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Responding to our consultation: Our new strategy from 2021

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We launched our formal public consultation on CQC’s new strategy in January 2021. We enabled a wide cross-section of people and organisations to tell us what they think about the ambitions and proposed changes set out in The world of health and social care is changing. So are we.

It was important that we involved the health and social care providers that we regulate, the people who use their services, our own colleagues in CQC and all our strategic partners, to ensure we have a strategy that will enable effective regulation.

How we consulted

Engaging before formal consultation

To develop a more relevant, inclusive and collaborative strategy, we started conversations about the future of our organisation in September 2019, exploring what excellent health and social care regulation would look like in the future.

  • We held a leadership conference with over 500 colleagues exploring our future direction.
  • We engaged with more than 2,000 people and public representatives from September to November 2019.
  • We held conversations with more than 200 organisations representing both service providers and our strategic partners.

We also used research on where our regulation has contributed to improving the quality of health and care services.

From March 2020 the COVID-19 pandemic prevented us from holding face-to-face events. We were still able to engage widely on our initial proposals through online webinars, forums and discussions. This was to enable feedback from the public, health and care service providers, our colleagues in CQC and other stakeholders to help adapt and evolve the direction of the strategy and develop proposals in our four themes.

We engaged extensively with external stakeholders during the summer of 2020 through:

  • five interactive strategy themed webinars reaching more than 5,000 service providers and strategic partners
  • online surveys looking at each strategy theme, receiving around 1,100 public responses and a further 1,000 responses from service providers and strategic partners.
  • a number of activities through our partnerships with the voluntary sector to enable seldom-heard groups of people to share their views through open conversations.
  • publishing 11 blogs from senior colleagues in CQC to encourage people to participate in events and give their views.

In October 2020, we shared a draft version of our strategy on our online CitizenLab platform. This enabled stakeholders to help us test and refine our proposals ahead of launch. Following this, we:

  • involved more than 500 CQC colleagues at all levels of the organisation in workshops on the strategy themes during a conference in November 2020
  • engaged with more than 5,000 people and organisations representing different groups through a mix of one-to-one discussions, focus groups, webinars and surveys
  • engaged with people whose voices are seldom heard to ensure our ambitions met their needs and expectations
  • received 350 responses to our CitizenLab surveys and held theme focused meetings and cross-sector co-production sessions with organisations representing providers. Our pre-recorded and live webinars reached more than 7,500 viewers and a popular series of podcasts covering the four themes of the strategy, reached more than 2,000 listeners.

We carefully considered all feedback about the draft ambitions and proposals and used this to develop a version of the strategy for the full public consultation in January 2021.


Engaging during the consultation period

The consultation ran for eight weeks from 7 January to 4 March 2021. We published the draft consultation content on our website, both as a PDF document and as text on web pages, along with an easy to read version. We asked a set of questions relating to each theme in the draft strategy. People were able to respond either by completing an online webform, by emailing, or by posting their responses.

As part of the consultation we produced a draft Equality and Human Rights impact assessment. This reflected our early thoughts on the potential opportunities for improving and promoting equality and human rights through the draft strategy and ways to maximise these, and how we propose to mitigate potential risks to equality and human rights as a result of implementing proposals.

To encourage people to respond to the consultation, we:

  • held briefing calls with our colleagues focused on our strategy
  • hosted focus groups targeted at people who are at risk of receiving poor care, as well as a series of one-to one interviews to make sure seldom-heard communities were represented.
  • held four webinars, one for each theme, for both service providers and our strategic partners
  • used our regular bulletin channels with all our audiences to promote the consultation.

The final strategy is a product of a collaborative journey with everyone who contributed over the last 18 months.


Responses to the consultation

We are grateful to all those who responded to the consultation for the valuable feedback. All responses were analysed by Traverse Ltd, who provided independent analysis of the qualitative and quantitative information.

We received a total of 790 responses. These were from:

  • People who use services / public / voluntary and charity groups: 213 (27%)
  • Service providers / commissioning bodies: 398 (50%)
  • CQC teams (team responses equate to more than 400 individual CQC colleagues): 65 (8%)
  • Other stakeholders: 114 (14%)

We received responses in the following ways:

  • 611 through our online webform
  • 114 sent by letter or email
  • 65 responses taken at engagement events.

Many responses represented the views of organisations.

Our extensive engagement on the draft strategy before the formal consultation meant that we had already incorporated a great deal of feedback. The nature of the consultation prompted a large number of ‘qualitative’ responses, which included detailed views and suggestions.

