When the White Paper was published it was clear that regulation for the NHS would be changing significantly in the future. Greater roles for Monitor, Care Quality Commission (CQC) and the National Institute for Clinical Excellence (NICE) were apparent but the detail of how the regulators would work together was less than clear.
There has now been a consultation published, Liberating the NHS: regulating healthcare providers which provides some insight into how the Government sees regulation in the future. Our briefing on the consultation can be accessed here.
The consultation document has provided some further clarification on the proposed role of Monitor and how this will link with the CQC. It is proposed that Monitor will regulate health and social care in three core functions, namely the regulation of price, promotion of competition and to support service continuity. Monitor will also have the function of licensing NHS providers in addition to CQC registration. There will be the possibility of enforcement action with removal of the licence or fines if terms of the licence are breached. For NHS organisations this will mean registration with two regulators and the payments of two sets of registration fees with the possibility of enforcement from two regulators.
Social care providers and private health providers will not require a Monitor licence on the basis that these are mature markets with a range of choice between alternative providers. CQC will retain the registration function for both health and social care providers and will provide quality assurance in respect of levels of quality and safety for both health and social care.
Despite the broad heading of the consultation document, there is no real detail about the role of CQC or NICE in the future landscape. CQC will regulate the NHS and social care providers based on the “essential standards of quality and safety” which have been drafted to inform providers how they can ensure compliance with the section 20 regulations of the Health and Social Care Act 2008. So far we have not been informed how the 150 quality standards of care from NICE will fit in with the new CQC standards. Will a breach of NICE standards mean enforcement action from CQC, have consequences for the Monitor licence, or result in no action at all?
The consultation document states that the Government is committed to reducing the overall burden of regulation across the health and adult care sectors. Once we have more detail about how the proposed regulatory bodies will work together in the future, we will see if this commitment is likely to be achieved.