Changing how we regulate to improve care for everyone

Care Quality Commission
4 min readJan 21, 2021


Ian Trenholm, Chief Executive of CQC, blogs about the proposed changes in our strategy and shares details of how to respond.

Ian Trenholm, Chief Executive

The world of health and social care has changed significantly since we were established nearly a decade ago as an independent regulator — not least in response to the COVID-19 pandemic. In this new world, we must also change.

We’re responding to the current situation in three ways: proactively, reactively, and supportively. Our Chief Inspectors recently explained how we’re doing this; you can read more about it on our website.

Beyond remaining flexible and responsive to the pandemic, we need to make longer term changes to how we regulate. We want our regulation to be more relevant to the present day, and continue to work in a flexible way to manage risk and uncertainty. We’ve learned a lot from our response to the pandemic so far, and we’re using this to put us in a better place for the future and support services to keep people safe.

After over a year of engagement and more than 10,000 interactions with stakeholders in the past few months alone, we’ve launched a formal consultation on our strategy. As I’ve said previously, our proposals are ambitious and represent a bold future for us.

This consultation is running against a backdrop of worsening pressures relating to COVID-19 and a further national lockdown. The ambitions in the strategy support our response to the pandemic. They help to give us the flexibility to respond to an ever-changing environment; to promote change and improvement; and to respond to concerns raised by people using, and working in services to make sure they are as safe as they can be.

Following on from this, we’re launching a second formal consultation later this month. In it, we present proposals to help us in our immediate response to the pandemic which will benefit providers and members of the public. They also lay the foundation for delivering our next strategy and future regulatory model. We’ll talk more about this soon.

Changing how we regulate to improve care for everyone

Our strategy is built on four themes. Together, these determine the changes we want to make.

People and communities

We want our regulation to be driven by people’s experiences as well as what they expect and need from health and care services. We’ll focus on what matters to the public and local communities when they access, use and move between services.

Smarter regulation

We want our assessments to be more flexible and dynamic. We’ll update our ratings more often to give an up-to-date view of quality. Being smarter with data means our visits will be more targeted, with a sharper focus on what we need to look at.

Safety through learning

We want all services to have stronger safety cultures. We’ll expect learning and improvement to be the primary response to all safety concerns in all types of service. When safety doesn’t improve, and services don’t learn lessons, we’ll act to protect people.

Accelerating improvement

We want to do more to make improvement happen. We’ll use our unique position to spotlight the priority areas that need to improve and enable access to support where it’s needed most. We want to see improvement both within individual services, and in how they work together as a system so that people get the care they need.

Running through each of these four themes are two further ambitions:

  • We want to improve people’s care by looking at how well health and care services work together as a local system and how the system is working. It’s now not enough to look at one service in isolation: it’s how services work together that has a real impact on people’s outcomes. So we now need to look at every stage of people’s journey through the health and care system, looking at both individual services and across different providers and organisations.
  • The pandemic has renewed the focus on inequalities in health and care. We want to understand why there’s such a variation across the country in how people get the care they need, so we can help to tackle it so that everybody has access to safer and better-quality care.

We are changing. What do you think?

Your views and feedback have been invaluable as we’ve developed our draft strategy. We’d now like to hear what you think to our proposals so we can make sure it works for everyone.

I encourage you to visit our website to read the consultation document and tell us what you think of our ambitions: The easiest and quickest way to respond is through our online form. The consultation is open for responses until 5pm on 4 March 2021.



Care Quality Commission

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.