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CQC consults on plans to evolve regulation of independent healthcare services in England

26 January 2018
  • Public

The Care Quality Commission (CQC) is inviting people to give their views on plans to evolve its approach to regulating independent healthcare services in England to ensure a more targeted, responsive and collaborative approach.

The proposals, published today (Friday 26 January) set out how CQC intends to develop its next phase of regulation for independent healthcare services, such as independent acute hospitals, independent doctors and clinics, and independent substance misuse services. They include:

  • How CQC plans to introduce quality ratings following its inspections for those independent healthcare services that it was given the power to rate by the Department of Health and Social Care last month.
  • Changes to the regulation of independent healthcare services, including the scheduling and intensity of its inspections and how CQC will monitor providers and gather its intelligence on an ongoing basis.

Commenting on the proposals, Sir David Behan, Chief Executive at CQC, said: “CQC’s ratings of health and care services are incredibly important in providing the public with assurance about the quality and safety of the services that they use and also in helping providers to improve.

“The proposals we are consulting on today clarify how we plan to award ratings to those providers that we have been given additional powers to rate following our inspections, such as cosmetic surgery, termination of pregnancy and substance misuse clinics, independent doctors – including those that provide primary care online – and independent community healthcare services.

“The consultation also sets out our plans to evolve our current approach to regulating independent healthcare services to be more focused, targeted and intelligence driven in line with our strategy and the approach we have introduced already for NHS hospitals, adult social care services and primary care.

“This is the third in a series of documents in which we have asked the public, providers, professionals and stakeholders for their views to help develop the ‘next phase’ of regulation.

“Our proposals are based on the learning from our inspections of the sector over the past three years and feedback from independent healthcare providers about our regulation, which will continue to focus on ensuring people receive safe, high-quality and compassionate care and on encouraging improvement. We welcome the further feedback that this consultation will bring.”

Key proposals outlined in the consultation are:

  • Ratings of outstanding, good, requires improvement and inadequate following inspections of those independent providers that CQC now has additional powers to rate. Ratings will be awarded for whether services are safe, effective, responsive, caring and well-led at overall service and location level using the same ratings principles used for all other services.
  • Improved systems for gathering intelligence to monitor the quality of care including the development of ‘CQC Insight’– a data monitoring tool currently in use for NHS hospital trusts and primary care providers – to help inform decisions about when and what to inspect, and a new regular provider information request to support and feed into CQC’s monitoring of services in between inspections.
  • The phased introduction of a more targeted approach to inspection that is more responsive to risk and improvement and involves greater focus on leadership – as CQC has introduced already for NHS trusts, adult social care and primary care providers.
  • Changes to the core services that CQC assesses during its inspections of independent acute hospitals and community health services. This includes assessing and rating ‘outpatients’ and ‘diagnostic imaging’ services separately and combining the existing core services of ‘medicine’ and ‘surgery’ into a single ‘inpatient’ core service to better reflect the way these services are organised and managed at many independent hospitals. It also includes introducing ‘community single specialty’ as a new core service for some independent community healthcare services.

The consultation is open for eight weeks closing on Friday 23 March 2018. CQC will formally respond to the feedback provided later in the year.

CQC has already inspected and rated every independent acute and mental health service in England. A national report on the findings from its inspection programme of all specialist mental health services was published in July 2017. A further report that brings together the findings from its inspections of independent acute hospitals will publish in the coming weeks.

Twitter: @CareQualityComm #CQCnextphase


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Last updated:
26 January 2018

Notes to editors

You can respond to the consultation via our online webform or by email to Alternatively you can send feedback by post to:  

Next Phase Consultation
Care Quality Commission
151 Buckingham Palace Road

Following public consultation the Department of Health and Social Care has confirmed that ratings should be the default way that CQC presents the judgements from its inspections. There will be a few services regulated by CQC, which will be exempt from this. These are:

  • Primary dental care
  • Minor cosmetic surgery
  • National screening programmes
  • Health and Justice services
  • Hyperbaric Chambers
  • Blood and Transplant Services
  • Services licensed by the Human Fertilisation and Embryology Authority
  • Independent Pathology Laboratories
  • Independent Podiatry Services
  • Children’s Homes undertaking regulated activities

These services will be exempt because they are considered to be low risk, are regulated by other bodies already and/or because they are limited in number and so, do not offer the same level of choice that other rated services do. However, CQC will continue to inspect and regulate these services as before, take action in response to failings whenever necessary, and publish its findings in full.

For further information on the quality of health and social care in England, please refer to CQC’s State of Care report, published in October 2016.

About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England.

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.