Key overall feedback on the strategy

Responses indicated overwhelming overall support for the aims, ambitions and proposals in the strategy. Over 75% of respondents ‘fully’ or ‘mostly’ supported our proposals under each of the four themes proposed.

  • Respondents felt it is right for CQC to regulate health and social care in a way that emphasises the perspective and experiences of people who use services and that reflects wider trends in health and social care, focusing on the pathways that a person takes on their journey through services.
  • People welcomed the focus on CQC working more closely with health and care services and building strong relationships. They felt closer collaboration with services will help to identify where there is a need to improve, so that people’s care improves.
  • Respondents also commented positively that by ensuring our information is up to date and accessible to all, people will be more informed and able to choose the care that is most appropriate for them.
  • They also welcomed the proposal to share good practice and for CQC to be a source of advice for services as a positive development, which should improve the way care is delivered.
  • Respondents felt that the pandemic has shown how delivering care using digital solutions can work effectively when needed, and that this strategy helps to further build on encouraging innovation when it’s used appropriately.

We were particularly pleased with the high level of engagement and enthusiasm from respondents, especially with the eagerness to help us develop our thinking further in areas such as safety and improvement.

We will use the richness of detail in the feedback to inform our thinking further as we move forward with implementing our strategic vision. We’ll share some of the main priorities for implementation when we publish the strategy on 27 May 2021.

This strategy needs to be flexible to allow us to review it and adapt when things change in health and social care, so our work remains relevant and effective. We will review it regularly to make sure this happens.

Clarifying some questions in responses

There were, as we would expect, some areas where respondents asked for more information or expressed concerns. We address specific points in the sections for each theme, but there were some overarching comments that applied across our ambitions:

  • A number of respondents wanted more detail on how we will implement our strategic vision. Although we’ve set out our strategic direction, we can only make the strategy a success by working together with health and care providers, people who use these services, and all our stakeholders. The support for the strategy provides the endorsement we need to start this work and build on it through continuing involvement and engagement. This means we don’t have all the details now and we won’t implement everything straight away. An overall aim is for our regulation to be flexible and to adapt our thinking throughout the duration of the strategy, making changes where we need to.
  • We want to assure all respondents that we will use a range of ways to assess quality and update ratings – this still includes on-site inspections. We’ll use our powers to visit services when we need to respond to risk, when we need specific information, when we need to observe care or to ensure that our view of quality is reliable. We’ll make the best use of our time on site, ensuring we carry out the activities that we can only do in person, such as observing care and having better conversations with care staff and people using the service This is how our inspection visits will be more targeted and proportionate.
  • There was some concern that our strategic ambitions would result in a greater workload for services. We want our strategy to benefit everyone. One of our overall ambitions is to minimise unnecessary workload that can be associated with regulation. We won’t duplicate the role of other regulators, but will work with them to improve outcomes. This strategy is built on the desire to target action where it’s needed, using the information we hold in a more intelligent way so we can be more insight driven to tailor our approach. We know there’s pressure on providers with limited resources, and so this will be a key principle throughout all our work. This is particularly important as the country moves on and re-builds after the COVID-19 pandemic. Our regulation will become more constructive and supportive – using what we know to help services to tackle problems early.
  • Some respondents wondered if we would have enough capacity and the right capability to implement the strategy, as some areas would require new or different skills. Over the coming years, our programme of work will be underpinned by investing in the tools, processes and training needed to do this. This involves developing our own skills in areas such as data analysis, safety and improvement. We are keen for CQC to be a ‘learning organisation’ and will make sure our colleagues have the right learning and development to assess local health and care systems as well as individual service providers. We’ll develop a process so that we can learn and understand what impact our actions have and where we need to improve our approach.
  • There were some questions about our overall ambition to reduce inequalities in health and care. The most common concern was that CQC is unlikely to be able to influence the wider determinants of inequality. We want to make it clear that our focus will be on reducing inequalities in health and care – specifically people’s journey through care – making sure that everybody has fair and equal access, and an equally good experience and good outcomes from their care. We’ll share more specific details on how we will achieve this, and the areas of focus, in our revised Equality Objectives that we’ll publish in summer 2021.
  • A few respondents expressed concern about wider constraints of the healthcare system that are beyond the scope of providers to address, and that providers can sometimes be penalised for circumstances that are outside of their control such as funding and the impact of commissioning. Our assessment of services will look at how they are meeting the needs of their population, given the resources available to them, and how they work collaboratively.

