The Five year forward view has been at the front of CQC's thinking as we develop our strategy for 2016-2021 and prepare for the next phase inspections after we have inspected and rated all providers across health and social care for the first time.
We have started projects to look at how well services work together, how the way we regulate could respond to new ways of providing care, and how we could assess the overall quality of care in an area.
New models of care: We are looking ahead so that we are prepared for future developments in such a way as to ensure the quality and safety of new services for the people who use them. This means considering how we should best register, monitor, inspect rate and report on new care models that cross sectors; how we take enforcement action if that becomes necessary and how we encourage and share good practice.
We are talking to vanguards, to understand more about the developing new models of care and to consider how we can support them and encourage more joined-up, patient-centred care. We are also considering registration issues; for example, making it simpler to register new models, and looking at how we may need to adapt or change the way we register organisations to reflect and respond to the new models of care.
Quality of care in a place: This project explores through pilots in two places how we can assess what care is like for the people who use a range of different services in a local area. We are testing whether the knowledge about the quality of care in a place can help encourage improvement locally. The work will identify issues that need to be tackled and what's working well across organisations as well as by individual services. We will be able to explore how we can better understand the impact that quality of leadership, funding and commissioning have on quality across a local area.
Looking at the quality of care across and between services: This is being done through our work that looks at how well the 'system' delivers joined up care for people under specific circumstances. During 2015/16, these include:
Diabetes care in community settings – examining how well people with diabetes are supported by community services to achieve good outcomes.
Integrated care for older people – exploring how well care is organised and coordinated for older people and how this affects the quality of the care they receive and their outcomes.
End of life care – a project to develop our understanding of the barriers that prevent people with the poorest experience of care from receiving good quality, joined-up care at the end of life.
Neonatal care – aiming to identify good practice and make recommendations to address gaps and risks identified in the care of new-born babies and infants.
People's involvement in their own care – examining what our existing evidence can tell us about how well people are involved in their own care and about what outstanding involvement looks like.
Safety in hospitals – looking at how well hospitals investigate when care has gone seriously wrong, and whether they are learning from these cases in the way they respond to serious incidents.
Urgent and emergency care – to develop a methodology for inspecting urgent and emergency care services which reflects the changes taking place and includes a drive for further integration of urgent and emergency care.
As well as these three strands, a range of other CQC activity supports the Five year forward view.
Providing high-quality information about care services
We are continuing to monitor, inspect and rate health and care services, and we are building a comprehensive baseline assessment of the quality of all health and care services from which the system will be able measure and track provider quality. We use our analysis of ratings, findings from inspections, performance data and a wider and richer evidence base of information and research, to highlight priorities for improvement and to disseminate good practice, including through the publication of the annual State of Care report.
Other national reports we have published have examined 'pathway' issues, such as Right here, right now, a report into mental health crisis care, Celebrating good care, championing outstanding care, that sought to share good practice across providers, and our Mental Health Act annual report, which looks at the experiences of patients who received care under the Act.
Assessing use of resources
We continue to ask if services are safe, effective, caring, responsive to people's needs and well-led in all of our inspections and, from April 2016, we will also start to assess the use of resources in NHS trusts. This will help us to better assess quality, recognising that in a time of financial constraint, a provider will not be able to deliver sustainably high-quality care without efficient and effective use of resources. It will also enable us to encourage improvement by sharing examples of how resources are used well.
National Quality Board
We jointly chair the National Quality Board and share the role of secretariat to the board with NHS England. All three of our Chief Inspectors – representing the hospital, primary care and adult social care sectors – are members of the NQB. We are working jointly with NHS England and our ALB partners to develop a shared quality strategy, and to support greater alignment across the system.
National Information Board
We are an active member of the National Information Board, and we are working with NHS England, Monitor and the Health and Social Care Information Centre to lead the Framework for Action strategic workstream on the secondary use of data (for research, commissioning and regulation).
The National Taskforces
Alongside our partners on the National Quality Board, we are committed to supporting the implementation of the aims and recommendations of the Cancer Taskforce, the Mental Health Taskforce and the Maternity Review.