Recommendation 34

External performance management whilst under regulatory investigation

Accepted in principle
Where a provider is under some form of regulatory investigation, there should be some form of external performance management involvement to oversee any necessary interim arrangements for protecting the public.

It remains the responsibility of providers’ boards to identify and resolve risks to patients swiftly.  However, where there are significant issues that require action the Care Quality Commission will issue an enforcement notice and it is the roles of Monitor or the NHS Trust Development Authority to ensure that this is complied with.

The response to recommendation 19 outlines a single failure regime that can be enacted where risks to quality and patient safety are identified.  As part of that regime, the Care Quality Commission, the NHS Trust Development Authority or Monitor will work together, with the Trust and its commissioners, to ensure that where concerns are raised, the Trust acts swiftly to resolve them and to protect patients.


Under the new special measures regime, the NHS Trust Development Authority and Monitor are now able to intervene at providers which the Care Quality Commission are providing poor quality care as part of their new inspection programme. This includes partnering the failing provider with a high-performing buddy, the appointment of a dedicated Improvement Director at the trust as well as other targeted interventions to ensure rapid improvements where failings have been identified.