1. How Does regulation contribute to improvement?
Ella Jackson
Policy Advisor
12 October 2018

2. NHS Providers – who we are

3. Regulation and oversight of NHS providers
NHS England
NHS Improvement
Care Quality Commission
Competition
& Markets Authority
NHS Resolution
MHRA
NHS Digital
Commissioners
Royal Colleges
Local authorities
Professional regulators

4. A provider’s improvement journey
Outstanding
Reaction to initial inspection report/rating
Leadership
NHS resolution
Cultural change
Vision and values
Governance
Improving safety
Commissioners
Royal Colleges
Patient and public involvement
Special measures
Local authorities
Professional regulators
Looking outwards
CQC engagement
Driving Improvement, CQC, 2017

5. Contribution of regulation – the positive impacts
Outstanding
Reaction to initial inspection report/rating
√ Recognition and validation of good practice
√ Boosts staff morale and credibility with stakeholders
√ Brings focus to areas requiring improvement
√ Uncovers pockets of hidden good practice
√ Evidences need for culture change and prompts self-reflection
√ Helps boards engage clinicians
Leadership
NHS resolution
Governance
Improving safety
Commissioners
Royal Colleges
Special measures
Local authorities
Professional regulators
Looking outwards
CQC engagement

6. The danger that regulation stifles improvement
Only 26% said CQC inspection highlighted areas of concern the board was not aware of
67% said ad hoc requests from regulators had increased over the last 12 months
39% think the benefits of inspection did not justify the cost
51% believe support has been appropriately tailored to their sector
56% said reporting requirements are not proportionate to the level of risk they manage
36% felt the regulators had coordinated effectively
NHS Providers regulation survey, 2018

7. Special measures experience – the negative impacts
Outstanding
Reaction to initial inspection report/rating
X Scrutiny and requests ‘Feeding frenzy’
X Unrealistic expectations and demands
X Erosion of board autonomy
X Variability of improvement support
X Focus on quality or on finances
X Model assumes problems lie in individual organisations
Leadership
NHS resolution
Cultural change
Governance
Improving safety
Commissioners
Royal Colleges
Special measures
Local authorities
Professional regulators
Looking outwards
CQC engagement

8. What providers would like to see from regulation and support
√ Focussed on assurance that boards are leading organisations effectively
√ Aligned, coordinated and proportionate scrutiny and requests
√ Realistic expectations
√ Sector-specific
√ Based on up-to-date data
√ Models inclusive and compassionate leadership
√ Takes into account local system context
√ Support tailored to providers’ needs, taking account of priorities identified by staff
√ Facilitates peer support and sharing good practice

9. Q&A
THANK YOU