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Tuesday 25 October 2016
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Future of healthcare regulation is pathway inspection, says CQC chief

David Behan has said they are working towards regulating care pathways as well as individual providers

The chief executive of the Care Quality Commission (CQC) has said they are working towards regulating care pathways as well as individual providers.

Speaking to delegates at the Health+Care event at Excel London today, David Behan said: “I think our future is to look at the system. Our model of regulation will flex as we go forward to look at issues around systems.”

However, he added that moving to inspect care pathways over services providers is “not a binary”.

“We’re looking to develop a model where we can do both,” he said, adding that the CQC is set to publish two system-wide report in the coming weeks.

“We’re just about, next week, to publish a report on integrated care for older people, which looks at the issues of the patient journey.

“The clues are in the title – Cracks in the pathway: Transition from care homes into acute and back again – because there’s fractures and fragmentation,” he said.

Furthermore, Behan said he signed off on a report yesterday that looks at health care services for looked after children.

Behan’s comments came in answer to a challenge from Dr Phil Moore, deputy chair (clinical) at NHS Kingston clinical commissioning group (CCG).

Moore said: “We use different providers for different bits of the system and when the CQC or NHS improvement look at a provider, they don’t look at the system the patient goes through.

“I think we’ve got to change that and say: "How does our local place based commissioning and provision deal with the quality, the safety and the effectiveness of that patient’s journey throughout the system.”

Moore added that commissioners want to move their contracts to being single outcomes across a variety of providers.

“That I think is where the CQC has got to regulate much more than where it is at the moment.”

However, Ben Dyson, executive director of strategy at NHS Improvement, warned that pathway assessments might not deliver the information patients are looking for.

He said: “We need to be careful that we do this is ways that are right for local patients in local communities.

“If I’m using services at a particular hospital, I need to know what quality of care I can expect.

“What I don’t want to find that is that the answer to that is aggregate data that tells us across much bigger geography that the performance is ok – but I’m not sure what that means for my local hospital.”

David Behan also added that, although the CQC is looking to do more in the way of pathway regulation, an organisational merger is not in the cards.

He said: “I’m not making a bid to regulate CCGs. That’s done by NHS England. The issue is how do we work with NHS England.

"I’m not sure an organisational merger across NHS Improvement, CQC and NHS England is what we should be doing. It’s disruptive and it deflects attention.”