The Long-Term Plan sets out the ambitions to further develop a system approach to the reduction of inequalities, supporting the workforce, using data and utilising technology to deliver NHS care. This system approach drives regulators to collaborate, creating coherent and, where appropriate, common approaches to oversight which will develop over the coming years as system working evolves. Organisations currently have statutory duties in terms of regulation which would require changes in legislation to reflect a full change to system working.
Regulation of health care in England has two main elements: regulation of the quality and safety of care provided by health care providers, by the Care Quality Commission (CQC), and regulation of health care services and governance, the responsibility ofNHS England and NHS Improvement.
Resources: Commissioning – NHS England’s role in overseeing commissioning in England, including the Commissioning regulations outlining NHS England’s statutory duty to conduct annual assessments of Clinical Commissioning Groups.
NHS Provider Licence – the licence contains conditions for providers of NHS services, including NHS foundation trusts, NHS trusts and other providers.
Details of powers of NHS Trusts and NHS Foundation Trusts– these two types of trusts have different statutory powers relating to governance and provision.
Professional Regulators – NHS clinicians are regulated by a respective professional regulatory body, and practising individuals must be registered by law.
The well-led framework for leadership and governance developmental review supports NHS trusts and foundation trusts to maintain and develop the effectiveness of their leadership and governance arrangements. It is recommended providers undertake a review which is externally facilitated every three to five years to identify the areas of leadership and governance of organisations that would benefit from further targeted development work to secure and sustain future performance. The framework’s key lines of enquiry (KLOEs) are wholly shared with the CQC, and underpin the CQC’s regulatory assessments of the well-led framework. These are also reflected in NHS England’s improvement and assessment framework for clinical commissioning groups (CCGs). This means that information prepared for regulation can also be used for development, and vice versa.
Resources: Care Quality Commission are the independent regulator of health and social care in England. The CQC regulates providers across health and social care but does not include commissioning organisations. It is recognised that the current regulatory system will evolve and develop over the coming years to regulate the quality of care delivered by and across systems.