News / CQC inspections extended to hospital use of resources

The CQC said the work will focus on organisations’ ability to deliver high-quality patient care that is also efficient and sustainable. It was crucial that the health service could deliver both quality and efficiency at a time of tight finances and an ageing population.

CQC chief executive David Behan said: ‘CQC’s focus will always be on quality and safety – and effective use of resources is increasingly recognised as a key element of quality. We’ll be working with partners, patient organisations, stakeholders, providers, commissioners and our staff to develop a common, comparable measure of the use of resources in the NHS – so that our judgments of hospitals’ performance are informed by assessments of patient care and use of resources alongside each other.’

The HFMA welcomed the recognition that effective use of resources was a key part of quality. ‘You can’t look at quality and use of resources or costs in isolation; they are two sides of the same coin,’ said Emma Knowles, HFMA head of policy and research. ‘So use of resources has to be a factor when considering
the quality of services.’

Ms Knowles noted the CQC was working with partners to develop an approach based on existing efficiency metrics. ‘Any new measure has to add value itself – be useful to the centre and to local organisations – and avoid an increase in bureaucracy or any perverse incentives.’

Detail is scant and a CQC spokesperson told Healthcare Finance that the watchdog would sit down with other stakeholders, including Monitor, the NHS Trust Development Authority and NHS England, to thrash out the fine print. They were unable to confirm at this stage how the use of resources assessment would fit with Monitor’s regulatory framework.

However, the CQC said its assessment would build on existing efficiency metrics. It also acknowledged that the methodology would be different from the one it uses to monitor the financial health of large, difficult-to-replace adult social care providers.

The approach will go out to consultation in December and is likely to be piloted in NHS trusts and foundation trusts from April 2016.

RAF changes

Monitor has consulted on changes to the risk assessment framework (RAF) to allow it to take regulatory action earlier if a foundation trust is in deficit, is failing to deliver its financial plan or is not providing value for money. It proposes a four-level financial sustainability and performance risk rating that combines the existing continuity of service risk assessments (balance sheet sustainability and liquidity) with measures of underlying performance and variance from plan. Underlying performance will be measured using income and expenditure (I&E) margin; variance will be assessed with two measures – variance of I&E margin and variance of capital expenditure from plans.