Coordination with NHS England

Both the CQC and NHSE have regulatory functions that impact trusts and foundation trusts. Effective coordination is therefore important to avoid duplication and ensure their respective regulatory and oversight activities complement rather than cut across each other. Our findings suggest there is considerable scope for improvement. Only 13 per cent of leaders rated coordination between NHSE and the CQC as effective, while 43 per cent considered it ineffective.

Half (50 per cent) also disagreed that NHSE’s provider capability assessments and the CQC’s well-led reviews are well aligned. While the assessments have different purposes and frequencies, both consider aspects of organisational leadership and capability. Without sufficient alignment and information sharing, trusts risk having to provide similar assurance through separate processes, adding burden without necessarily generating additional insight.

The same concern applies to regulatory intervention. One leader described serious concerns that had already been identified by new leadership and were being addressed with the ICB and NHSE. In their view, a subsequent CQC warning notice added little new insight, while generating additional action-planning and stakeholder management that diverted capacity from the improvement work already underway. This raises a wider question about whether national bodies are sufficiently coordinating their response to known risks and focusing their interventions where they can add most value.

Changes underway across both organisations provide an opportunity to address this. Clearer roles, better aligned processes and greater sharing and reuse of information will be essential if national oversight and regulation are to become more coherent, proportionate and focused on improvement.