Better Regulation, Better Care CQC Consultation
Task
In 2025, the Care Quality Commission (CQC) launched a formal consultation titled ‘Better Regulation, Better Care’ which focused on proposals to improve how health and care providers in England are assessed, rated, and regulated. This consultation formed part of a wider transformation programme at the CQC, including work on leadership and expertise, revision of the assessment framework, and improvements to ways of working.
The consultation was structured around two main areas:
How the CQC proposed to develop their frameworks and guidance for assessing providers.
How the CQC proposed to change their methods for inspecting, assessing and awarding ratings to health and care services.
Proposed improvements to the CQC’s Assessment Framework included:
Rating Characteristics: The CQC proposed to publish clear rating characteristics for each rating level, making expectations explicit.
Quality Statements: The existing quality statements would be reframed as supporting questions, similar to the previous Key Lines of Enquiry (KLOEs), to clarify what ‘good’ looks like.
Sector-Specific Frameworks: Assessment frameworks would be tailored to each sector, balancing consistency with sector-specific needs. The CQC intended to publish the draft assessment frameworks on their website as part of ongoing engagement and co-production of its content.
Supporting guidance: The CQC also intended to publish more detailed supporting guidance that set out the key standards and sources of evidence that need to be considered.
Simplification: The frameworks would be made simpler and clearer by removing duplication and using more accessible language, to ensure an appropriately balanced level of detail in the different areas of the framework.
Alongside the public consultation survey, the CQC conducted a programme of targeted engagement events to enable direct dialogue with stakeholders across the health and care sectors. This included online workshops, in person co-design workshops, focus groups with service users, and internal CQC staff engagement.
TONIC was commissioned to conduct quantitative analysis for all consultation responses to the closed survey questions, use thematic analysis to summarise written responses to open questions, as well as triangulating the data with findings from the CQC engagement events.
Our Approach
Consultation survey data was first cleaned, then all comments were read in full by the analysis team. Through this process, recurring themes, patterns, and points of consensus or divergence were identified. Themes were then written up in narrative form, with the most frequently occurring themes generally presented first. Where quantitative polling data was available, this was reported alongside the qualitative findings. Anonymised verbatim quotes were used throughout the report to illustrate the themes identified and ensure participant voices were represented directly. Quality assurance measures were built in at every stage of the process, which included sampling, inter-rater reliability, and controlling bias.
Outcome
The consultation survey received 1,703 responses, representing a broad range of health and care providers, professionals, stakeholders, people who use services, and the public.
TONIC produced two individual reports: one for quantitative and qualitative survey analysis, the other with qualitative workshop output analysis. The former was structured around each question within the survey, whereas the latter was sectioned according to themes extracted from the workshops.
Read the CQC’s initial response to the public consultation here: https://www.cqc.org.uk/about-us/how-we-involve-you/consultations/initial-response-public-consultation-better-regulation-better-care