This report outlines the findings of our sixth annual regulation survey, which was carried out in December 2020 to January 2021. The regulation survey usually explores NHS trusts and foundation trusts' experiences of regulation over the preceding 12 months and their views on the future of regulation, and trends over time. This year's survey differs from previous years as it covers trusts' experience of regulation and oversight specifically within the context of the COVID-19 pandemic and looks ahead to shaping the future strategic approach to regulation.

About the survey

This survey was sent to all trust chairs, chief executives and company secretaries in December 2020. This is the sixth annual survey in our series to understand and track NHS providers' experience of the regulatory and oversight framework in which they operate. Mindful of the operational trusts are facing, we sought to keep our survey short and focused this year, so that we could gain vital insight from trusts to inform important changes to national policy on regulation currently taking place.

In this report, where we refer to 'the regulators' and 'national bodies', we mean the CQC and NHS England and Improvement, as these are the key regulatory bodies we work with and seek to influence constructively on behalf of trusts.

We received responses from 51 trusts, which represents 24% of the sector. All regions and most trust types are covered in this survey. We did not receive responses from any ambulance trusts this year.

This is a significantly lower response rate than in previous years, reflecting the COVID-19 pressures trusts are working within. This year, our analysis and commentary are also drawn from ongoing engagement and dialogue with trusts - through conversations with trust leaders, roundtable events and our engagement with trusts and foundation trusts on NHS England and NHS Improvement's recent paper Integrating Care: Next steps to building strong and effective integrated care systems across England.

We are grateful to those trust leaders who responded to this survey during an extremely busy and challenging time, and to CQC and NHS England and NHS Improvement for working with us to develop the survey questions.