creating a comprehensive data platform that would streamline regulation and oversight while improving transparency.

Such a platform would provide a common data set on quality of care across all sectors, allowing for more consistent and accurate performance assessments. It would also reduce duplication of effort, as providers would no longer need to submit the same data to multiple regulatory bodies.

Creating a unified data platform would be transformative for healthcare providers, particularly those operating across NHS and social care services. It would allow for better coordination between regulators and a more streamlined approach to data collection and analysis, ultimately leading to better care for patients and service users.

Addressing the regulatory burden - Simplifying the landscape

Navigating CQC’s Operational Effectiveness A Review of Best Practices - Dr Richard Dune -

Image by MargJohnsonVA via Envato Elements

One of the most significant challenges highlighted in the review is the complexity of the regulatory landscape in the UK’s health and social care sectors. With over 100 organisations exerting some form of regulatory influence over NHS providers, the current system is confusing and burdensome for many providers.

The report points to the example of maternity services, where over 12 different regulatory and inquiry bodies have made over 100 recommendations for a single NHS trust. This level of regulatory scrutiny can overwhelm providers, making it difficult for them to focus on delivering high-quality care.

The review recommends a more coordinated and streamlined approach to regulation, particularly in areas where multiple regulatory bodies are involved. For example, there is significant overlap between the roles of NHS England, Integrated Care Boards (ICBs), and the CQC, all of which oversee different aspects of care quality.

Simplifying this landscape would reduce providers' burdens and improve regulation's efficiency and effectiveness. By reducing duplication and ensuring that regulatory bodies work more closely together, the CQC can focus on its core mission of ensuring that services are safe, effective, and well-led.

Rebuilding trust and credibility

CQC Performance Review Assessing Operational Effectiveness in Healthcare - Dr Richard Dune -

Image by adam121 via Envato Elements

A recurring theme throughout the report is the need for the CQC to rebuild trust and credibility within the sector. The review found that many providers, particularly those in the independent sector, have lost confidence in the CQC’s ability to deliver timely and accurate assessments.

Part of the problem lies in the CQC’s operational performance. The report highlights significant delays in the publication of inspection reports, with some providers waiting months to receive their final ratings. This has created frustration among providers and raised concerns about the CQC’s ability to respond to emerging risks and issues in a timely manner.

The review calls for urgent improvements in the CQC’s operational performance, including fixing the provider portal and regulatory platform to speed up and improve the accuracy of inspections and reports. It is also recommended that the CQC set clear performance targets in collaboration with the DHSC to ensure progress in addressing these issues.

Additionally, the report emphasises the need for the CQC to rebuild relationships with providers. This includes appointing senior clinicians as Chief Inspectors of Hospitals and Primary and Community Care and encouraging greater involvement from top-performing managers, carers, and clinicians in the inspection process. By involving more frontline professionals in its work, the CQC can demonstrate its commitment to understanding the realities of care delivery and building stronger partnerships with providers.

Enhancing the Single Assessment Framework

Key Recommendations for Enhancing CQC's Operational Effectiveness - Dr Richard Dune -

Image by leungchopan via Envato Elements

The CQC’s new Single Assessment Framework (SAF), introduced in 2023, is designed to provide a more sophisticated and risk-based approach to inspections. However, the review found that the SAF still requires significant improvement to ensure it is fit for purpose.

One of the main criticisms of the SAF is that it lacks explicit descriptors for each quality statement or evidence category, making it difficult for providers to understand how they will be assessed. The review calls for a fundamental overhaul of the SAF to provide greater clarity and transparency, particularly around what constitutes ‘Outstanding’, ‘Good’, ‘Requires Improvement’, and ‘Inadequate’ ratings.

The report also recommends placing a far greater emphasis on effectiveness, outcomes, innovation, and the use of resources in the SAF. By focusing more on these areas, the CQC can ensure that its assessments reflect the realities of modern healthcare delivery and support providers in delivering high-quality, innovative care.

In particular, the report calls for the CQC to build on its work with the Healthcare Quality Improvement Partnership, the Getting It Right First Time (GIRFT) programme, and national clinical audits to expand the range of outcome measures used in its assessments. This would provide a more robust and evidence-based approach to assessing care quality and ensure that the CQC’s ratings are grounded in real-world outcomes. Moreover, greater emphasis should be placed on the efficient use of resources, especially in the context of increasing financial constraints across both health and social care sectors. Ensuring that resources are being used effectively and efficiently is crucial for delivering high-quality care within the limits of available funding.

Strengthening sponsorship and governance

Operational Effectiveness of CQC A Critical Analysis of Findings - Dr Richard Dune -

Image by margaritaylita via Envato Elements

A significant recommendation of the report is the need for stronger sponsorship and governance arrangements between the DHSC and the CQC. Given that the CQC plays such a vital role in the safety and quality of care across England, the DHSC’s sponsorship of the regulator must be robust, efficient, and clear. The report advocates for a more structured and formalised relationship between the DHSC and the CQC, with regular performance reviews and the setting of clear performance targets for the CQC.

These reviews should take place at the highest levels, involving senior civil servants at the DHSC and the CQC’s leadership. They should focus on tracking progress against the recommendations outlined in the report. By introducing more formal sponsorship arrangements, the DHSC can ensure that the CQC is held accountable for its performance while also providing the support necessary to enable the regulator to meet its objectives.

