Health regulator CQC set to overhaul systems in the coming years

Independent health and social care regulator, Care Quality Commission (CQC), has this week published its annual report for 2016/17, in which it outlines a number of plans to invest in technology and overhaul existing systems, following the appointment of a new Chief Digital Officer at the end of last year.

The regulator is responsible for making sure that health and social care services provide people in England with safe, effective, compassionate and high-quality care, encouraging services to improve.

CQC has also played an active role in recent discussions with parliament about the need to rethink adult social care and delivery of care models within the NHS, given funding challenges and the pressures introduced by an ageing population.

The annual report notes that CQC made efficiency savings for the period for the first time since 2011, thanks to improvements made in systems and processes. It hopes that year-on-year savings can now be made up until 2019/20.

However, despite positive gains and investments being made in its technology, CQC also identified data collection and technology as two of its key risks going forward.

Introducing the report, chair Peter Wyman and chief executive Sir David Behan, said:

Our achievements have been in the context of a reducing budget – from £249 million in 2015/16 to £236 million in 2016/17. At the same time, the main source of our funding has moved from the Department of Health to fees paid by providers. Our budget will continue to reduce and we need to deliver our purpose with fewer resources.

This year we have focused on strengthening our systems and processes to become more efficient and effective, and to ensure we can deliver value for money to the public, people who use services and their carers, and providers. We have managed to significantly reduce the cost of our inspections for the first time since 2010/11 and we will look to achieve further reductions.

New systems

Throughout the annual report, the appointment of Chief Digital Officer Peter Sinden in December last year is highlighted as a key achievement in addressing the need to improve CQC’s systems and processes.

In a 2015/16, CQC drew attention to the emerging theme of IT systems within its reviews, which has in turn led it to consider and assess its requirements for technology in the future. The appointment of Sinden as CDO and his ongoing work on a new digital strategy aim to address this.

CQC goes as far as to say that its overall strategy “would need to be reviewed and potentially updated to align to the development of the digital strategy in due course”.

Chair Wyman and chief executive Behan, said:

We appointed a Chief Digital Officer to oversee delivery of our information management and technology strategy, setting out to overhaul our systems over the next few years. This will include putting far more of our transactions with providers online, helping to improve the information we collect and rationalising the burden, particularly in data collection and processing. Public accessibility to our data will also be enhanced.

They added that it’s not only CQC’s own technology that needs to be considered, but those of the health and social care providers, as this will have implications for how it assesses care in the future.

New ways of providing care, such as online GP services and innovative solutions to managing hospital discharge processes, present us with important challenges and considerations for the way we regulate. We wish to encourage innovation while ensuring that all care, however provided, is safe and effective.

Some of the technology investments identified in the report, include:

• CQC is working with NHS Improvement and NHS England to establish a single, shared data set, to establish a more joined up view of care.
• It started to develop a user-needs approach to digital development to engage better with the public.
• Worked towards a streamlined registration process by phasing out paper applications and encouraging new providers to register using our online system.
• CQC is exploring longer-term transformation of its supporting systems to enable full digital delivery of report publishing.
• It is improving the range of information and data it collects, while also finding ways to reduce the burden of data collection on providers.
• CQC says that it takes too long to publish its inspection reports – and so is continuing to examine how it can streamline its systems and simplify reports to make sure people can access a report as quickly as possible after an inspection.
• The regulator has invested in a new national resource planning tool, Cygnum, which will improve the way it manages and schedules inspection activities.
• Improvements to CQC’s customer service centre have been made to create a better experience for customers. It developed new tools and training for staff to help listen and respond better.

A single view of quality

In addition to the investments being made in new digital systems, CQC is also undergoing work to improve how it uses data, across a number of stakeholders, to get a better understanding of quality and care provision.

The report identifies one of CQC’s key risks as not ‘effectively collecting and processing the information it needs to be an effective, intelligence-driven regulator and accurately predict quality’.

The report reads:

We developed and started to test data dashboards as part of our new CQC Insight model. CQC Insight will make better use of information from people who use services by better analysing comments and concerns, and integrating feedback from local partners and stakeholders.

We began collaborating with providers and partners to develop a single shared view of quality, which aims to help reduce the burden of regulation on providers. This included publishing our shared commitment to quality framework as part of our work with the National Quality Board – a nationally agreed definition of quality in health care, and guide for clinical and managerial leaders.

CQC’s operating budget for 2017/18 (which excludes depreciation) is £227.6 million. It now has a spending review target of £217.0 million for 2019/20, based on these investment plans.