The Care Quality Commission (CQC) has launched another public consultation on how it assesses and rates health and care providers — this time under the banner of “Better Regulation, Better Care.”
On paper, it’s about improving consistency and rebuilding trust.
In reality, it’s yet another reset of the inspection framework, before the last one has even bedded in.
The Single Assessment Framework – Barely Embedded, Already Being Rewritten
In 2024, the CQC replaced its familiar Key Lines of Enquiry (KLOEs) with a new system called the Single Assessment Framework (SAF) — a move it described as a “modernisation” of how it inspects and monitors care.
The SAF introduced Quality Statements to define what good care looks like, alongside a new scoring model, digital portal, and “evidence categories.”
But many providers have barely had time to understand it — let alone experience a full inspection under it — before the CQC is now proposing to scrap the Quality Statements altogether and replace them with Assessment Questions.
This is not evolution. It’s confusion.
And it reinforces what most providers already feel: the CQC keeps changing the goalposts while expecting everyone else to stay compliant.
A Regulator Criticised by Its Own Sponsor
The timing of this consultation is not accidental.
It follows a wave of criticism, including from the CQC’s own sponsor department.
In August 2024, the Health and Social Care Secretary publicly responded to an independent review of the CQC, highlighting “serious concerns” about how the regulator identifies and responds to risks.
The Government called for system-wide reform and a return to credible, consistent regulation — noting that inspection delays, poor communication, and lack of accountability were undermining trust.
That review was prompted by real-world failures with tragic consequences.
So the CQC’s sudden rush to “simplify” and “streamline” its framework should be seen in that context — as a regulator under pressure to prove relevance, rather than one acting from strategic foresight.
The Real-World Problem: A Moving Target
In primary care, practices rated Good or Outstanding can go three to five years before being reinspected.
By the time that happens, the inspection framework may have changed once — or even twice.
That means:
· The standards you were once rated against might no longer exist.
· The evidence you’ve built could suddenly be “non-aligned.”
· And the guidance you’ve trained staff on may have quietly expired.
No other regulator changes its rulebook this often.
It creates instability, undermines confidence, and wastes time for providers trying to do the right thing.
What the Consultation Proposes
According to the CQC, this new consultation proposes to:
· Reintroduce rating characteristics for clarity on what “Good” or “Outstanding” means
· Replace Quality Statements with Assessment Questions
· Simplify the framework and make it sector-specific
· Strengthen professional judgement in ratings
While those points sound reasonable, the problem isn’t the structure — it’s the constant reinvention.
Providers don’t need another “simplified” framework.
They need a stable one.
A System That Needs Stability, Not Spin
If the CQC truly wants to rebuild confidence, it must stop treating frameworks like software updates.
Every reset forces thousands of providers to rewrite policies, retrain teams, and re-audit systems — all while the regulator itself struggles with inspection backlogs and staffing pressures.
Before changing the model again, the CQC should first prove it can apply the current one consistently, transparently, and fairly.
The consultation, “Better Regulation, Better Care”, is open until 5pm on 11 December 2025.
You can read the full details and respond here:
CQC Consultation – Better Regulation, Better Care
The CQC doesn’t need another acronym or framework refresh — it needs credibility.
Providers aren’t asking for perfection, just stability.
Until that happens, “better regulation” will remain a slogan, not a reality.
At Primary Care Management Solutions (PCMS), we’ve supported GP practices, PCNs, federations and independent healthcare organisations through every version of CQC inspection — from the early KLOEs to the Single Assessment Framework, and now whatever comes next!
If you need help making sense of the current, the old, or the “soon-to-be-replaced” inspection model, you’re in safe hands with PCMS.
We’ll help you stay compliant, confident, and inspection-ready — no matter how many times the goalposts move.
