Increased powers to the CQC

The Bill proposes that the CQC’s scope should be widened. The new powers and duties are as follows:

• The power to require NHS England to appoint a special administrator for both Foundation Trusts (FTs) and non-FTs, provided the CQC is satisfied that there is a serious failure by an NHS trust to provide services that are of sufficient quality. This is consistent with the changes introduced by the Bill which see NHS England becoming the regulator for both FTs and non-FTs, sitting in the place that was previously occupied by Monitor and the Trust Development Authority (TDA). At the moment, the CQC only enjoys these powers in relation to FTs. On the appointment of a trust special administrator, the trust's chairman and executive and non-executive directors are suspended from office.
• A new duty to assess the performance of local authorities in terms of how they discharge their adult social care functions. The precise scope of what the CQC will be reviewing under these new powers and how it will do this is to be determined but this is likely to be in the form of inspections and ratings as it presently is the case for providers of health and adult social care.  These powers will be accompanied by a system of ‘special measures’ for local authorities as overseen by the Secretary of State and the ability of the CQC to issue ‘warning notice’ style letters to local authorities.
• The power to police new hospital food standards to be set by the Secretary of State in relation to food or drink provided or sold to patients, staff or visitors on hospital premises. These changes are likely to elevate hospital food standards to the same level as other CQC standards, such as those relating to the safe care and treatment, safeguarding, staffing and duty of candour.
• A duty to co-operate with the Health Service Safety Investigations Body (HSSIB) in relation to HSSIB investigations.

What about the CQC’s remit over Integrated Care Systems?

Currently the Bill makes no provision for the CQC to inspect and issue ratings for Integrated Care Systems. This was a surprise to many commentators. The Secretary of State has been pressed on this by the Health and Social Care Committee and he has since confirmed that the Department has been “working closely with the CQC and NHSE to develop detailed proposals” in this regard. These proposals will be included in the Bill as an amendment as it makes its way through the legislative process.

The Committee is not content with the assurances given by the Secretary of State and has reminded him that his predecessor stated the government was committed to ensuring: “that the CQC will be able to inspect how well systems are doing and publish on that basis, including setting out the high-level, four-part report—Outstanding, Good, Requires Improvement and Inadequate—that everybody knows and understands”.

We will keep a close eye on future amendments to the Bill to see what powers the CQC will be given to inspect and rate Integrated Care Systems.

For more information, please contact Ian Cooper.

Highlights from the Health and Care Bill

We have prepared a series of “bite sized” updates on those aspects of the Bill that are likely to have most practical impact on your day-to-day work.  

What does the Health and Care Bill mean for...

• procurement, patient choice and competition?
• service reconfiguration?
• information governance and data sharing?
• employers and workforces?
• the establishment and governance of Integrated Care Systems?