NHS England paused its Use of Resources assessments in response to the COVID-19 pandemic. The assessments remain paused until NHS England resumes them.
In the meantime, the assessments are being re-evaluated and refreshed to ensure they are fit for purpose. Therefore, inspections do not currently include a Use of Resources assessment. This means that a trust’s use of resources and combined rating will not be updated until NHS England advises us. NHS England’s national team can provide more information about the Use of Resources assessments (england.uorenquiries@nhs.net).
The following describes the process for the Use of Resources assessments before they were paused.
Use of resources assessments were developed to improve understanding of how effectively NHS trusts are using their resources to provide high-quality, efficient and sustainable care for patients. This includes their finances, workforce, estates and facilities, technology and procurement. The Use of Resources assessment only applies to non-specialist acute trusts.
NHS Improvement assesses trusts' use of resources using the joint use of resources assessment framework. This describes the assessment process, which is based on a series of key lines of enquiry (KLOEs) and prompts. It takes a qualitative and quantitative approach by looking at initial productivity and finance metrics and then corroborating this with local intelligence, and rating characteristics.
The use of resources assessment team comprises a small group of senior staff from NHS Improvement. During the on-site visit, the assessment team will meet leaders from the trust who have responsibility for clinical and operational services, workforce and finances.
To prepare for the assessment and inform particular lines of questioning, the assessments include an analysis of the trust's performance against a small number of metrics, as well as evidence from local information gathered during NHS Improvement’s day-to-day interactions with the trust and any other relevant evidence. Before the visit, NHS Improvement will ask trusts to provide a high-level commentary about their performance against the five KLOEs in the use of resources assessment framework. Trusts may also submit any more recent data that might help to inform the assessment.
NHS Improvement will collate all relevant qualitative and quantitative evidence into a report, which is used to reach a proposed rating for the trust’s use of resources. The rating will be either: outstanding, good, requires improvement or inadequate. NHS Improvement will also use the findings of the use of resources assessment to identify potential support needs at the trust as part of the Single Oversight Framework.
Before NHS Improvement submits the report and proposed rating to CQC, it carries out an internal quality assurance and calibration process that involves moderation at both regional and national level.
The draft report and proposed rating will be considered as part of the post-inspection process for reviewing and approving the inspection reports and ratings for the trust.
We will publish the final use of resources report and rating with the trust-level inspection report and the current trust-level quality ratings for that trust.
CQC also uses the use of resources rating to award trusts a combined rating at the overall trust level. We do this by aggregating the use of resources rating with our five trust-level quality ratings for the key questions of: safe, effective, caring, responsive and well-led.