Strategy theme: People and communities

Q1a. To what extent do you support the ambitions set out in this theme?

There were 618 responses to the closed question in the online form. The vast majority of these (496) either ‘fully’ or ‘mostly’ supported the ambitions in this theme (80%). Only 21 of these respondents did not support the ambitions at all (3%).

"We must hear from everyone – even the seldom heard voices. The barriers to hearing the messages must be broken. We must seek out feedback and not just listen to those that openly come forward".

(Provider/commissioner)

Q1b. Please give more details to explain why you chose this answer

We received 653 responses to this open question through all response channels. Most respondents made general comments such as “fully support” or “I agree with the sentiment”. Respondents made more detailed comments in support of our proposals under specific areas. For example, providers and commissioners supported our emphasis on raising public awareness of CQC to address misunderstanding about our role; people also welcomed our focus on feedback about the entire journey through care, including how different services interact with each other, to highlight persistent issues in a system and to hold them to account.

"It has to be a really positive change to use the expectations and experiences of people and communities when assessing the quality of health and care services. It is not just about the decor and look of care, but the quality and sensitivity with which care has been delivered, and how people in receipt of care have been communicated with".

(person using services/public)

We clarify some specific queries and concerns from responses to this theme, including:

  • The need to use the views and experiences of people who work in health and care services

Some respondents felt that the draft strategy didn’t emphasise using the views of staff. We know that staff have valuable insights about a service and we will include these in our assessments – including positive aspects of care as well as concerns. We always encourage staff to speak up and we will be spending more time talking with staff when we visit a service.

  • Not enough emphasis on the impact of local health inequalities and deprivation on the quality of care

An overall ambition of the strategy is to look at local health and care systems as well as individual services. Some respondents felt CQC should focus on improving care for all – not on reducing inequalities, and that we won’t have an impact on wider inequalities that could affect people’s health or outcomes. We believe that we will improve care for all by ensuring that the quality of care improves for people who have difficulty accessing good care or who currently or more commonly experience poorer care. We will also work with strategic partners and other stakeholders to influence how local health and care systems develop and influence wider factors causing health inequalities beyond the health and social care system – such as poverty, educational opportunities, employment and environmental factors.

"There has to be an understanding of how services are commissioned and funded if regulation is driven by users' expectations. To deliver truly person-centred care is impossible if it is not funded properly. Regulation should encompass commissioning and how services are procured".

(Provider/commissioner)

  • Need to focus on positive feedback

Some respondents were concerned that we will only focus on negative experiences and feedback about services. We want to hear about good, neutral and bad experiences of care to give us a full view of quality. We will encourage people to share any positive feedback and experiences so that we can use it in our assessments and share with others.


Strategy theme: Smarter regulation

Q2a. To what extent do you support the ambitions set out in this theme?

There were 608 responses to the closed question in the online form. More than three-quarters of these (471) either ‘fully’ or ‘mostly’ supported the ambitions in this theme (77%). Only 30 of the 608 responses did not support the ambitions at all (5%).

"I think the smarter regulation will be a welcome change... I believe a lot of services prepare for CQC visits and know exactly what to show, which I don't think always gives a true reflection to people. This way a lot more will be involved in ensuring people get an up to date and truer reflection on services."

(Provider/commissioner)

Q2b. Please give more details to explain why you chose this answer

We received 627 responses to this open question through all response channels. Care providers supported the ambitions to keep ratings up to date as it will help them to highlight improvements and address long periods between inspections without changing a rating. People also supported a more holistic view of quality and believed up-to-date ratings would help them to choose care services.

Respondents also believed better use of technology would help to streamline data collection, for more efficient regulation.

"Having a more targeted and dynamic approach to regulation and inspections will result in quicker improvement in failing areas."

(person using services/public)

 

There were some specific queries and concerns from the responses, which we clarify below:

  • A potential reduction in the time CQC spends in a setting

We have listened to the concerns from people with a learning disability and autistic people about the risk of not identifying poor care if we carry out fewer physical, on-site inspections. We want to clarify that we’ll continue to carry out site visits in services and use a mix of the best methods for understanding people's experiences in different care services, specifically people who face additional challenges or are afraid or unable to speak up because of communication barriers. We’ll focus more on the types of care setting where there’s a greater risk of a poor culture going undetected. This may mean we make more frequent site visits. One of the most effective ways of understanding people's experiences is through observation and talking to people who live in or use a service, and we will continue to do this. We’ll use our powers to visit services when we need to respond to risk, when we need specific information, when we need to observe care or to ensure that our view of quality is reliable.

