Regulators need to take better account of the escalating
operational pressures that trusts are facing, following the
findings of NHS Providers' latest annual regulation and oversight
survey.
A pivotal moment for
regulation shows trusts are experiencing intense
pressures on quality, finances, performance and staffing against
a backdrop of 'unrealistic' regulatory demands. Trust leaders
report that regulators are not doing enough to understand
and help address the complexity and challenges of the
operating environment.
With NHS regulation going through a significant period of change
and renewal, trust leaders are also concerned about duplication
of functions and requests across the system, especially between
integrated care boards (ICBs) and NHS England (NHSE). Trusts are
also sceptical about the credibility and objectivity of the
Care Quality Commission (CQC).
Other key findings include:
-
The majority of respondents (53%) reported an increasing
regulatory burden, which was most strongly associated
with ICBs. 72% said the burden from ICBs has increased
compared to 48% from NHSE and 36% from the CQC.
-
Less than a third of trusts are comfortable with ICBs' role
as performance managers, with 62% seeing ICB activity as
duplicating that of NHSE.
-
Concerns were raised about CQC's credibility, objectivity,
and sector-specific expertise. Trust leaders also report
weakening relationships with CQC at the local level.
-
The majority of those who commented would like to see CQC
move away from single-word ratings, viewing them as overly
simplistic, often confusing for patients and demoralising for
staff.
Saffron Cordery, deputy chief executive at NHS Providers
said:
"Regulators have shown openness to working constructively with
trusts, but this year's survey results indicate that regulatory
requirements are detached from operational realities. Regulation
needs to take better account of the level of challenge and risk
trusts are managing, and better enable them to focus on improving
quality of care.
"Trust leaders are particularly concerned about unrealistic
expectations and the burden of meeting what are at times
duplicative regulatory requirements.
"As the health and care system continues to face significant
challenges, it's vital that regulation adds value and supports
improvement rather than creating additional pressure. We look
forward to continued engagement with regulators to ensure the
system works together for the benefit of patients and service
users."
ENDS
Notes to editors
-
The survey was carried out during April and May 2024 and
received responses from 122 trusts accounting for 58% of the
provider sector and representing all regions and trust types.
-
The analysis in this report is also informed by ongoing
engagement with providers.
