CQC and Monitor coordination
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.
- Monitor and the NHS Trust Development Authority merged to form NHS Improvement in April 2016, and NHS Improvement subsequently merged with NHS England in July 2022 under the Health and Care Act 2022.
- The CQC and NHS England operate under a shared regulatory framework with joint working arrangements (Health and Care Act 2022, c.31).
How was this evidence gathered?
Response
Accepted
Response
Accepted87. 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.