Recommendation 104

Care Quality Commission use of National Patient Safety Agency data

The Care Quality Commission should be enabled to exploit the potential of the safety information obtained by the National Patient Safety Association or its successor to assist it in identifying areas for focusing its attention. There needs to be a better dialogue between the two organisations as to how they can assist each other.

A new start – Consultation on changes to the way CQC regulates, inspects and monitors care set out the Care Quality Commission’s intentions to  gather information from a range of sources to inform its work. It noted that the Care Quality Commission’s Chief Inspectors will use the expert judgements of their teams of inspectors, together with information and evidence held both by the Care Quality Commission and its partners in the system, to provide a single, authoritative assessment of the quality and safety of care services.

A New Start made clear that the Care Quality Commission would be looking, among other things, at whether a service is safe (i.e. people are protected from physical, psychological or emotional harm) and set out proposals for safety indicators. The consultation closed on 12 August 2013, and responses were considered alongside the recommendations from the Berwick Review, Improving the Safety of Patients in England, which included recommended actions around better streamlining of data requests via the Care Quality Commission acting as the coordinating hub for intelligence about quality and safety of care. On 17 October 2013, the Care Quality Commission published the responses to its consultation in A new start: Responses to our consultation on changes to the way CQC regulates, inspects and monitors care services, which showed that there is broad agreement with the new approach.NHS England and the Care Quality Commission are committed to working together to develop a shared and agreed approach to measuring safety in the NHS, both for regulatory and improvement purposes.  They are working to develop a set of patient safety measures that are best suited for use the Care Quality Commission in their surveillance model and NHS England is providing patient safety expertise on how patient safety data might be used by the Care Quality Commissions for its surveillance and inspection processes. A joint statement between NHS England and the Care Quality Commission is being published setting out how the two organisations will align their work to support inspection and surveillance work for safety.

The National Clinical Assessment Service, previously a division of the National Patient Safety Agency transferred to the NHS Litigation Authority in April 2013. The NHS Litigation Authority is also putting in place an information sharing agreement with regulators, which will include relevant information relating to the National Clinical Assessment Service.


NHS England and the Care Quality Commission have worked jointly to ensure a shared view of patient safety data (and what it means) is developed, and that this is reflected in the new Care Quality Commission’s surveillance model for acute and specialist NHS trusts. The Care Quality Commission now has free and unfettered access to all incident reporting information collected by the National Reporting and Learning System and through the Strategic Executive Information System. The Care Quality Commission and NHS England’s Patient Safety Domain regularly meet to share information, review and co-develop initiatives to improve patient safety. For example, NHS England and the Care Quality Commission have co-developed a new set of indicators that are used in the Care Quality Commission’s Intelligent Monitoring system. In March and July 2014, the Care Quality Commission updated its surveillance model for acute and specialist NHS trusts.