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The role of regulation in supporting transformational change

The increasing pressure on today’s NHS has been well documented. Hospitals are facing an unprecedented level of demand for their urgent and emergency services and continued challenges from delays in discharging patients to community and social care services. What this shows us is that while there are many individual examples of good and outstanding care, the model of acute care that once worked well cannot continue to meet the needs of today’s population. This need for change is something we highlighted in our recent report- ‘The state of care in NHS acute hospitals: 2014 to 2016‘, which set out what we have found about the quality and safety of care in acute and specialist trusts based on our first round of inspections.

The report described wide variation in the quality of care in our hospitals, but also highlighted cases where hospital trusts have made practical changes to the way they deliver their services for the benefit of patients, even in the most challenging of times. Some of these changes were within individual hospitals, for example centralising specialist services to improve safety or changing the model of care to ease pressure and allow better patient flow between departments. But they also included hospitals working with other local healthcare organisations to deliver new models of care and using new technologies to improve people’s experiences and ensure people are being cared for in the right place.

We are starting to see some very encouraging examples of integrated care with hospitals working much more closely with local primary care services, enhanced pharmacy and specialist nursing input into care homes.

As the regulator of health and adult social care in England, we are keen and ready to adapt to these changes. We want to encourage innovation but we need providers to tell us about their plans so that we can work with them and be ready to regulate them as they are introduced.

The development of new and complex models of care across traditional sector boundaries is important. It is also vital that learning about what does and does not work is shared across the country.  We also need system leaders to come together to help drive the programme of transformation that is needed to safeguard the sustainability of our health and social care system. Sustainability and transformation partnerships (STPs) will be central to this.

This transformation won’t be easy to deliver – but, coupled with strong leadership it will provide the best defence against the challenges ahead while ensuring that people continue to receive safe and effective care.

We are working with providers where they are developing new models of care as part of their STPs to help guide our approach.  Following an eight week consultation with providers, stakeholders and the public we established a set of core principles for regulating services in a complex and changing landscape.  We are now seeking people’s views on about how we put these principles into practice and develop a proportionate and flexible approach for inspecting and rating new and complex providers while maintaining a focus on quality. To find out more and to get involved, visit the Care Quality Commission website.

Sir Mike Richards

Professor Sir Mike Richards was a hospital physician for more than 20 years. After a variety of training posts he was a consultant medical oncologist between 1986 and 1995, and Professor of Palliative Medicine at Guy’s and St. Thomas’ Hospitals between 1995 and 1999.

In 1999 Sir Mike was appointed as the first National Cancer Director at the Department of Health. In 2007, his role was extended to include end of life care. He led the development and implementation of the NHS Cancer Plan in 2000, the Cancer Reform Strategy in 2008 and Improving Outcomes: A strategy for cancer in 2011.

In July 2012 he was appointed as Director for Reducing Premature Mortality on the NHS Commissioning Board (now NHS England). In this role he led the development of a cardiovascular outcomes strategy.

He became CQC’s first Chief Inspector of Hospitals in July 2013 and led the development and implementation of a new approach to hospital inspection which assessed services on whether they are safe, caring, effective, responsive and well-led. Sir Mike will be retiring from this role at the end of July.

Sir Mike was awarded a CBE in 2001 and appointed a Knight Bachelor in 2010

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