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I have extensively written about the Care Quality Commission’s (CQC) evolving regulatory approach over the last couple of months.  The CQC has now published its draft strategy for 2021 and beyond; “Changing regulation to improve care for all” setting out how it will regulate  in 2021 and beyond.

The draft strategy is built on four central and interdependent themes that determine the changes we want to make to our regulation:

  • PEOPLE: We want to be an advocate for change, ensuring our regulation is driven by what people expect and need from services, rather than how providers want to deliver them.
  • SMART: We want to be smarter in how we regulate, with an ambition to provide an up-to-date, consistent, and accurate picture of the quality of care in a service and in a local area.
  • SAFE: We want all services to promote strong safety cultures. This includes transparency and openness that takes learning seriously
  • IMPROVE: We want to play a much more active role to ensure services improve.

In this article, I will focus on SMART, how the CQC will regulate to “provide an up-to-date, consistent, and accurate picture of the quality of care.”

The stated ambition is:

“We’ll have a more dynamic approach to regulation. Inspections are not the only way to assess quality: we want to move away from relying on a set schedule of inspections to a more flexible approach. This means using all our regulatory methods, tools, and techniques to assess quality continuously, rather than relying only on scheduled all-inclusive on-site inspection visits. We want our local teams to have a regular view of the services they manage based on their knowledge –not a calendar date.”

The CQCs smarter approach to regulation “means more dynamic approach to regulating: moving away from relying on periodic inspections of services, and harnessing information from all sources to continually assess quality and update ratings.”

I previously wrote about the CQC’s next phase of regulation and its increased focus on data instead of traditional inceptions. The CQC’s Chief Inspector confirmed that CQC inspectors will substitute on-site inspections with monitoring and reviewing information from “all available sources, collecting further information where necessary.”  CQC inspectors will review the monitoring this information and existing streamlined set(s) of Key Lines of Enquiry (KLOEs) to make their judgement.  The CQC has been clear that “an inspector’s professional judgement will remain part of how we monitor risk.”

The draft strategy confirms this by stating:

“Data will underpin all our activity, allowing us to understand risk and how people are experiencing care, target our resources for the greatest impact, and be more proactive than reactive.”

A key aspect of this new data driven approach requires a trusted, robust and open flow of information.  The draft strategy recognise the need for care providers to play their part in providing the CQC with information based on “open, ongoing, and constructive relationships, based on trust”.

Does the draft corporate strategy spell the end of CQC inspections?  Not for everyone no.

The CQC confirmed that:

“Traditional inspection site visits will become just one of our tools in our toolkit. But we’ll still use our powers to inspect when appropriate–in response to risk, when we need specific information, and when sampling to check the reliability of our view of quality.”

It is clear that traditional inspections will not be the norm anymore.  The CQC approach to regulation will largely be data and information driven and, where this data and information identifies risk or safeguarding concerns, the CQC will use it powers to inspect.

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