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Care regulator in annual inspection U-turn

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The Care Quality Commission could move away from regular inspections of all regulated organisations and back towards a more risk-based model, under plans being put out for consultation today.

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The proposal, which forms part of the regulator’s strategy for 2013-16, comes just over a year after former chief executive Cynthia Bower announced the CQC would introduce annual inspections of all NHS providers and move away from a risk-based approach.

However, the new strategy is clear there are no extra resources available, meaning the CQC needs to improve its efficiency if it is to operate within its current budget.

New chief executive David Behan developed the strategy. It sets out a vision for “differentiated regulation” which will approach regulation of the three different sectors the CQC is responsible for – health, social care and mental health - in different ways.

It proposes moving towards a more “evidence-based” model which the consultation document says is likely to mean revisiting the current frequency of inspections.

Mr Behan said this “differentiated” approach was perhaps the “most significant” of the changes being proposed.

He added: “[The] CQC is now in its fourth year. As we enter the next stage of our development I am clear that our role is to check that health and care services meet national standards and in that way drive improvements in the quality and safety of services.”

The strategy also sets out plans to be “more ambitious” with the use of the information the CQC collects, publishing performance data and reports aimed at driving improvement in the provision and commissioning of services.

Inspectors will start to highlight where things are working well, not just where things are going badly, and also begin to consider the culture of the organisations they regulate by assessing how providers listen to the views of patients and their families and staff.

The proposed changes appear to mark a shift in thinking at the top of the beleaguered regulator. At an event hosted by the King’s Fund earlier this week, former chief executive Ms Bower said the CQC could not be “an improvement agency and a control agency” and had to settle for “policing the bottom line”.

She said the problem with a risk-based approach, where not all providers were subject to regular inspections, was working out “who the good guys are”.

Asked her biggest regret in her three years at the CQC, Ms Bower said if she had her time again she would have had a much more open political debate about where the role of the regulator sits and what it could achieve.

She added: “My biggest mistake was assuming that people would understand it would take a while to get going.”

A key part of the new strategy is to work more closely with strategic partners such as the Health and Social Care Information Centre and local authorities in a bid to avoid duplication.

The consultation runs until 6 December and will take into account any relevant recommendations from the report of the Mid Staffordshire Foundation Trust Public Inquiry which is due to be published in late October or early November.

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