Regulating new care models Dr Zoe Fyffe, Strategy Manager Managers Quality Networking Forum 1 March 2017 1 1

About CQC: our purpose The Care Quality Commission is the independent regulator of health and adult social care in England We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve We published our new strategy in May 2016. We are now moving into implementation – and developing the next phase of our approach to inspections. In all sectors. And also thinking through what it means for a more integrated health and social care landscape (new models of care, vanguards) Strategy Slides - 24 May 2016 - MASTER

Our new strategy gives us clear priorities We published our new strategy in May 2016. We are now moving into implementation – and developing the next phase of our approach to inspections. In all sectors. And also thinking through what it means for a more integrated health and social care landscape (new models of care, vanguards) Strategy Slides - 24 May 2016 - MASTER

Monitor, inspect and rate Our model of regulation Register Monitor, inspect and rate Enforce Independent voice We register those who apply to CQC to provide health and adult social care services We monitor services, carry out expert inspections, and judge each service, usually to give an overall rating, and conduct thematic reviews Where we find poor care, we ask providers to improve and can enforce this if necessary We provide an independent voice on the state of health and adult social care in England on issues that matter to the public, providers and stakeholders

What is a new model of care? New models of care emerging through national initiatives and local change Includes Vanguard sites, specific models (e.g. enhanced health in care homes), newly developing networks and other local innovations Some common themes include: Greater integration; Providers working more closely together; Cross-sector working.

Supporting change Supporting health and care services to make future vital changes Increasingly nimble: developing our approach to support, not obstruct, change Will not compromise our focus on high quality care New care models work based on three intentions: Listening and learning Supporting innovation Working with partners to align what we do and reduce duplication

New care models raise questions for regulation Register: How to register innovative organisational forms? Monitor: What information do we need? Inspect and rate: Crossing traditional boundaries or taking on challenged providers Enforce: Holding the right people to account Independent voice: Sharing good practice and learning

Our principles Take action to protect people Accountability Proportionality Minimise complexity for combined providers Transparency Providers will not be penalised for taking over poor providers Comparable assessment for each type of service Report in a meaningful way Bring together inspectors from different sectors The full principles are: 1. We will always take action to protect and promote the health and well-being of people using services where we find poor care. 2. We will hold to account those responsible for the quality and safety of care. 3. We will be proportionate, and will take into account how each organisation is structured and its track record to determine when and how to inspect. 4. We will align our inspection process, where possible, to minimise complexity for providers that deliver more than one type of service. 5. We will be transparent about our approach and about how we make regulatory decisions. 6. We will not penalise providers that have taken over poor services because they want to improve them. 7. We will deliver a comparable assessment for each type of service, regardless of whether it is inspected on its own or as part of a complex provider. 8. We will rate and report in a way that is meaningful to the public, people using services and providers. 9. We will bring together inspectors who have specialist knowledge of different sectors to inspect jointly, where this is most appropriate for the provider.

Consultations on our proposed changes to inspections 20 December 2016 – 14 February 2017 New care models and complex providers Cross sector changes to assessment frameworks Updated guidance for registration of learning disability services Changes to Hospitals inspection methodology Developing quality ratings for NHS trusts and other complex providers Spring/Summer 2017 Changes to Adult Social Care inspection methodology Changes to Primary Medical Services inspection methodology Changes to registration We want to hear your views on these proposals, which are aimed at achieving more integrated approach that enables us to be flexible and responsive to changes in care provision more targeted approach that focuses on areas of greatest concern, such as safety, and where there have been improvements in quality. greater emphasis on leadership, including at the level of overall accountability for quality of care closer working and alignment with NHS Improvement and other partners so that providers experience less duplication  There will be two consultations on these changes: one in Winter 2016/17, and another in Spring 2017 CQC will be supporting and NHS Improvement will be consulting on Use of Resources and the ‘well-led’ key question for NHS trusts due on 16 December In Dec consultation we will not be describing proposed changes for Independent hospitals -the approach for this sector will be developed when we have completed the majority of comprehensive inspections so we understand the sector and the quality of care it provides (but there are relevant areas and this will be highlighted) NHS Improvement consultation on Use of Resources and ‘well-led’ scheduled for December 2016

Key messages: If you are developing a new model of care, engage with us at an early stage. If you aren’t sure who to go to, contact us at enquiries-newmodelsofcare@cqc.org.uk Thank you for your responses to the next phase consultation – look out for our response and next consultation in Spring/Summer Take a look at our registration update for providers developing new models – www.cqc.org.uk/new-care-models We will not compromise our focus on high quality care

Thank you www.cqc.org.uk enquiries-newmodelsofcare@cqc.org.uk @CareQualityComm