Rebuilding regulation: What we’ve heard — and where we go next
Blog from Chris Day, Director of Engagement
Over the past 4 months, I’ve had the privilege of sitting down, in person, with hundreds of providers representing all the sectors we regulate as part of our regional roadshows. We’ve now completed our stops in Manchester, London, Leicester, and Bristol.
The purpose was simple but important: to listen, to share, and to co-design the future of regulation with the people who live it every day.
Whether you came from a large NHS trust, a small homecare service, a GP practice, or somewhere in between — thank you. Your candour, passion, and professionalism made these sessions honest, insightful, and deeply motivating.
And while each conversation was different, the messages we heard across the regions were remarkably aligned. You want a regulatory system that works with you, not just about you. One that’s transparent, proportionate, and rooted in real-world experience.
What we set out to do
The roadshows were built around 4 key areas where we know we need to make improvements:
- Improving our technology and provider portal
- Shaping the content of our assessment framework
- Understanding the levels at which we make judgements
- Exploring how to build better relationships between providers and inspectors
We designed the sessions to go beyond presentations. These were working discussions, to co-design with you. We asked you to critique, challenge, and shape our thinking. And you did.
The diversity of views, the depth of expertise, and the shared commitment to better care were all on full display. It’s reminded us, powerfully, that good regulation can’t be built in a silo.
What we heard
Technology: “Please fix the basics –and build for the future”
One of the clearest and loudest messages across all regions was that our technology simply isn’t working well enough. You told us:
- The provider portal is difficult to access, navigate, and trust.
- Notifications and registrations feel clunky, repetitive, and prone to error.
- Access issues — especially for larger organisations — make coordination difficult.
- There’s a need for dashboards, better status tracking, and clarity on what’s been submitted and where things stand.
- Support is too limited — you want live chat, and clearer guidance.
Before we improve, you urged us to pause and reflect, to “stop and think,” not just “plough on”. You want a system that feels designed for you, developed in co-design, with your needs at its core.
Assessment framework: “Make it clearer, fairer, and sector-sensitive”
We asked for your feedback on our assessment framework and quality statements. What we heard:
- There’s broad agreement on moving ‘workforce wellbeing’ and ‘enablement’ quality statements under the well-led key question and you strongly favour merging it with the ’shared direction and culture’ quality statement.
- The theme of equity is vital — but must be applied differently to staff and people who use services, respecting legal and operational realities.
- You raised concerns about duplication and missing elements (like cyber security and risk management), and highlighted the need for clearer, simpler language.
Smaller providers told us that the administrative burden feels disproportionate. Larger providers asked for frameworks that recognise the scale and complexity of multi-site services. You don’t want generic standards — you want sector-specific inspection approaches that reflect how different services operate.
Above all, you want clarity. Clarity on what’s expected. Clarity on what ‘outstanding’ looks like. Clarity on how to improve.
Levels of judgement: “Keep it simple, but keep it meaningful”
The assessment framework is a significant shift, and we asked you what level of granularity we should use when making judgements.
Here’s what you said:
- You favour scoring at the quality statement level, because it shows where to improve and gives more useful feedback.
- But you want fewer statements overall, with less complexity and less emphasis on mathematical scoring.
- You emphasised that ratings should be transparent, evidence-based, and defensible — so that providers can challenge and learn from them.
- There’s tension between professional judgement and consistency — you want us to get the balance right.
Some of you called for a return to simpler systems; others welcomed the ambition of the new framework but stressed that it must be usable. Everyone agreed: we must build a model that focuses on quality of care, not just compliance paperwork.
Relationships with inspectors: “Bring back the human side”
Perhaps the most heartfelt feedback came in this area.
You told us you miss having named inspectors — people who understand your service, your residents, your local context. The move away from relationship-based regulation has, for many, made the experience feel more distant and more
Transactional.
We heard:
- You want continuity, not a revolving door of new contacts.
- You want respectful challenge, not just critique.
- You want a regulatory relationship that’s built on trust and professionalism, not fear or compliance alone.
This isn’t about being soft. It’s about being fair, consistent, and collaborative. You told us clearly that when you have strong, constructive relationships with inspectors, outcomes are better — for people using services, providers and staff.
What’s next
This isn’t the end of the conversation. It’s the foundation for what comes next.
- Between now and autumn 2025:
We’ll continue to engage with you through a range of channels — regional events, webinars, working groups, surveys, and online platforms, to make sure your voice stays central as changes take shape. - Autumn 2025: Formal consultation
We’re preparing a formal consultation that will ask for your views on the proposals we’ve developed based on everything we’ve heard. Your feedback will directly shape our next steps. - Late 2025 into 2026: Early testing and phased improvements
We’ll begin testing improvements with early adopters helping shape and refine the changes in practice. - 2026 onwards: Continuous rollout and improvement
This isn’t a big bang change. It’s a phased, co-designed evolution — guided by your insight, grounded in evidence, and shaped by the reality of health and care delivery. We’ll continue to work with you to make improvements and developments to our approach.
Final thoughts
What struck me most across all 4 cities was your willingness to engage — not just to critique, but to co-design. Despite real frustrations, I saw a deep commitment to improvement, to fairness, and to the people you care for every day.
You told us where things aren’t working. But you also told us what could work — and how we can build it together.
These conversations have been some of the most powerful I’ve had in my time at CQC. They reminded me that, when we come together with openness and honesty, we can make regulation not just better, but genuinely supportive of great health and care.
We’ve heard you. We’re acting. And we’ll keep working with you, every step of the way.
Let’s keep re-building. Together.
