This year's survey highlights some useful lessons to learn from an unprecedented year. Many trusts expressed support for the way regulation and oversight and bureaucracy was pared back during the pandemic, particularly the first wave to allow trusts to focus their efforts on responding to COVID-19. Yet over time, trusts' sense of whether the regulators related to the pressure they faced at the frontline lessened with slightly less than half of respondents (47%, 21 respondents) agreeing that the regulatory approach taken during the pandemic supported their trust to manage quality and risk.

The fact that key elements of regulatory activity designed to provide assurance of the safety and quality of services were unsuited to the context of the operational response to the pandemic raises interesting questions for the future of regulation, which we look forward to working with CQC and NHS England and NHS Improvement and our members to resolve. The emergence of new regulatory models from both CQC and NHS England and NHS Improvement is an opportunity to re-evaluate how regulators interact with the services they seek to assure, and trusts are keen to see a move to a regulatory model which is responsive and proportionate with greater real-time awareness of emerging risks and local plans to manage risk.

While there are clear examples of where COVID-19 has been the catalyst for positive change in the NHS, there is a need to consider how these changes can be safely and appropriately adapted for longer term reform. We would support a leaner, more streamlined approach to the processes described above with learnings from COVID-19 taken forward, however would emphasise the need to robustly evaluate the impact of such changes and ensure longer term transformation is properly resourced and given time to bed in.

The COVID-19 pandemic – and the new White Paper – offer an opportunity to consolidate a new and constructive dialogue between providers and the bodies that regulate them in the interest of improving services and ensuring people receive safe care.