CQC’s Consultation: Have your say on the future of assessments & ratings

The consultation is focused on two areas:

1. How CQC proposes to develop the assessment framework and guidance for providers
2. How CQC proposes to change their methods of inspection, assessment and awarding ratings

Whilst this article will focus on the proposals for the framework and how ratings are to be awarded, it is worth mentioning that the consultation also addresses their IT functionality (or lack thereof) and sets out proposals for CQC’s approach to follow-up assessments and updating rating judgments, as well as proposed changes to how NHS trusts and independent hospitals are regulated.

The current framework asks five key questions (is the service safe, effective, caring, responsive and well led) with quality statements expressed as ‘we’ statements and ‘I’ statements.

Dr Penny Dash and Professor Sir Mike Richards (and many others) highlighted that the Single Assessment Framework (SAF) needed to change.

So what might stay and what might go?

CQC is proposing to keep the five key questions the same but crucially, they are now proposing that they:

1. Describe the expectations of quality for all rating levels with the re-introduction of rating characteristics
2. Develop a framework of supporting questions similar to the previous key lines of enquiry (KLOEs)
3. Re-introduce sector-specific frameworks with consistent scoring and clear links to the regulations
4. Publish more detailed supporting guidance setting out the key standards and evidence that will be considered
5. Make the assessment frameworks clearer and simpler by removing duplication and simplifying the language used

The scoring approach implemented with the SAF essentially involved CQC awarding a score for each evidence category and amalgamating those scores to create a score for the quality statement – which in turn created a score for the key question. The overall view was that, far from creating clarity – the system was overly complicated.

CQC is proposing to scrap the scores under each question rating and has illustrated the difference in approach as below:

Current approach:

Proposed approach:

The current aggregating principles are to remain; for example if two or more key questions are rated ‘requires improvement’, the overall rating will be ‘requires improvement’.

Well, this will largely depend on what responses the consultation brings. There is no doubt that the proposed changes are far more in line with what CQC scrapped in the first place but maybe that is not a bad thing.

In their haste to ‘evolve’, CQC bit off far more than they could chew, and the fall out has been disastrous. A return to more familiar territory may calm the waters, restore some much-needed confidence, and potentially allow future reform to be properly thought out and considered.

Whatever your views, we urge all providers to keep ‘banging the drum’ and make themselves heard by responding to the consultation before the deadline of 5PM on 11 December 2025.  We will be hosting a webinar about the CQC consultation on 4 December 2025. To reserve a place, please sign up here.