The CQC’s response to their consultation – changes for more flexible and responsive regulation

In January 2021, the CQC launched a consultation to find out your views on some specific changes to make regulation more flexible.  

There were 566 responses to the consultation, the majority, 72%, were from service providers or commissioning bodies. 

Proposals with broad support 

• Using a larger variety of regulatory approaches in order to assess quality, and not just rely on full on-site inspections.  
• Reviewing and updating regulations more often and flexibly.  
• Rating GP practices and NHS trusts differently.
• Improved CQC relationships with providers and more collaborative working. 

Areas of concern 

• The importance of seeing care provided and how it affects ratings could be lost through a more flexible approach with fewer on-site inspections. 
• The reliability and availability of data and information used to change a rating and how it’s collected.
• Simpler rating processes for GP practices and NHS trusts could lose important detailed information. 

Next, we’ll briefly look into the CQC’s responses to these concerns. 

Assessing and rating quality 

This proposal received enough positive support for the CQC to go ahead. 

They have stated that they will still focus on-site assessments where most needed, and that they will remain a major part. However, they will also bring in other sources of information which means they may not always need to visit. 

They will ensure their regulation is targeted and flexible, while continuously developing their approach.  

Reviewing and updating ratings 

Encouraged by the level of support for this proposal, the CQC is taking it forwards. 

They are going to increase the flexibility of their regulatory approaches including: 

• Overall ratings produced through published inspections will be relied less upon. For the rest of 2021, the CQC will still respond and re-inspect services where appropriate. Then they will provide information about how often they will be updating ratings while they begin their approach to Smarter Regulation. 
• Where there is evidence of a change in quality, the CQC will more frequently change ratings. 

Changing how the CQC rate GP practices and NHS trusts 

This will also be taken forwards by the CQC. From October 2021, the CQC will stop providing separate ratings for the 6 population groups in GP practices. Instead, ratings will be focused on the 5 CQC standards: safe, effective, caring, responsive and well-led, as well as an overall rating. 

The CQC will speak to providers and stakeholders to make sure their approach reflects how care is being delivered and acting to address inequalities. 

Looking to the future of flexible regulation 

The CQC have made some commitments for future changes to activity in order to stay transparent: 

• Undertake less large formal consultations and more on-going opportunities to engage in different matters. 
• Publish information of updated changes to their approach. 
• Include information on their website that is up-to-date, accessible and formatted to be easy to read. 

Find out more on the CQC’s recently published article.