"Although we support the collection of information about services in a diverse range of ways, it is essential that in-person inspections remain (by teams with appropriate specialist knowledge and skill), especially for learning disability and autism services at risk of developing closed cultures etc."

(person using services/public)

We’ll build stronger ongoing relationships with services by having more regular contact with them. This will give us better insight and understanding about individual services and improve our ability to tailor our approach when we need to. By looking at data continuously, we’ll have more time to spend during our visits to services to observe care. We’ll also be able to talk to people using services and to staff so they can tell us about improvement and good practice.

"There should also be the opportunity for providers to provide any context, as data alone won’t necessarily tell the whole picture."

(Provider/commissioner)

 

  • More assurances needed on how we will source and manage accurate data

We will work with service providers, other regulators and strategic partners to coordinate data collections so that it is easier for services to give us the information we need, update it, and access more of the information we hold about them.

  • More clarity needed on how we will use data and information to change a rating

We’re developing our approach to assessing quality more continuously, using all our regulatory tools and methods. When we update a rating, we’ll be open and clear about the type of data and information we’ve used, and how it has contributed to our decisions about any changes.


Strategy theme: Safety through learning

Q3a. To what extent do you support the ambitions set out in this theme?

There were 610 responses to the closed question in the online form. The vast majority of these (508) either ‘fully’ or ‘mostly’ supported the ambitions in this theme (84%). Only 23 of the 610 respondents did not support the ambitions at all (4%).

"Embedding safety into everything that is undertaken is very important, it needs a culture shift as all too often with the time restraints placed upon health and social care workers, this is an easy thing to miss."

(person using services/public)

Q3b. Please give more details to explain why you chose this answer

We received 586 responses to the open question through all response channels. Many supported our focus on learning from safety incidents to prevent future mistakes, working collaboratively on a consistent definition of safety and the importance on strong safety cultures.

"Recognising providers who have a culture of learning and improvement at their core will be a great step forward, as will the sharing of CQC learning and insights to help services improve."

(Provider/commissioner)

We clarify some specific queries and concerns from the responses on the safety theme, including:

  • A lack of detail for regulating safety and how the proposals would be implemented

The level of support for our ambitions around safety is an endorsement to move forward and make them a reality. As part of our programme of work to implement our strategy we’ll be working with strategic partners and other stakeholders to develop our thinking further in the details of how our regulation can improve safety, including how we will develop a standard definition of safety for all health and social care.

"Who wouldn't want safer care? CQC must do everything it can to make all care safe. But I think it's hard for them to do this if services don't train staff properly or they don't have money to train"

(person using services/public)

  • The need for CQC to be accessible and willing to work with a provider’s staff when they have a concern

Our assessments of safety will have a sharper focus on checking for open and honest cultures. We’ll encourage health and care staff to speak up about safety issues where they work, including discrepancies and/or neglect. We’ll expect all services to have stronger safety and learning cultures and that learning and improvement should be the primary response when anyone speaks up. We want staff to feel confident that we’ll also listen and act when they raise concerns with us and we’ll intervene quickly, where appropriate. We want staff to feel confident they can report concerns to us if a provider is failing to take action.

"It is essential that this focus on safety achieves the right outcome, so providers who take a very proactive, open approach to identifying concerns themselves and addressing them do not find that they are then penalised in any inspection for doing so because that information was proactively offered to CQC. We are concerned that this focus does not inadvertently undermine other work to ensure services are truly person-centred and not so risk-averse that people’s choices are unreasonably limited."

(Provider/commissioner)

  • The lack of mention of safeguarding in the strategy document

In the Safety through learning theme, when we refer to ‘safety’, we mean avoidable harm, neglect, abuse and breaches of human rights. Our role in safeguarding is to make sure providers have the right systems and processes to protect people from abuse, improper treatment and neglect and to hold them to account for this. We encourage staff to follow local safeguarding procedures to raise concerns, including mistakes, lapses and institutional neglect.

There is therefore a strong link between safety, safeguarding and human rights.


Strategy theme: Accelerating improvement

Q4a. To what extent do you support the ambitions set out in this theme?

There were 603 responses to the closed question in the online form. The vast majority (473) either ‘fully’ or ‘mostly’ supported the ambitions in this theme (79%). Only 28 of the 603 respondents did not support the ambitions at all (5%).

