Supporting improvement and innovation

Trust leaders expect the CQC not just to identify where care standards fall short, but to provide unique insights that help boards better understand risk, improve quality and learn from good practice. As one trust leader said:

However, less than half of trust leaders agreed that the CQC helps their trust develop its own approach to monitoring quality and safety (39 per cent) and supports improvement in care (38 per cent). Around a third disagreed with each statement, at 34 per cent and 31 per cent respectively.

The picture is starker on whether leaders think the CQC supports innovation and the spread of good practice, with just 12 per cent agreeing that the CQC’s current approach supports these things. By contrast, 60 per cent disagreed.

Repeated free-text responses point towards the current inspection culture as a key contributor, with multiple leaders describing an approach still focused more on finding fault than enabling improvement. Numerous leaders described the CQC’s approach as adversarial.

Importantly, some leaders had seen a shift over the past year with a more constructive approach emerging for some.

These more positive experiences show that a constructive regulatory relationship is possible, but it is not yet consistent. The challenge for the CQC is to make rigorous scrutiny and supporting improvement mutually reinforcing, combining independent challenge with useful insight, recognition of good practice and opportunities for learning to spread.