“Providers play a critical role in the regulatory relationship: the benefits a provider derives from regulation can be related to the effort it puts in to the process,” concludes a report from the King’s Fund on the impact of regulation on provider performance.
In the report, the King’s Fund concludes that the providers likely to gain most from interaction with the CQC are those which “develop strong ongoing relationships” with CQC: there is ongoing improvement; CQC quality definitions are embedded into local quality monitoring processes; they draw on the CQC’s broad knowledge of quality across the system as a tool to help them improve.
It urges providers “to recognise that the impact of CQC’s regulatory processes is co-produced by… the provider… and that they have a responsibility to engage collaboratively in order to maximise impact and improvement”.
Managers can also encourage staff to engage in open, improvement-focused discussions with CQC, the research concludes.
Looking at the impact of the CQC in general practice, adult social care, acute care and mental health care, researchers found a general consensus that quality regulation is necessary, but that there is “room for improvement in how organisations on both sides of the regulatory relationship, and stakeholders in local systems, work to maximise its value”.
GP practices told the King’s Fund that the current approach to inspection and rating “presented a radically different interaction and outcome” to previous regulation. Identified limitations to the model’s effectiveness, negative or unintended consequences, include that a single-handed GP may feel unable to make the necessary improvements, and will voluntarily cancel their registration, retire or merge the practice into a larger practice that can support them.
Of the four sectors identified, GP practices and social care providers were least able to adopt CQC quality improvement models internally due to the more limited availability of external improvement support.
Conducted with the University of Manchester, the evaluation looked at CQC inspections between 2015 and 2018 in six areas of England. It identified eight areas of impact, including the nature of the relationship between regulator and provider, and information about provider performance placed into the public domain.