The independent regulator of health
and social care in England

Update from CQC

A regular update for providers and professionals working in primary medical and dental services

30 March 2023

Improving how we listen to, learn from and act on concerns

Two new reports setting out how we can improve the ways we listen to, learn from and act on concerns have been published on our website.

We commissioned the reports following an employment tribunal case brought by Mr Shyam Kumar.

The findings of this tribunal, which we accepted in full, were highly critical of us, finding that the decision to disengage Mr Kumar was materially influenced by the concerns he raised. During the same period, other issues were being raised around how we listened to and acted on concerns, including from our own staff.

The first report gives the findings from an independent review which we asked Zoë Leventhal KC to lead. This looks into the handling of protected disclosures shared by Mr Kumar, alongside a sample of other information of concern shared with us by health and care staff. It included consideration of whether the ethnicity of the people raising concerns impacted on decision making or outcomes.

The second report looks at whether there are areas of culture or process within CQC that need to be improved. As part of this, we committed to looking at whether race or any other protected characteristic has any impact on how we treat information of concern, reflecting on findings from Mr Kumar’s employment tribunal.

Our regulatory activity: What’s happening now

In January 2023, we published our response to winter pressures. This involved adjusting our regulatory activity until the end of March 2023.

We’ve now published our plans from 1 April 2023. You’ll find the full update on our website.

For GP providers, including NHS and independent sector providers working with the NHS, out-of-hours, NHS 111 and urgent care services, we will:

• Respond to new and emerging information of concern.  
• Prioritise inspections of services where there is inherent risk, including those in special measures, services rated as inadequate or requires improvement, newly registered services, and inspections to follow up enforcement action.  
• Continue our monitoring calls with GP providers. 

For dental and other primary medical services, we will continue our inspections and monitoring activity. 

Smiling matters - oral health in care homes Progress report 2023

Our 2019 review of oral health in care homes found steps were often not being taken to ensure that people get the oral health care they need to ensure that they are pain-free and that their dignity is respected. This follow-up review of how providers have responded to its recommendations from 2019 showed that improvements were being made.

The report shows there have been improvements in the understanding of how important oral health is to keep people healthy.

Read the new report to learn more about the findings and recommendations.

We also recently held a webinar to mark the publication of the progress report. Share your examples of best practice in supporting people's oral health via our CitizenLab project. You’ll need to sign up to the platform to take part.

How you see me matters: perspectives of autistic people using primary care services

One of our strategic ambitions is on tackling inequalities in care. This is specifically pushing for equality of access, experiences and outcomes from health and social care services. 

We've published a piece of work highlighting examples of real experiences and perspectives from autistic people on challenges they face when using primary care services. It aims to raise awareness and add to the wider conversation about the care provided to autistic people. You can also read the accompanying blog from Debbie Ivanova, Director for People with a Learning Disability and Autistic People.

Our ambition is to support providers to see things from a different perspective and think about what they could do to make changes in their own services.

Ethnic minority-led GP practices: impact and experience of CQC regulation – a year on

We have published a ‘One year on update’ about what we’ve done in response to the recommendations from our research and report on ‘Ethnic minority-led GP practices: impact and experience of CQC regulation’. The update highlights the changes we’re making as part of our new regulatory methods that will enable us to meet the recommendations specifically for CQC. They include:

• Tackling health inequalities
• Making more transparent judgements
• Reflecting contextual factors
• Using more data and experiences
• Monitoring ethnicity data for colleagues in CQC
• Support for GP providers

We’ve also published best practice and case studies of Using and sharing innovation to reduce health inequalities. This guidance builds on work that looked at how we can capture, consider and share innovative practice by NHS GP providers that aims to reduce health inequalities. This was another recommendation from our research, which found that our methods did not always take into account the context of deprivation or recognise innovation to tackle health inequalities by GP practices in poorer areas. The work was funded by the Regulators’ Pioneer Fund.

Launch of new AI and Digital Regulations Service

Our AI and Digital Regulations Service supports the development and widespread adoption of safe, innovative, value-adding technologies in health and social care. It aims to optimise care and improve outcomes across the system.

We’ve launched the section of the website aimed at developers. By mapping out the regulatory and evaluation pathway, the service helps developers progress their technology in line with legal requirements and best practice principles. This will enable practitioners, patients and the public to benefit from effective technological advances sooner.  

We’re currently testing the section of the website aimed at adopters. If you’d like to access the adopter content, please register for user research.

This service is a multi-agency collaboration between the National Institute for Health and Care Excellence, the Care Quality Commission, the Health Research Authority and the Medicines and Healthcare products Regulatory Agency.

Other news

• New dental mythbuster: our dental mythbusters aim to clear up some common myths about of inspections of dental services and share agreed guidance to best practice. A new dental mythbuster about caring for people with dementia in a dental practice has been published. 
• We’ll shortly be updating our guidance on the adult trans care pathway and need your help. We're looking for examples of good practice of providing care to trans people on the trans care pathway, outside of specialised gender dysphoria clinics, specifically in the following areas: maternity and gynaecology, speech and language therapy and GP services.
• CQC and Healthwatch England's ongoing Because We All Care campaign is looking to expand and work with other stakeholders. If you're interested in taking part, please contact Jay Harman, Campaigns Lead at CQC.
• We've made some changes to our Executive Team. Read more about new appointments on our website.
• Skills for Care and Supported Loving have published training materials around supporting people who need care and support to have meaningful and safe personal relationships. Read more and access the training materials.
• The Department for Environment, Food and Rural Affairs (DEFRA) are seeking views from health and social care providers on the next round of the Adaptation Reporting Power (ARP). The ARP was introduced to help ensure reporting organisations are taking appropriate action to adapt to climate change. The consultation closes 5 April 2023.