Public consultation on CQC’s new strategy

Between September 2019 and January 2021, the Care Quality Commission (CQC), the independent regulator of health and social care in England, developed its new strategic approach to regulation. This involved several rounds of stakeholder engagement. Changes to regulation during the COVID-19 pandemic, such as the temporary suspension of routine inspections, and reforms of the health and care system with the development of integrated care systems, shaped the development of the new strategy.

Launch of public consultation

On 7 January 2021, CQC published its draft strategy from 2021 to 2026 for public consultation, alongside a draft equality and human rights impact assessment. The consultation ran until 4 March 2021. The Care Quality Commission stated that ‘the approach of delivering care as a “system” is very different to the “single provider service model” that CQC was set up to oversee in 2009.’ It aimed to adapt to changes in the health and care sector, particularly highlighted by the pandemic.

The new strategy had two overarching objectives: regulating systems and how they worked together instead of services in isolation, and reducing inequalities in health and care.

Four main themes were put forward:

• Ensuring that CQC’s regulation was ‘driven by people’s needs and their experiences of health and care services’. This included providing different ways for people to provide feedback and assessing how providers worked with their communities.
• Regulating in a ‘smarter’ way through a more targeted and flexible approach. CQC proposed updating ratings more often, providing a clearer definition of quality and standards and diversifying methods to assess services.
• Improving safety in services by enabling a stronger ‘learning culture’. Measures to do this included establishing a national definition of safety, assessing organisational cultures and intervening faster in the case of evidence of risks to the safety of patients.
• Finally, the new strategy aimed to support improvement within services and in how they worked together.

Consultation responses

In May 2021, the CQC published the consultation responses and their finalised strategy for the next 5 years. It received 790 responses from a range of stakeholders including service providers, people who use services, charity groups and CQC teams. CQC reported ‘overwhelming overall support for the aims, ambitions and proposals in the strategy’.

Some concerns were raised in the consultation exercise, such as the lack of detail on the implementation phase of the strategy. Some stakeholders were also concerned about CQC’s capacity and capability to deliver the strategy. Additionally, there was apprehension that this new approach would increase the workload on services and that wider system constraints would not be considered. Finally, there was some feedback that the organisation would be unlikely to be able to influence the wider determinants of health.