Quality regulation

Quality regulation has risen up the agenda following some major failings in care in recent years. As a result, the Care Quality Commission (CQC), which regulates all health and social care services in England, has undergone significant reform. The CQC sets the fundamental standards of quality and safety for healthcare services and monitors and inspects providers to ensure standards are upheld. This page provides an overview of the CQC's regulatory model and the key elements providers should be aware of. 

Care Quality Commission

All providers of NHS services are required to register with the CQC and meet the fundamental standards of quality and safety for healthcare services. The CQC monitors, inspects and regulates these providers' core services to ensure they consistently meet the fundamental standards and do not put patients at risk of harm. Where a provider falls below these standards, the CQC is able to take enforcement action or recommend that the provider should enter special measures.

The CQC regularly inspects providers by location and service, and awards ratings based on what it finds. Inspection teams typically include experts by experience (people who are experienced users of healthcare services) and specialist advisors (health professionals external to the organisation being inspected). The CQC completed its first round of comprehensive inspections of NHS foundation trusts and trusts in 2016 and has now published its five year strategy for 2016-21, which sets out how it intends to take forward its activities in the future.

Quote mark We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve. Care Quality Commission

As part of its strategy, the CQC is reviewing its approach to monitoring risk within providers. The proposed CQC Insights model will use qualitative and quantitative data to identify concerns with the quality of services and determine where the regulator targets its resources, including when and where to inspect. In addition, the CQC has committed to assessing its impact and value for money on an on-going basis and to support new ways of delivering care.

Following an inspection, providers will receive a report on the findings, including examples of good practice and any areas for improvement, and will be awarded an overall rating as well as individual ratings for each service and location inspected. 

The CQC inspects against five key questions: are services safe; are they responsive; are they caring; are they effective and are they well-led? In each domain, providers will receive one of the following ratings:

Providers have an opportunity to ‘fact check’ the report and inform the CQC of any factual inaccuracies prior to its publication. Following the publication of the inspection report, providers may also request a ‘rating review’ if they feel that the CQC did not follow due process for making and aggregating ratings decisions. Providers are required to display their overall ratings at all sites where they deliver services.

The CQC provides sector-specific guidance which outline how it regulates and inspects services across each of the sectors it regulates.