CQC plans to test quality of NHS across whole local areas

BMJ 2015; 351 doi: (Published 13 August 2015) Cite this as: BMJ 2015;351:h4413
  1. Adrian O’Dowd
  1. 1London

The way the NHS is regulated could change to include reviews of services across whole healthcare areas rather than regular separate inspections of each part of the NHS, under plans by the main NHS regulator, the Care Quality Commission (CQC). A “lighter touch” approach to regulating general practice may also be a feature of the new system being considered.

The CQC has announced that it will run “Quality of Care in a Place” pilots (, consisting of place based inspections in two areas—Greater Manchester and North Lincolnshire—to test how well coordinated health and care services are in local areas.

The project will use the results of CQC inspections already carried out, together with other intelligence from local and national organisations, to assess whether combining this information on the quality of care of a whole geographical area helps encourage providers of health and social care to make improvements locally and inform people better. The pilot schemes will also specifically look at the experiences of older people and those who need mental healthcare.

A CQC spokesman told The BMJ that data analysis for these pilots was already under way and that interviews with local people and stakeholders would begin in the autumn. Findings will feed into the regulator’s strategy for the next five years, which is currently being developed.

Steve Field, CQC chief inspector of general practice and integrated care, said, “We already know what a valuable source of information our published reports with ratings are for members of the public. Our new Quality of Care in a Place pilot is really about increasing that level of openness even further by building a picture of what the whole quality of care is like for people living in a particular area—including how well services are coordinated.”

In an interview with the Health Service Journal Field said that the commission would, depending on the outcome of the pilots, consider whether to move to a more light touch regulation of general practice. He said that there would “always be a role for looking at the institution that delivers the care,” but he also hinted that institutional inspections may become less regular or more targeted to providers with known problems.

Field said to the journal, “The question will be . . . what is the interval between rating [provider organisations]? If we’re looking at, say hospitals and GPs, if 80% are ‘good’ on our current ratings, are resources better spent looking at those which aren’t as good, and encouraging improvement, and having a more light touch [approach]?”

In-depth discussions of how to change regulation had not yet taken place, he said, but results of the pilots would feed into those. In the meantime, the regulator had no plans to change the ongoing GP inspections before all practices had been rated once—a process due to be completed by September 2016.

CQC will issue and consult on its report findings for each local area early next year.


Cite this as: BMJ 2015;351:h4413

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