"It is absolutely the role of the regulator to drive rapid improvement... Where there is good and outstanding practice it should be shared and celebrated more widely, particularly when it empowers service users towards having greater independence and choice in their care."

(person using services/public)

Q4b. Please give more details to explain why you chose this answer

For the open question, we received 548 responses through all response channels. There was broad support for encouraging continuous improvement, collaboration and sharing good practice to help improve care. The provider/commissioner group in particular commented positively on the idea of a more collaborative relationship between CQC and service providers. Respondents also supported the drive to encourage innovation.

"The advisory role has long been missing from CQC's function and can only serve to improve what and how we do things and work together...Being more open and accessible will also encourage people to raise concerns about poor practice and abuse."

(Provider/commissioner)

We clarify some specific queries and concerns from the responses, including:

  • The need to strengthen our commitment to supporting research

Our strategy strengthens and clarifies our position and commitment to supporting research, as we recognise the importance of research in driving improvements in the quality and safety of care. We’ll encourage services to play an active part in research to improve care for all, foster innovation and enhance experiences for people.

"The intentions to accelerate improvements in services are supported but clarity is sought on the role of CQC as compared with that to NHS England / Improvement in this regard...There is the potential that diversifying too much could distract from the business of regulation of services, particularly in view of the significant changes that are proposed through this consultation."

(Provider/commissioner)

  • More clarity on our role in terms of improvement

We’ve clarified that we see our role as supporting but not directing improvement. We will facilitate access to external improvement support, and point services and local care systems to where they can get it, while still retaining our clear regulatory role. We will collaborate with others to provide improvement support, rather than duplicating their efforts.

"For accelerated improvement we need full system sign up by all parties...Telling providers the ways they can improve without the resource to do so will not be effective. Will CQC be championing the resources to support best practice delivery? CQC would also need to ensure it has sufficient person-centred and organisational development experience and know how to make wise recommendations for development."

(Provider/commissioner)

  • The need for CQC to develop its internal improvement culture and capabilities

We are committed to developing a culture of improvement in CQC. We will look to develop expertise within inspection teams and consistency in our decision-making processes.

  • Clarifying the role of local health and social care systems in driving improvement

We consider local health and care systems to have a pivotal role in leading improvement activities. We have made this clear in our strategy alongside our intention to support this, and we will look at this in our assessments.

  • Recognising the implications of commercial sensitivity in encouraging collaboration between providers

We recognise there are legal limits on cooperation between commercial providers. We will take this into account in implementing our expectations for services to collaborate.


Core ambition: Assessing health and care systems

Q5a. To what extent do you support our ambition to assess health and care systems?

There were 608 responses to the closed question in the online form. The vast majority of responses (500) either ‘mostly’ or ‘fully’ supported the ambition to assess health and social care systems (82%). Only 34 of these did not support the ambition at all (6%).

"Absolutely it is essential to look at the partnership between health and social care and to see the experience of service users as a whole. Many service users and families don't know the difference between the two. There is huge inequality because navigating this complex area requires high levels of literacy, understanding of systems, tenacity and emotional resilience. This should not be the case. It leads to huge inequalities of outcome. "

(person using services/public)

Q5b. Please give more details to explain why you chose this answer

There were 499 responses to the open question received through all response channels. Supportive comments in general were that collaboration and system working are central to improving the quality and safety of care.

"Providers do not work in isolation, and service users rarely access care from only one organisation. It is therefore important to ensure that the transition between providers is as seamless as possible for patients, and also that the level of care is consistent...we consider it to be logical for CQC to assess the whole care system and the way in which organisations work collaboratively for the benefit of all service users."

(Provider/commissioner)

We clarify some specific queries and concerns from the responses, including:

  • Legislation to allow us to fulfil our ambitions around assessing systems

After we published the draft strategy for consultation, the government announced the draft Health and Care Bill. This states that integrated care systems (ICSs) will be accountable for people’s health outcomes and the government is exploring ways to enhance CQC’s role in reviewing how local health and care systems work.

 

We welcome this statement and are currently working with the Department of Health and Social Care to develop an approach. Our assessment of people’s care must look at every stage of their journey through the health and care system, looking at both individual services and across different service providers and organisations.

