Improving how we work

Our core purpose is to make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve. But problems when implementing our new assessment approach and issues with our new technology mean we are unable to fully deliver that purpose.

We know we need to improve how we work. To do this, we have been developing a plan using feedback from the public, providers and our colleagues alongside the recommendations from reviews by Dr Penny Dash and Professor Sir Mike Richards into our effectiveness and new assessment framework. We will share the full plan and timeline by the end of this year. As we progress with this work, we will share regular updates and opportunities to get involved here and through our regular email bulletins.

We will only be able to fulfil our core purpose by completing enough assessment activity to give people using services, health and social care providers and stakeholders an up-to-date view of quality across the health and social care system. To do this, we need to give providers the right guidance to understand how to work with us, equip our staff with the tools they need to carry out assessments, and publish assessment reports that are accurate and easy to understand.

Everything in our improvement plan will be focused on enabling these priorities.

Latest news

While we are working on our full plan, we have been delivering rapid improvement work across 5 areas:

Strengthening our leadership

We have appointed Sir Julian Hartley as our new Chief Executive, who will take up his role from 2 December, and will soon be starting recruitment for 4 permanent Chief Inspectors. Collectively, this will strengthen our leadership across the health and social care sectors we regulate. We will also be working on how we align our assessment teams under the Chief Inspectors and around areas of sector expertise.

Having the right expertise

We have invested £2 million to support resourcing our assessment workforce and increase inspection activity. We are also piloting approaches to ensure that assessments are led by people with expertise in the specific sectors they are assessing.

Reviewing our assessment framework

We are looking at where we need to make changes to our methods. These include:

  • discontinuing scoring at evidence category level
  • discontinuing the use of previous ratings to produce scores
  • reviewing how we use quality statements for each assessment
  • reviewing how we use professional judgement when producing a final rating.

We will also be working with Professor Sir Mike Richards and members of the Care Provider Alliance (CPA), which is chaired by Professor Vic Rayner OBE, who will take forward a second phase of activity. They will explore and provide recommendations on the future of our regulatory assessment. This important work will inform both immediate and long-term decisions and will align with our own engagement activity.

Updating our approach to relationship management

We are piloting approaches to improve the way we manage relationships with health and social care providers. This work is across all sectors, and we will evaluate this in early 2025 to decide how to apply the most effective approach.

Delivering improved tools for providers

We are working to identify improvements that are needed for the provider portal, to ensure it works well for all users and meets the needs of different types of providers. We will also be introducing improved customer support to help any providers that have problems accessing the portal. We have removed registration functionality from the portal to give providers an improved experience of registering with us.

We are co-designing a new clear and accessible provider handbook to ensure our guidance meets the needs of all who use it and is available in the right format. This includes the development of new ratings characteristics.

Inspection report publishing

What’s happening

We are experiencing some technical issues with assessment reports. These are resulting in delays to final reports appearing on our website and delays in sharing draft reports with providers to check factual accuracy. This is partly due to changes we have made to the technology used to plan, carry out and report on assessment activity as well as the system we use to publish the reports.

We are sorry for the impact this is having on providers and people using services.

What we’re doing about it

We are working on fixes to our technology to reduce delays and improve access to the reports. Until the fixes are in place, we are adding assessment reports to our website manually, which is a longer process – but we are publishing them as quickly as we can.

What providers need to do

We understand this delay is frustrating. There is no need for individual contact at this time - our operations team will proactively let you know when your report is going to be published. We will also share updates through our website and provider bulletins.

What next

Tackling these delays is a high priority for us. Assessment reports are central to our work, and we know they are important to give an up-to-date view of quality to the public and providers. We will update you on our progress as soon as possible.

Working with you

In this section, you can see the latest opportunities to get involved in our improvement work and what we have been engaging on.

We can only deliver effective regulation by developing our improvements in equal partnership with people who use services, health and social care providers and stakeholders.

We will work in partnership to design better ways of working and test ideas for improvements. Importantly, we will make sure we listen and act on your feedback. Read more about recent work in this area in a blog from Director of Engagement, Chris Day.

Ratings characteristics

We’ve heard that there’s a need for more detailed guidance to describe the specific characteristics of the quality of care in a service under each of our 4 ratings: outstanding, good, requires improvement and inadequate. We are therefore co-designing a new set of ratings characteristics.

For providers:

For organisations that represent people:

For Local Healthwatch:

Changing how we use scoring in assessments

In response to feedback, we are considering making changes to:

  • how we use an existing rating for a provider to generate new scores
  • the levels at which we score
  • how our teams apply professional judgement to decide a rating.

If you would like to get involved with this work, keep checking here.

Provider handbook

We’ve started developing a new handbook for providers, which will explain clearly how we carry out our assessments and what to expect from us. Through workshops, one-to-one conversations and surveys, we’ve had feedback from over 1,800 people on how the handbook should look and what it needs to cover. Thank you to everyone who’s engaged with us on this so far.

Other recent updates

Blogs

Videos

Bulletins