CQC’s new inspection framework: Collaboration, clarity, and the path forward

We recently attended one of the CQC consultation workshops in which the CQC outlined its vision for a more dynamic, transparent, and impactful regulatory process, with collaboration and clarity at the heart of its approach. We have set out below some key observations from the consultation:

Collaboration and consultation

The CQC highlighted its commitment to collaboration as a cornerstone of its new approach, they confirmed they were committed to working closely with providers and service users to co-design a framework that reflects real-world practices. In fact, provider input was described as "mission critical" to the CQC’s efforts to rebuild trust and deliver a more effective, responsive inspection process.

Accountability and learning

The importance of fostering a culture of accountability and learning, where providers are supported to innovate and improve services was highlighted. How do they plan to do this? Key points to note include:

Key Lines of Enquiry: reintroduction of ratings characteristics, previously known as Key Lines of Enquiry, which outline the standards and criteria used to inform judgments.
Key Question Level Ratings: Providing ratings at the key question level to make assessments clearer and more impactful.
Sector Specific Frameworks: Tailoring of frameworks for specific sectors, such as adult social care and mental health, to ensure relevance while maintaining simplicity and offering practical guidance.

Provider feedback?

Providers attending the session highlighted the need for greater clarity and consistency in inspections, stressing the importance of fairness and transparency. The CQC acknowledged these concerns, recognising that rebuilding trust is a key priority and central to the development of its new framework.

A significant focus was placed on collaboration, with providers calling for strengthened links between the CQC, local authorities, and councils. Aligning assessments and reducing duplication of effort will help ease the pressure on providers while maintaining robust oversight. The CQC reiterated its commitment to identifying and addressing bad practice while fostering collaboration and recognising good practice across the sector.

Providers raised several concerns during the session:

Strengthening Relationships: This was highlighted as a key focus, with proposals to reintroduce relationship managers to build trust and foster collaboration. The CQC acknowledged this feedback and indicated it would consider reintroducing relationship managers, particularly if this emerged as a recurring theme during the various consultations.
Outdated Ratings: Ratings were also raised as a significant issue, with providers calling for inspections to be triggered by factors beyond complaints. In response, the CQC is actively exploring a return to in-person inspections, recognising that direct engagement offers deeper insights into service quality compared to reliance on data alone. The possibility of live data submission is also under consideration, aimed at creating a more dynamic and responsive framework which enables providers to more easily supply evidence of good practice.
Inspector Calibre and Expertise: This was another area of concern, with providers emphasising the importance of sector-specific expertise. The CQC is addressing this by recruiting and training inspectors to ensure assessments are both informed and fair.

Primary Care focus

In discussions with Primary Care providers specifically, several key themes emerged that are shaping the CQC’s approach to regulation. Diversity and transparency were highlighted as critical areas for improvement. Providers expressed concerns about fairness in inspection processes and highlighted the need for accessible options for redress beyond judicial review. In response, the CQC acknowledged these concerns, emphasising the availability of the factual accuracy check following inspections or rating reviews. The CQC reaffirmed its commitment to enhancing transparency and accountability throughout its regulatory processes.

Neighbourhood health services were another focal point, with providers encouraging the CQC to act as a supporter and enabler of these local systems. The regulatory approach must adapt to the diverse and interconnected nature of care pathways, recognising the unique challenges faced by neighbourhood services. Providers also stressed the importance of integration, likening seamless service delivery to the operations of an airport. The CQC agreed that treating organisations as individuals, rather than applying a one-size-fits-all approach, is essential for effective regulation.

Adult Social Care focus

For Adult Social Care providers, the consultations emphasised the need for a regulatory framework that reflects the nuances of the sector. The CQC is exploring the possibility of proactive information submission, enabling providers to supply live data that demonstrates good practice and compliance. This approach aims to create a more dynamic and responsive framework, reducing the administrative burden on providers.

Inspector delivery was identified as a key factor in the success of the framework. Providers highlighted the importance of ensuring inspectors have sector-specific expertise to deliver fair and informed assessments. The CQC committed to recruiting and training inspectors to meet these expectations, ensuring consistency and professionalism in its approach.

Summary

Looking ahead, the CQC is set to publish draft frameworks early this year, followed by testing and piloting. The full rollout is expected by the end of 2026. The consultations are a positive start to the process and we will keep you updated as developments occur this year as the CQC strives to deliver a regulatory approach that is fit for the future.

If you have any regulatory queries or issues, our specialist regulatory team are here to help, please contact Jen Davie in our Regulatory Compliance team.