 

"Oversight of health and care systems is required to help identify gaps or opportunities for better joined up working. CQC are in a unique position to support integrated health and care systems... To be effective, CQC does require the necessary regulatory powers to address failings beyond that of the providers for example local authorities. Good care is made possible by local authorities who fund care services fairly resulting in well-paid staff who feel valued and provide higher quality services. These factors must be considered by CQC who should have power to take action when local authorities are not commissioning services appropriately."

(Provider/commissioner)

  • More clarity needed on the role of commissioners and how this affects quality, and how CQC intends to work with commissioners to deliver the strategy

The draft Health and Care Bill recognises the increasing number of people who need adult social care and the need for greater oversight of how these services are provided and commissioned. The proposal is to introduce a new duty for CQC to assess how local authorities are meeting their adult social care duties, and a new power for the Secretary of State to intervene if we consider that a local authority is failing to meet these duties. Improvement activity from a range of sources will be key to helping commissioners raise the quality of care in their area and help improve outcomes for people. To support this increased oversight, the government is also proposing changes to the types and frequency of data it collects centrally from the sector.

"Partnership working is crucial, but achievements, good practice and areas of concern relating to individual services should not be overlooked. Further, weak links in the partnership chain should not adversely affect ratings for providers where they are not responsible for these weak links."

(Provider/commissioner)

  • The impact of financial constraints on system working and whether CQC will draw the link between finance and quality

Our role in assessing local health and care systems will be about how they are coping with the challenges in their local area, given the resources available to them – for example, ensuring equal access to services, meeting the needs of their population and how they work collaboratively.


Core ambition: Tackling inequalities in health and care

Q6a. To what extent do you think our ambitions in the strategy will help to tackle inequalities?

There were 606 responses to this closed question in the online form. Just over half of these (306) either ‘mostly’ or ‘fully’ felt our strategy would help to tackle these inequalities (50%).

There was a more mixed response to this question as more respondents (61) selected ‘don’t know’ compared with the other options (10%), and 65 did not support the ambition at all (11%).

"For most of the services that CQC inspects, there is little choice for the service user. It shouldn't be a postcode lottery as to what standard of care you get. By addressing inequalities, service users should get good care regardless of who they are, what their differences are, and where they live. "

(Provider/commissioner)

Q6b. Please give more details to explain why you chose this answer

We received 577 responses to the open question through all response channels. Many respondents supported the ambition and consider this a very important focus, particularly in light of the effects of the COVID-19 pandemic on some groups of people.

Respondents supported CQC being able to detect inequality by continuous, proactive monitoring of services and by engaging with people who use services from diverse backgrounds.

"The focus the entire strategy places on hearing from diverse populations and involving people is admirable and vital for tacking inequalities. However, to fully address inequalities, services would need to make financial investments... "

(person using services/public)

There were also some specific queries and concerns from the responses, including:

  • CQC is unlikely to be able to influence the wider determinants of inequality and there is no clear plan what our role would be

Our ambition focuses on reducing inequalities in health and care. Our core purpose is to make sure that everyone receives safe, high-quality care in whatever setting and wherever they live. This involves working with partners across health and social care to ensure that individual services and local system frameworks deliver good care for all people, including people in different equality groups, so they can:

  • access good quality care that meets their needs and preferences
  • have an equally good experience of care
  • have equally good outcomes from using care services.

We will ensure the evidence we gather and the way in which we assess and report on the provision of services specifically includes a focus on reducing inequalities such as in access to care and in people’s outcomes. Where possible, we will report back on progress for people with different equality characteristics and in different places. We will take action where we find services are not making improvements

We’ll focus on getting feedback from people who are most likely to have a poorer experience of care and who are less able to speak up about their care.

We’ll also work with strategic partners and other stakeholders to influence how local health and care systems develop and shape the wider factors that cause health inequalities beyond the health and social care system – such as poverty, educational opportunities, employment and environmental factors.

Our new Equality Objectives, to be published later in summer 2021, will provide further information about this.


Measuring the impact on equality

We produced a draft impact assessment to identify the opportunities and risks for promoting equality and human rights through our new strategy. We asked for views on:

We received 381 responses through all channels. Respondents supported the focus on equality and human rights. They felt it will help to reduce inequalities and the opportunities identified are a welcome development, particularly for minority groups that may be under-represented.

Some respondents felt the draft equality impact assessment was lacking in detail about what practical steps we would take as a result of the assessment.

As this was a draft impact assessment, we have considered feedback and made some changes. We will have more specific actions and in our Equality objectives, to be published in Summer 2021.

Last updated:
26 May 2021