Enhancement of monitoring and the importance of inspection

Accepted.
The Care Quality Commission is developing Memoranda of Understanding with medical, nursing and midwifery Royal Colleges. These will ensure that peer review and accreditation schemes are taken fully into account as new methods of inspection are introduced in each sector and evolve. The Care Quality Commission will continue joint inspection with other regulators and inspectorates. This will include extending from December 2013 the approach to coordination developed with the General Medical Council (see below), to other professional regulators.
In A new start – Consultation on changes to the way Care Quality Commission regulates, inspects and monitors care the Care Quality Commission consulted on new approaches to regulation and, as part of that, proposed closer work with other agencies and better use of accreditation and peer review schemes. On 17 October 2013, it published the responses to the consultation in A new start: Responses to our consultation on changes to the way Care Quality Commission regulates, inspects and monitors care services, which showed that there is broad agreement with the new approach.
The Care Quality Commission and the General Medical Council have explored coordination through shadowing each other’s inspections and assessments of professional education; this is reflected in an operational protocol50 that they have published. Discussions are under way on how best to learn from this, and extend the learning to other professional regulators in healthcare.

CQC have some joint inspections. For example, inspections of local authority areas in partnership with Ofsted, HM Inspectorate of Constabulary, HM Inspectorate of Probation and, where relevant, HM Inspectorate of Prisons. The CQC also involve NHS England at trust level well led assessments. Please see our response to recommendation 35 for how NHS England works with CQC. The Academy of Royal Medical Colleges produced key principles for the undertaking of external reviews.

Principles 13, 14, 15 and 16 are relevant to good governance.

Under the leadership of the Chief Inspectors, the Care Quality Commission has put in place specialist inspection teams that subject providers to greater scrutiny. Inspections now routinely involve expert inspectors and people with experience of receiving.

The Care Quality Commission is currently undertaking work whether on it might take account of accreditation schemes in Adult Social Care. During May 2014, the Care Quality Commission held a series of roundtable events with stakeholders and also co-production sessions, which generated mixed views. As a consequence, the Care Quality Commission with its staff and stakeholders will be giving further consideration to accreditation.

Memoranda of Understanding are being developed and revised with other strategic partner organisations, often supported by joint operating protocols. For example, a joint working protocol has recently been established with the Nursing and Midwifery Council and will be embedded in 2015. The Care Quality Commission is close to updating its joint working arrangements with the National Institute for Health and Care Excellence and the Health and Care Professionals Council, and the Care Quality Commission intelligence teams are liaising with the Health and Care Professionals Council on routine information sharing.

General Medical Council /The Care Quality Commission protocol
• The General Medical Council and the Care Quality Commission reviewed their Joint Operating Protocol, and published the revised version on 11 December 2014.

Revalidation and General Medical Council/The Care Quality Commission joint training
• The Care Quality Commission has submitted their Annual Organisational Audit report
• The Care Quality Commission is preparing a development plan to set up structure and processes for the Care Quality Commission as a designated body.
• The Care Quality Commission is including questions about appraisal and revalidation in our GP inspections.
• The Care Quality Commission is developing a process for working with Area Teams to discuss practice and individual performance prior to and following inspections.
• A representative from the Care Quality Commission sits on the General Medical Council’s Expert Advisory Group on Standards for Education and Training. The Care Quality Commission has introduced the concept of Key Lines of Enquiry to this group and this methodology is now being looked at in the creation of new standards.
• An e-learning package is being developed – by agreement with the Chief Inspector for Primary Medical Services and Integrated Care, Professor Steve Field - and will be integrated into the Care Quality Commission’s annual programme of GP training. Data to support GP inspections:
• Internal discussions at the Care Quality Commission are underway to understand how the General Medical Council can provide information to support this process. Data to support hospital inspections: The General Medical Council continues to send the Care Quality Commission sets of information relating to individual trusts, for use as part of our inspection process. The data covers each of their core functions: Registration & Revalidation, Fitness to Practise and Education. The General Medical Council also shares this information with the responsible officer at the trust. Information Sharing Agreement: Development of the Information Sharing Agreement and the individual sharing schedules therein has been progressing slowly, partly due to the development of the Care Quality Commission’s new approach and data packs, but it is a priority and the Care Quality Commission is aiming to finalise this in the near future.

This recommendation was accepted by the Government.

The Care Quality Commission entered into joint working protocols with the Nursing and Midwifery Council (in 2015) and the General Medical Council (revised in December 2014).

As to current versions, the Care Quality Commission – Nursing Midwifery Council joint working protocol makes explicit reference to involvement of the Nursing and Midwifery Council in the inspection regime, including information sharing and aligning of inspection and visiting activities. The Care Quality Commission – General Medical Council joint working protocol makes mention of exchange of information, but does not explicitly refer to inspections. The Government also said in the February 2015 Culture Change report that the General Medical Council continued to send the Care Quality Commission information relating to individual trusts for use as part of the inspection process, which related to registration and revalidation, fitness to practise and education.