Responsibility for setting standards

Accepted.
The Care Quality Commission is taking steps to ensure that stakeholders, particularly including professional bodies, are fully involved in designing and developing its new approach to inspection. The Care Quality Commission’s new approach to inspecting hospitals involves large teams of specialists as well as patient experts. The Care Quality Commission is working with medical and nursing Royal Colleges to resource the inspection teams. These teams give professionals a key role in how a hospital’s quality of care is assessed.
The Care Quality Commission has consulted extensively on its new approach to inspection. The consultation engaged 5,154 individuals and 4,500 organisations, plus 41 consultation events. Professional bodies, and individual professionals, have been prominent contributors to these. On 17 October 2013, the Care Quality Commission published the responses to the consultation in A new start: Responses to our consultation on changes to the way the Care Quality Commission regulates, inspects and monitors care services, which showed that there is broad agreement with the new approach.
The Care Quality Commission is undertaking further work to deepen the engagement of professional bodies in developing its new approach, and in particular medical, nursing and midwifery Royal Colleges. Memoranda of understanding are in development with all of these bodies, covering collaboration in:
• resourcing inspection teams;
• developing standards and expectations of ‘what good looks like’ in different services; and
• recognising accreditation schemes where that can encourage achievement of best practice standards and avoid duplicated inspection.

In developing their standards, professional regulators will regularly consult with a range of stakeholders, including their registrant population, to ensure policies and guidance meet the needs of the professionals they regulate.

Professional regulators are members of the Joint Strategic Oversight Group (JSOG), which was established to support the joint working of regulators and oversight organisations including the General Medical Council, Nursing and Midwifery Council, Health Education England and Care Quality Commission.

JSOG is the forum for sharing intelligence, enhancing the sharing of information and coordinating regulatory action in response to safety concerns.

The National Quality Board (NQB) continues to champion the importance of quality and drive system alignment of quality across health and care on behalf of NHS England, the Care Quality Commission, the UK Health Security Agency, the National Institute for Health and Care Excellence, the Office for Health Improvement and Disparities, the Department of Health and Social Care, Healthwatch England and the Health Services Safety Improvement Body.

All of the Care Quality Commission’s new style inspections involve healthcare professionals as part of the inspection teams, according to their areas of specialism and training and depending on the service being inspected. In addition to this many of the Care Quality Commission’s inspectors themselves come from specialist health backgrounds and are working in the sector in which they trained. For example, the Care Quality Commission inspectors who are clinical scientists and radiographers by training inspect radiology facilities and departments, both as individual inspections and as part of broader hospital inspections, providing specialist insight. The Care Quality Commission’s Chief Inspectors of Hospitals, Adult Social Care and General Practice themselves have significant experience and expertise in their sectors, as well as a number of their Deputy Chief Inspectors.

The Care Quality Commission has been working with healthcare professionals including the Royal Colleges and their faculties, as well as providers, the public and other stakeholders throughout the development of its new regulatory approach. This has included:

• Engagement in the development of the Care Quality Commission’s new approach to monitoring, inspecting and rating services and guidance on new regulations and enforcement powers

• Identification of healthcare professionals to participate in the Care Quality Commission’s inspections

• Support for the Care Quality Commission’s work on the use of clinical service accreditation schemes

• Commitment to working together through the development of memoranda of understanding, joint working statements and information sharing agreements

Joint agreements

The Care Quality Commission works with strategic partner organisations including healthcare professional bodies in the development and delivery of its regulatory activity. These partnerships are underpinned by the development of joint agreements which set out:

• clear expectations and objectives for the relationships
• a framework for information exchange and operational working
• clear evaluation criteria
• a public signal of intent to work together

This recommendation was accepted by the Government.

In the January 2014 Hard Truths report, the Government said that the Care Quality Commission had worked with healthcare professionals, including the Royal Colleges and their faculties, providers, the public and other stakeholders in developing its new regulatory approach. In the February 2015 Culture Change report, the Government also referred to the Care Quality Commission’s new inspections involving healthcare professionals as part of the inspection teams as well as joint agreements between the Care Quality Commission and strategic partner organisations.