The Care
Quality Commission (CQC) is the independent regulator of health and adult social
care in England. Its purpose is to ensure health and social care services
provide safe, effective, compassionate, high-quality care and the regulator
encourages improvement, where providers fall short of CQC’s fundamental
standards. Its role is to register providers of services, monitor,
inspect and rate, take enforcement action for poor care, and speak
independently on matters of quality in health and adult social care
services.
The body is
primarily funded through fees charged to registered providers, with DHSC
providing grant-in-aid for expenditure for which the CQC are unable to charge
fees. In 2020/21, fees made up 88% of the CQC’s income, with 11% from
grant-in-aid (GIA), and the remaining 1% coming from other external sources.
2019/20 was the first year that the CQC were at ‘full chargeable cost
recovery’. The fee income was £205.2m and revenue grant-in-aid from DHSC
was £27m and £1.6m for reimbursement for services and other income.
The CQC is
organised as follows: Operations and Regulatory Leadership covers
primary medical services and integrated care, hospitals including mental
health, and adult social care. In addition, there are three further
directorates supporting CQC’s work: regulatory, customer and cooperate operations;
data, technology and insight; and engagement, policy and strategy. In
terms of employee numbers, the actual number of directly employed whole-time
equivalents as at 31 March 2022 was 2,982.
The CQC has
begun work to consider future ways of regulating and working that will enable
it to deliver its new strategy as effectively and efficiently as possible in a
changing health and social care landscape. In its new
strategy CQC sets out its ambitions under four
themes – people and communities, smarter regulations, safety through learning
and accelerating improvement. Running through each theme are two core ambitions
- assessing local systems and tackling inequalities in health and care. The CQC is expected to have a complimentary role with
NHSE, in the oversight of ICSs (Integrated Care Systems). In April 2022
the Health and Care Bill completed all parliamentary stages in the House of
Commons and House of Lords and received royal assent from the Queen to become
the Health and Care Act 2022. The legislation gives CQC a new duty to review
each local Integrated Care System (ICS), as well as a new duty to assess local
authorities on the delivery of their social care duties under part 1 of the
Care Act.
Pivotal to its
new strategy, is the CQC’s organisational transformation programme, charged
with delivering a new target operating model, i.e. translating the new strategy
into a tangible delivery plan for determining what the organisation will do and
how it will do it. There are a number of major programmes to support the
work of the Regulator as it looks to the future and a regulatory role that is
informed by intelligence and data and digitally led way of working.
In addition to
its role described above, the CQC is required to maintain a statutory
committee, Healthwatch England, which
acts as a national consumer champion in collecting and disseminating the views
of people who use health and social care services. Although Healthwatch England
is part of the CQC, it sets its own priorities, has its own brand identity, and
speaks with an independent voice.
The National Guardian is a non-statutory appointment by the CQC to lead cultural
change in the NHS, to establish and support a strong network of
Freedom to Speak Up Guardians. The National Guardian’s Office highlight NHS
providers that are successful in creating the right environment
for staff to speak up safely
and share this best practice across the NHS. It Independently reviews cases
where healthcare providers may have failed to follow good practice, working
with statutory bodies to take action where needed.
