Aligning the regulatory frameworks: how NHS Improvement and the Care Quality

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2 Aligning the regulatory frameworks: how NHS Improvement and the Care Quality Chair: Susan Sjuve, Chair, Sussex Community NHS Foundation Trust Dr Malte Gerhold, Director of Policy & Strategy, CQC Miranda Carter, Executive Director of Provider Appraisal, NHS Improvement

3 Aligning the regulatory frameworks: how NHS Improvement and the Care Quality Commission will work together Malte Gerhold, Director of Policy & Strategy Care Quality Commission Miranda Carter, Executive Director Provider Appraisal NHS Improvement NHS Providers Governance Conference 07 July

4 1. The priorities of CQC s new strategy 4

5 Ambition Our ambition for the next five years: A more targeted, responsive and collaborative approach to regulation, so more people get high-quality care 5 5

6 Four priorities to achieve our strategic ambition 1. Encourage improvement, innovation and sustainability in care 2. Deliver an intelligence-driven approach to regulation 3. Promote a single shared view of quality 4. Improve our efficiency and effectiveness 6

7 What will our strategy mean for hospitals? Focus on core services that require improvement, and on well-led Update ratings based on smaller, more focused inspection; use more unannounced inspections Expect providers to describe their own quality against our five key questions Work with NHS Improvement to give new ratings on efficient use of resources Produce shorter reports, more quickly that make clear how we have come to our conclusion Hold an annual review of each provider to determine where to focus our inspection activity for the year ahead 7

8 8 2. NHS Improvement: Our new approach

9 NHS Improvement Monitor Intensive Support Teams (from NHS IMAS) NHS Improvement NHS TDA Advancing Change Team (from NHS Improving Quality) Patient Safety (from NHS England) 9

10 Our mission To provide the national leadership, oversight and practical support that providers will need to deliver urgent improvements at the frontline and work towards long term sustainability 10

11 11 The core components of our operating model

12 Collaborating with system partners We want to move to a model where collaboration across health and care systems becomes instinctive not just locally but nationally NHS Improvement will work closely and collaboratively with other national bodies, especially NHS England and CQC As part of our reorganisation we plan to align NHS Improvement s structures at sub-regional level with those of NHS England Our new operating framework will also move to a shared definition of success for strategic change in partnership with NHS England In this way we will support providers, by speaking to them in a single voice 12

13 Our objectives Quality Finance & use of resources Operational performance Strategic change Leadership & improvement capability Continuously improving care quality, helping to create the safest, highest quality health & care service Balancing provider finances and improving productivity Maintaining & improving against core standards Ensure every area has a clinically, operationally & financially sustainable pattern of care Building capability to deliver sustainable services 13

14 NHSI will oversee and provide support on five themes Quality of care CQC s key questions Real-time information, including on seven day hospital services Finances / Use of resources Providers financial performance and efficiency, control totals Reflects Carter Review recommendations Co-developing this theme with CQC Operational performance Focus on small number of core NHS Constitution standards A&E waiting times, RTT, Cancer, Ambulance response times, and access to mental health services Strategic change Delivery of the strategic changes set out in the Five Year Forward View - with a focus on STPs Working with NHS England Leadership and improvement capability Build on existing governance tools (e.g. well led framework) Shared system view on what good leadership looks like

15 Breach Concern NHSI will segment the sector using the Single Oversight Framework Segments for providers Support from NHSI Mandated support Targeted offer of support Critical issues Serious issues Emerging concerns / minor issues No evident concerns Universal support Approach to improvement On 5 themes champions in providers who lead on priority areas, such as A&E part of our role is to broker improvement relationships so the good providers help those who need support

16 3. How we will work together 16

17 CQQ and NHSI Working together Well Led Jointly updating and aligning what good looks like by April 2017 Potential to include system level governance, leadership and strategic changes NCM and Use of Resources Use of resources We are co-developing this theme with CQC Future Operationalisation Streamlining approach between NHSI and CQC Best approach to conducting reviews, benefits of joint review

18 Questions for you A shared definition of success should CQC s and NHSI s description of what good looks like be aligned further? Assessing well-led and use of resources what would be most helpful for you, to encourage improvement? Day to day working with you how could our interactions with you be further streamlined, given our different remits? 18

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