Special measures: online services, independent doctors and clinics

Page last updated: 12 May 2022
Organisations we regulate

Responding to inadequate care

Services rated as inadequate overall will be placed straight into special measures.

The purpose of special measures is to:

  • Ensure that providers found to be providing inadequate care significantly improve.
  • Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.
  • Provide a clear timeframe within which providers must improve the quality of care they provide or we will seek to cancel their registration.

Special measures does not replace CQC’s existing enforcement powers: it is likely that we will take enforcement action at the same time as placing a provider into special measures. In some cases we may need to take urgent action to protect people who use the service or to bring about improvement, in accordance with our enforcement policy.

We have published detailed guidance about our approach to special measures.

We want to ensure that services found to be providing inadequate care do not continue to do so.

Responding to care that requires improvement

Where services are rated as requires improvement on more than one consecutive inspection, it shows that they cannot demonstrate the necessary leadership or governance processes to assure and improve quality. In these cases, we will consider whether this may represent a breach of Regulation 17 (good governance). We may also ask the provider for a written report to set out how it will assess, monitor and improve the quality and safety of its services.

If we rate a service as requires improvement for a third time, we will hold a formal management review meeting (MRM) to consider the next steps and the potential use of our enforcement powers.

Where we register larger or complex providers, we will monitor quality across all their services. Where there are concerns across the group, we may consider taking action to hold the provider to account, for example by using our enforcement powers.