Source: Practice Index 30.10.25 CQC, GP Practice Management– By Phil Coates
Change for the sake of change is something we’ve all experienced and it’s often incredibly frustrating for all involved. There are some change initiatives that lead to wholesale changes which impact on thousands of organisations, are often time-consuming and require a great deal of compliance, let alone a whole new level of understanding.
So, what happens when someone has an idea that would potentially see changes implemented a year or two ago reset, and the reintroduction of sector-specific frameworks? I think we’re all aware of the phrase “light blue touch paper and stand back” and it can certainly be applied to the CQC’s consultation on how they assess and rate providers.
Let’s start with assessment frameworks. Not so long ago, much fuss was made about the introduction of the single assessment framework (SAF) which replaced previous frameworks. However, the CQC are proposing to reintroduce sector-specific frameworks which “clearly reflect and articulate the context of those health and care sectors”. One thing that must be clear is the supporting guidance that accompanies the frameworks, but has anything ever been clear with the CQC?
Up next, quality statements. You’ll recall that the 34 quality statements replaced the 150 Key Lines of Enquiry (KLOEs), the latter being classed as prompts/questions, and only recently we were advised that the CQC were reviewing the quality statements with the aim of minimising duplication. Well, it may come as no surprise that the CQC now propose to develop a range of supporting questions, replacing the current quality statements, which would be similar to the previous KLOEs. 2026 could prove to be the year of the U-turn for the CQC.
The effect of such changes is significant at both CQC and provider level. Whilst a consultation is a good way to engage with stakeholders, the aftermath for practices is something that seems to slip under the radar at CQC HQ. It takes a significant amount of time and effort to align evidence with frameworks or supporting questions, and when things change, this all must be reviewed. Thankfully, we’ll update CQC Manager in the HUB, making the transition much easier for you.
When discussing CQC assessments, evidence has always been a controversial subject. There has never been a definitive list of what’s required, and during a webinar about the SAF, the CQC reiterated that there would be no list of evidence provided. However, this could be about to change, as the CQC are proposing to support the assessment frameworks by introducing supporting guidance which will show the evidence that will be considered. Hopefully, this will remove the subjectivity around evidence requirements and offer much-needed consistency. We can but hope!
On the subject of consistency, do you remember that scoring was introduced to help the CQC make consistent rating decisions? Well, this too is a change destined for the exit door. The CQC propose to no longer award separate scores underneath key question ratings, instead opting for transparency about findings in each area of the sector-specific framework. This will be achieved through evidence gathering, a rounded assessment of evidence across the whole key question, key question rating, and then the overall rating.
Ratings will not change. Providers will be awarded one of the following ratings: Outstanding, Good, Requires Improvement or Inadequate. Ratings for each key question are aggregated to provide an overall rating. At last, consistency is apparent!
Finally, assessments – or are they inspections? Well, the CQC seem to use the word assessment semi-consistently, until they discuss the new assessment approach, which then refers to inspection activity. This is another area where we’re seeing further change. Out goes the ‘no set timescale’ and in comes the ‘routine planned inspections’ approach, which will see inspections take place on a three to five-year cycle. I’m sure we’ve been here before?!
Of course, we’re only in the consultation phase, and it would be unwise to make any assumptions about the proposed changes, other than for me to assume there will be many more WAGI (wouldn’t it be a good idea) moments until we alight from the merry-go-round of change!
The consultation closes at 5pm on 11th December 2025, but between now and then, we can expect to see draft assessment frameworks which will be developed and changed in line with consultation feedback, giving us a glimpse into the future of CQC assessments inspections.
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