On 3 March 2016, the Government published its findings from The Cutting Red Tape Reviews carried out across three sectors, including adult social care. The initiative, launched in July 2015 by the Government, aimed to get rid of unnecessary bureaucracy. The specific review of adult social care set out to reduce duplication and overlap of inspections, visits, paperwork and data requests created by commissioning, contract management and regulatory work. Looking at the activities of organisations including CQC, local authorities and Clinical Commissioning Groups (CCGs), the adult social care sector review has highlighted a range of issues that organisations face when dealing with regulation and its enforcement. The recognition of these issues will be a welcome step for providers who have been critical of unduly oneroussystems that add significant work to their compliance and risk management activities.
The Government will now lead on a programme of work to help make sure it is clearly understood which public bodies carry out particular functions and address those areas where overlap has been reported. The Department of Health (DH) has stated that it will lead a programme of reform that will include:
- Issuing a short, clear statement of which public bodies carry out particular functions in their interactions with care homes – addressing concerns that the role of different public agencies is not clear for many providers and appears to them to involve a significant amount of overlap.
- Improving and streamlining information requests placed on providers – addressing concerns that there is duplication and overlap in contract monitoring, inspection and data requirements.
- Looking at ways to standardise local authorities’ interactions with providers, including through the Primary Authority scheme – addressing concerns about inconsistency of approach, a lack of clarity about requirements and similar data being collected in multiple formats.
- Collating and disseminating examples of good practice through a single programme of work – addressing an observation that a number of different agencies are exploring improved approaches but not always in a coordinated way.
- Agreeing the priorities for the work programme and an approach to joint working on solutions with the sector – through a meeting with a selection of providers and provider representatives shortly after publication.
A report to Ministers is due on the initial progress within six months to assess how well the issues are being addressed and what more may need to be done. Commenting on the review, the Chief Inspector of Adult Social Care, Andrea Sutcliffe, stated:
“The responsibility for delivering safe, effective, person-centred and high quality care clearly rests with providers, supported by their commissioners and funders. Regulators must not get in the way of that – we have to ensure that we add value by setting clear expectations, providing transparent information about our judgments, encouraging improvement and tackling poor care when we find it.
“I am glad that the review recognises this valuable role and the progress we have made at CQC since the introduction of our new inspection approach in October 2014. This approach is focused on what matters to people using services so if care home providers are truly getting it right for their residents, they will be getting it right for us too."
“I welcome the challenge to reduce the burden of duplication – a concern the consultation on our 2016 to 2021 strategy has already recognised. We have set out proposals to streamline the way we collect and share information about services and our desire to agree a shared view of quality. We are sure life will be so much easier for the public and providers if everyone, including providers and commissioners, looked at quality in the same way."
The findings of this review are sensible and timely in light of the current CQC consultation on its long term strategy. Providers are keen to avoid technical breaches of their notification obligations by having integrated reporting requirements saving everyone time and money. The issue will be how this will work practically in view of the number of agencies involved in the regulation of adult health and social care.