CQC has defended its new policy of simpler ratings process for GP practices and NHS trusts despite fears it could result in a loss of detailed information that contributes to reports and judgements.
From October 2021, separate ratings for the six population groups will stop. Ratings of GP practices will be focused on whether practices are safe, effective, caring, responsive and well-led. There will also be an overall rating.
In a document summarising responses to its January 2021 consultation on changes for more flexible and responsive regulation, the CQC sets out some methodology for using wider regulatory approaches.
The consultation ran from 26 January to 23 March and included podcasts and webinars for social care providers. Some 407 responses (72 per cent of total) from service providers / commissioning bodies commented on proposals including to allow CQC to assess and rate services more flexibly, to update ratings more often in a more responsive and proportionate way.
CQC says that responses indicated broad overall support across all proposals, in particular to create more collaborative working between providers and the regulator. Specifically, respondents indicated:
- Support for the changes to rating GP practices and NHS trusts. Many respondents believed it will make ratings simpler and easier to understand.
- Strong support for using a wider range of regulatory approaches to assess quality, and not just rely on full on-site inspections. Many respondents believed this will lead to a more efficient and proportionate regulatory approach.
- Strong support for reviewing and updating ratings (or judgements of quality) more flexibly, rather than following a fixed schedule of inspections. Respondents believed this will allow CQC to be more responsive to changes in the quality of services, resulting in more accurate and reliable ratings.
Areas of concern were noted in the following:
- The more flexible approach leading to fewer on-site inspections, which some respondents believed could undermine the importance of seeing care being delivered and how it informs judgements about the quality of care.
- The reliability and availability of data and information used to change a rating and collection methods.
In terms of next steps, the CQC has outlined the scenarios in which GP quality will be assessed and services rated using regulatory approaches other than just on-site or comprehensive inspections:
- Separate ratings for the six population groups will stop from October 2021. Ratings of GP practices will be focused on whether practices are safe, effective, caring, responsive and well-led. There will also be an overall rating.
- Person-centred care and action to prevent inequalities will become central to ratings
- Further development of methods to gather evidence without always visiting. Where appropriate, site visits will continue
- More focused inspections of GP services to update overall ratings (including those with an existing overall rating of requires improvement where a comprehensive inspection was previously required).