The need for a stronger focus on patient safety and innovation

Insights into CQC’s Operational Effectiveness A Review for Stakeholders - Dr Richard Dune -

Image by AydinovKamran via Envato Elements

One of the most pressing concerns raised by the review is the need for a stronger focus on patient safety within the CQC’s regulatory framework. While the CQC has historically prioritised patient safety as a core component of its assessments, the review found that there is still room for improvement in how safety is monitored, measured, and enforced.

The report calls for the CQC to enhance its focus on patient safety by expanding the range of outcome measures it uses in its assessments. This could involve building on existing frameworks, such as the National Patient Safety Strategy, and incorporating lessons learned from high-profile incidents like the Mid Staffordshire NHS Foundation Trust scandal.

Additionally, the review highlights the need for the CQC to become more agile and forward-thinking in its approach to innovation. In today’s rapidly changing health and social care landscape, providers are increasingly adopting new models of care, digital solutions, and innovative practices to improve outcomes for patients and service users. The CQC must ensure that its regulatory framework supports, rather than stifle innovation.

The report suggests that the CQC should work closely with providers and other stakeholders to build a deeper understanding of emerging trends in healthcare and social care. This could involve establishing specialist teams within the CQC to focus on innovation and providing more targeted guidance on how innovative models of care will be assessed within the Single Assessment Framework.

Addressing the workforce challenge

CQC's Impact on Healthcare Reviewing Operational Effectiveness - Dr Richard Dune -

Image by iLixe48 via Envato Elements

The review also illuminates one of the most significant challenges facing the CQC and the wider health and social care sectors: workforce shortages. A lack of skilled professionals in key areas, including nursing, social care, and clinical leadership, has placed immense pressure on providers and raised concerns about the ability to deliver safe and effective care.

The report calls for urgent action to address these workforce challenges, including ensuring that the CQC has the expertise required to carry out inspections effectively. The review highlights the importance of rebuilding sector expertise within the CQC by appointing highly regarded clinicians and professionals to leadership positions, particularly in the roles of Chief Inspector of Hospitals and Chief Inspector of Primary and Community Care.

Additionally, the report recommends creating a programme that incentivises top-performing managers, clinicians, and carers from across the sector to take part in CQC inspections. By bringing in frontline professionals for short periods of time to assist with inspections, the CQC can ensure that its assessments are grounded in real-world experience and that providers feel more confident in the regulator’s understanding of the challenges they face.

A path forward - Implementing the recommendations

Operational Effectiveness in Regulation An In-Depth Review of CQC - Dr Richard Dune -

Image by iLixe48 via Envato Elements

The findings of this independent review mark a pivotal moment for the CQC and the future of regulation in the health and social care sectors. While the challenges facing the regulator are significant, the report outlines a clear path forward, with a series of practical and actionable recommendations designed to improve operational performance, rebuild trust, and enhance the regulatory framework.

The next steps outlined in the review call for rapid improvements within the CQC over the coming months. These include urgent action to improve the provider portal and regulatory platform, rebuild relationships with providers, and strengthen the CQC’s capacity to respond to emerging risks and serious incidents.

Over the next six months, significant progress must be made towards rebuilding expertise within the CQC and fostering stronger relationships with providers. By involving more clinicians and frontline professionals in the inspection process, the CQC can begin to restore credibility and trust within the sector.

Looking further ahead, the next 12 months will be critical in ensuring that the Single Assessment Framework is enhanced and improved to meet the needs of a modern, innovative, and outcome-focused health and social care system. This includes reviewing the quality statements, emphasising effectiveness and outcomes more, and ensuring that the framework supports innovation and the use of resources.

By implementing these recommendations, the CQC has the opportunity to strengthen its role as a regulator and play a pivotal role in improving the quality and safety of care across England. The road ahead will be challenging, but with the right leadership, governance, and support from the DHSC, the CQC can rise to the challenge and deliver the changes needed to build a safer, more effective health and social care system.

Moving forward with confidence - How ComplyPlus™ can help

As the health and social care sectors continue to navigate the challenges of regulatory compliance, innovation, and workforce shortages, the role of regulatory compliance management software has never been more critical. ComplyPlus™ is designed to support providers in meeting regulatory requirements, improving performance, and driving innovation.

If you would like more information on how ComplyPlus™ can help your organisation navigate the evolving regulatory landscape, contact us today. Let’s work together to build a safer, more effective health and social care system.

About the author

Dr Richard Dune

With over 20 years of experience, Richard blends a rich background in NHS, the private sector, academia, and research settings. His forte lies in clinical R&D, advancing healthcare tech, workforce development and governance. His leadership ensures regulatory compliance and innovation align seamlessly.

CQC’s Role in Healthcare Quality: A Review of Operational Effectiveness - Dr Richard Dune -

About the author

Dr Richard Dune

With over 20 years of experience, Richard blends a rich background in NHS, the private sector, academia, and research settings. His forte lies in clinical R&D, advancing healthcare tech, workforce development and governance. His leadership ensures regulatory compliance and innovation align seamlessly.

Northern Ireland’s struggling health workforce: Concerns continue - Dr Richard Dune -

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