Developing our assessments of quality in systems

Care Quality Commission
4 min readNov 3, 2021

In this blog, Rosie Benneyworth, Chief Inspector of Primary Medical Services and Integrated Care, and Kate Terroni, Chief Inspector of Adult Social Care, set out how they hope to use new powers in the Health and Care Bill to look at how the care provided in a local system is improving outcomes for people and reducing inequalities.

Graphic image of people holding connected circles of varying sizes and colours
People photo created by freepik

The Health and Care Bill gives CQC new powers to assess local authorities on the delivery of their social care duties, and, following the recent amendment, to have oversight of Integrated Care Systems (ICSs).

Our primary aim is to use these new powers to ensure that all system partners, including ICS leaders and local government, work together to improve outcomes for people. This means that we’ll be working with people to coproduce our approach, making sure that what we look at gets to the heart of what matters to everyone. This could be, for example, how easy it is for people to move between services in a local area, or the ability to find care that meets their individual needs.

As well as looking at integrated pathways of care for people using health and social care services, we will also look at leadership in systems. This will involve assessing how effectively leaders work together to plan and develop services in partnership with local people and deal with quality and safety issues.

When we are providing assurance on local authorities, we will want to understand how they are supporting people to have their care needs met, how they are shaping the local social care market to allow for equality of access, and how they are working across the system to continuously improve and manage risks.

Alongside this, we will continue to regulate health and social care providers. We will consider the safety and quality of care in services through the lens of the people using them, and will take necessary and proportionate action to secure improvement where we find poor care.

We’ll be doing all of this in line with our new strategy, which sets out our ambition of keeping regulation relevant to the way care is now delivered. At the core of our new approach will be our new single assessment framework, against which we will assess providers, ICSs, and local authorities. This framework will set out what we expect good care to look like in terms of what a person should experience when navigating the health and social care sector and accessing care.

You can also expect our regulation to become smarter and more flexible in how we respond to risk and assess quality. This will allow us to provide up-to-date and meaningful information about services we regulate in a clear and understandable way. The basis for this will be improved use of all available intelligence, evidence and insight in our decision making and regular assessments of quality and risk.

Visiting services in person will remain a hugely important part of our work. However, with our new approach we will already have much of the evidence we need, allowing us to use our time to focus in on people’s experiences of the care and support they receive.

It is our ambition that people will be able to easily use our assessments to understand the quality of care where they are, whether this is at a provider, local authority, or a system level.

It is vital that our role adds value and does not duplicate the important work done by our system partners, in particular NHS England and Improvement when considering ICSs, and the Local Government Association and the Association of Directors of Adult Social Services when we are looking at local authorities. We have already begun conversations and started to design our approach collaboratively with these and other key stakeholders, and this will continue as we develop it further. We want to hear a diverse range of views to give us the knowledge and understanding we need to make our regulatory approach as effective as possible. As with our regulation of health and care providers, we will be doing everything we can to minimise the burden on those we regulate, ensuring that data is shared between organisations, assessment methods are efficient, and visits are focussed and effective.

Finally, we want to be clear that while we will be holding the organisations we regulate to account where there are failings, we also want to continue to work across the health and social care sector to enable improvement and share good practice. We will ensure that this forms a key part of our methodology as we develop it in partnership over the coming months. This will include working with people using services, their families, voluntary sector organisations, health and social care providers, and other key stakeholders.

Visit our online participation platform to find out more and share your views on our new role in regulating systems and local authorities.



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.