Published: 20 May 2025
We know that working with CQC has been challenging for health and social care providers in recent months, and we've heard your concerns about delays in:
- registering new services
- carrying out assessments
- publishing assessment reports
- acting on statutory notifications from providers
But we’re working to address these concerns, as well as issues with our assessment processes and the technology we use, to enable us to get back to delivering effective regulation and protecting people from poor care.
We’re focused on a range of foundational improvements that are designed to strengthen how we work and to deliver more effective regulation, with stronger governance and regular accountability. This includes aligning our systems, processes, and ways of working to ensure greater clarity and impact.
Crucially, we’re doing this work collaboratively with providers, colleagues, and people who use services.
What we’ve done so far
Our journey to rebuild trust and confidence has already started with our CQC Way conversations at the centre of this. We are co-designing a shared understanding of our purpose, vision, values and expected behaviours.
We’ll continue this in partnership with you, and over the coming months, we’ll work together to shape the future of our approach collaboratively, ensuring it reflects the needs and voices of everyone involved.
We’ve already made a number of improvements:
- We’ve implemented a workaround for publishing assessment reports that require a rating for both the location and service type so that providers aren’t waiting too long. These are assessments of NHS acute trusts, independent health hospitals and independent health single speciality services. We have also been tackling our backlog of reports that are ‘stuck’ in our system for technical or process reasons. When we started this work in January 2025 there was a backlog of 500 – as at 11 May, we had reduced the backlog down to 38 reports.
- We have made progress on how we act on information of concern by reducing the backlog of cases received and working on our processes to ensure we reach assurance on the way we handle these cases safely and effectively moving forward.
Since mid-February, our Registration team has been running a pilot programme aimed at improving the workflow process for applications from homecare agencies. There has been significant progress in addressing key challenges and improving efficiencies around registration.
The primary goals of this pilot are to:
- Reduce delays: Speeding up the registration process for providers, ensuring good quality applications are processed in a timely and efficient way.
- Improve guidance: Identifying common themes and gaps that will help clarify the documentation and policy requirements for applicants.
- Make efficient decisions: Ensuring that any notices of proposal to refuse, whether due to documentation issues or fit and proper person interview assessments, are issued promptly.
Changes we’re working on now
Technology and data
Earlier in the year, we commissioned an independent review of the technology we use. This considered how and why the technology is causing such significant organisational disruption. It also explored whether we could continue with the technology as it is.
The report includes 23 recommendations. We have established strong digital transformation and change management leadership at CQC to deliver these recommendations. We have set the direction for how we will sequence the improvements we need to make, taking a phased approach that focuses on fixing a different aspect of our technology at a time in a planned and safe way. This will ensure the rebuilding process is manageable and effective. We have started to engage with CQC colleagues, external partners and providers at our provider roadshows to understand how we can work together in the best way to make this work a success. We will work in partnership with our colleagues, providers, the public and wider stakeholders, recognising the importance of involving people who use our systems as well as those who benefit from them.
Importantly, we will ensure work to improve our technology links to the other foundational improvements we need to make at CQC.
Our response to the independent review of our technology and our approach to delivering foundational improvements in this area will be set out at our Board meeting in June.
Assessment approach
Following the recommendations in the reviews by Professor Sir Mike Richards and Dr Penny Dash, and from the Care Provider Alliance, we are looking at the improvements we can make to the content of the assessment framework, how we develop our judgements and ratings, the supporting guidance, and the use of scoring and evidence.
It’s vital that the organisations we regulate are at the heart of how we improve as a regulator. We are developing plans to engage further on these areas, before a formal consultation on our assessment approach later this year.
The CQC Way
In February, we began a foundational piece of work to build a new collective vision for what good quality regulation looks and feels like. As part of this work, we have brought together over 2,500 colleagues, providers, public representatives and wider stakeholders through a series of events to agree what the vision should be and how we get from where we are now to where we need to be. We are continuing to analyse all the information and feedback received, including from recent roadshows with providers, before we launch the CQC Way over the summer.
Strengthening our teams and leadership
Having the right leaders in CQC is key to our improvement. Our new Chair, Professor Sir Mike Richards, brings a wealth of experience across health and social care and in building a successful regulatory approach. Alongside Sir Mike, we are recruiting new non-executive members of CQC’s Board to replace those whose terms have expired.
As well as appointing Professor Bola Owolabi as Chief Inspector of Primary and Community Services, and Dr Arun Chopra as our first ever Chief Inspector of Mental Health, recruitment is underway for the positions of Chief Inspector of Adult Social Care, and Chief Inspector of Hospitals. Together, these roles will lead on regulation and improvement across health and social care – re-aligning the organisation around expertise in each sector.
As part of this, we are also looking at our future organisational structure under these 4 chief inspectors, and to reflect on other recommendations from Sir Mike.
Next
In the coming months, there will be opportunities to work with us on the design, development and implementation of change as we shape our new direction.
We are hosting a series of roadshows for providers to look at core aspects of our regulatory approach. These sessions are an opportunity to support the development of a new CQC handbook for providers and set of ratings characteristics, as well as developing changes to our assessment approach. There will also be other opportunities for you to have your say, and we will keep you informed at key milestones as we progress on our journey of improving regulation together