You are here

Update on CQC's regulatory approach

13 January 2021
  • Media

We want to start this message with a thank you to everyone working in health and social care, for your professionalism and dedication. The pandemic has been one of the biggest health challenges the world has ever faced. Your work has enabled people to continue to receive care in incredibly challenging circumstances. We understand how difficult this is, and your response to this challenge is impressive.

Throughout the pandemic, our regulatory role has not changed. Our core purpose of providing the public with assurance that health and care services are safe has driven our decisions. As we are now entering a period of increased pressure on health and social care services it is only right that CQC continues to be flexible in our approach.

At the start of the pandemic we paused routine inspections and focused our activity only in response to risk. This was the right thing to do and we have kept this decision under review.

In response to the very latest position, we want to be clear that for the time being we will continue to only undertake inspection activity in response to a serious risk of harm or where it supports the system’s response to the pandemic.

We will continue to act to keep people safe from harm, protecting their human rights while supporting providers to focus on delivering care, including the COVID-19 vaccination programme.

What this means for providers of health and social care

We will only undertake inspection activity that either helps create capacity to respond to COVID-19 or that responds to significant risk of harm to the public.

For adult social care services, in addition to undertaking inspection activity where there is a clear risk to safety, we will:

  • continue to undertake infection, prevention and control (IPC) inspections in care homes to ensure people are receiving safe care.
  • rapidly inspect potential designated sites so that people who have COVID-19 can be discharged from hospital in a timely way, freeing up capacity in the system.
  • inspect services where there is an ability to award a new rating, supporting local authorities to commission care where needed.
  • continue to monitor and assess services where there is a risk of closed cultures developing.

For hospital services (including independent health services), in addition to undertaking inspection activity where there is a clear risk to safety, we will:

  • undertake some focused inspection activity of emergency departments where our monitoring of data and local intelligence indicates that increased pressure is having a direct impact on the quality and safety of care.
  • continue to undertake Mental Health Act (MHA) monitoring visits to ensure the rights of vulnerable people are protected.
  • carry out IPC inspections where we have concerns about infection control and a trust’s oversight of infection risk. This will enable us to highlight where trusts need to take action to ensure patient safety and support them with the return to non COVID-19 elective services as soon as possible.

For primary medical services we will:

  • only inspect in response to significant risk of harm – including concerns raised by people working in services and people using them – and when we cannot seek assurances through other routes. If an inspection is necessary, we will carry out as much activity off-site as possible
  • continue to work jointly with Ofsted to inspect SEND services.

For registration we will:

Additionally, we have paused our programme of Provider Collaboration Reviews and will restart only when it is appropriate to do so.

We continue to monitor and review the application of do not attempt cardiopulmonary resuscitation (DNACPR) decisions during the COVID-19 pandemic.

Any additional inspection activity for hospitals or primary medical services will only take place where there is clear evidence of risk to safety or human rights, and will be reviewed and authorised by the relevant Chief Inspector. Adult social care inspection activity will be agreed by Heads of Inspection.

How we are supporting the system

We recognise that some providers will be facing challenges around staffing and availability of clinical resources. It’s important that you put plans in place, in line with national guidance, that mitigate the risks that result from these challenges.

We will continue to support providers and the wider system through this challenging period, sharing information we receive from providers, the public and stakeholders, with the Department of Health and Social Care and others to help shape the national response.

We will also continue to publish information that the public and providers will find useful through our monthly insight report. We are also supporting the COVID-19 vaccination programme through rapid registration, coordination between sectors and sharing intelligence, helping to ensure it can be delivered quickly and safely.

Our approach to monitoring

Our inspectors will monitor and review information from all available sources, collecting further information where necessary. Along with Experts by Experience, our inspectors will gather information from people who use services. We’ll continue to listen to people who use services, their loved ones and people who work in health and social care, through our Give Feedback on Care service.

Our monitoring is focused on understanding where there are risks to safety and human rights, so that we know where services need to improve.

We will continue to adapt our approach and remain responsive as the situation changes. We are also considering how we might need to adapt further in the future through a consultation on our future strategy.

Thank you again for all the work you do.

Ted Baker, Chief Inspector of Hospitals
Dr Rosie Benneyworth, Chief Inspector of Primary Medical Services and Integrated Care
Kate Terroni, Chief Inspector of Adult Social Care

Last updated:
13 January 2021