33 Response Accepted AI-assessed

CQC and Monitor coordination

Recommendation

We considered carefully the effectiveness of separating organisationally the regulation of quality by the Care Quality Commission from the regulation of finance and performance by Monitor, given the close inter-relationship between Trust decisions in each area. However, we were persuaded that there is more to be gained than lost by keeping regulation separated in this way, not least that decisions on safety are not perceived to be biased by their financial implications. The close links, however, require a carefully coordinated approach, and we recommend that the organisations draw up a memorandum of understanding specifying roles, relationships and communication. Action: Monitor, the Care Quality Commission, the Department of Health.

Published Evidence Summary
The following publicly available evidence relates to this recommendation:
According to government responses from March and July 2015, a Memorandum of Understanding (MOU) was established between the Care Quality Commission (CQC) and Monitor (the predecessor to NHS Improvement), which was published on 26 February 2015, to ensure closer working links and improved coordination. NHS Improvement, which succeeded Monitor, has since merged with NHS England, further consolidating regulatory and oversight functions. According to the available evidence, no further published evidence on the ongoing impact of this coordination has been identified since the 2015 government responses.
How was this assessed?
Assessed by gemini-2.5-flash on 19 Mar 2026
Checked data held on this site (government responses, progress updates, independent evidence)
External sources searched: www.gov.uk, www.legislation.gov.uk, hansard.parliament.uk
Jurisdiction
England
Response
Accepted
Accepted CQC
16 Jul 2015

87. We accept this recommendation. Closer working links have been established
and will be developed further.
88. An updated Memorandum of Understanding between Monitor and the Care
Quality Commission was published on 26 February 2015. It describes what they
intend to achieve and their continued commitment to working together.
Both
organisations have improved how they work together in areas including: Monitor’s
assessment process and significant transaction reviews, management of Care
Quality Commission registration requirements, management of risk, and joint
escalation and enforcement of the new licensing regime. The Care Quality
Commission and Monitor have clarified their roles in the Single Failure Regime,
including Special Measures. Work is ongoing to further improve joint working and
the sharing of information. In addition, the Care Quality Commission will work jointly
with Monitor and the NHS Trust Development Authority to develop proposals to
assess the efficiency of providers as part of its inspection and rating process.
89. The Care Quality Commission and Monitor will keep this Memorandum of
Understanding under regular review and will update it as relevant to reflect the Care
Quality Commission’s new role in assessing Foundation Trusts’ use of resources
and any other changes to the functions of the two organisations.

Read Full Response
Source
Inquiry Morecambe Bay Investigation
Report Report of the Morecambe Bay Investigation 03 Mar 2015
View Source
Responsible Bodies
CQC Primary
Themes & Tags
Quality and safety oversight CQC Monitor Coordination
Recommendation age 11.1 yrs
Last formal update 3904 days ago