How we regulate, inspect and rate health and care services Our response to the Care Quality Commission's consultation

The Health Foundation has welcomed the constructive dialogue we have had with CQC during the development of its new approach. We have a wealth of expertise in patient safety and person-centred care and have made particular recommendations on these topics in previous consultations.

The Health Foundation's response

We have been particularly pleased to see that the key lines of enquiry, which inspectors use to assess the quality of a service, reflect the recommendations of research we funded entitled The measurement and monitoring of safety. The research encourages organisations to understand the future risks associated with their services rather than identify how often harm was caused in the past.

Our response to the consultation emphasised our concern that the role of CQC, and other arm's length bodies, have in encouraging services to improve is unclear and needs to be clarified. We want to see a medium-term strategy and a consistent approach to improvement that is implemented across the NHS.

We argued that there are four key steps that we would like CQC to take in order to bring about improvement in services.

• Step 1: CQC should encourage organisations to identify and report risks in their services. To aid this we feel the regulator should take a constructive stance to problems that are reported, so organisations can report concerns to CQC without fear of being sanctioned.
• Step 2: We would like CQC to consider how it shares examples of good or outstanding care with other organisations that may benefit. CQC can inspect every registered health and care service across England and is therefore ideally placed to spread examples of quality that other organisations can learn from.
• Step 3: CQC should emphasise the need for organisations to continually develop and prioritise locally developed metrics rather than simply focusing on the areas CQC will inspect.
• Step 4: we urge the CQC to consider carefully how it measures it owns success by how it encourages services to improve. We would like to CQC go beyond measuring the frequency of inspections and enforcement actions as a marker of success and instead focus on how successful these powers are at encouraging sustainable improvements in the quality of care.