Recommendation 141

Individual responsibility of regulators and performance managers as well as co-ordination between them

Any differences of judgement as to immediate safety concerns between a performance manager and a regulator should be discussed between them and resolved where possible, but each should recognise its retained individual responsibility to take whatever action within its power is necessary in the interests of patient safety.

Commissioners and regulators should have clear and distinct roles in ensuring the safety of people who use services and should act swiftly where patients are at risk.  Local and regional Quality Surveillance Groups actively share information and intelligence, including qualitative intelligence, including issues and cases of media and public interest, between commissioners, regulators and other organisations on the quality of care being delivered.  This provides a mechanism to share and discuss safety concerns between commissioners and regulators. In addition to the coordinated process outlined in recommendation 19 as part of the single failure regime, the NHS Standard Contract enables commissioners to intervene where substandard or unsafe services are being provided.  This includes the ability to suspend services, or elements of them, and terminate contracts.  See recommendation 137 for further details.

In addition, the Care Quality Commission will retain its ability to stop a service from providing care if it is putting people at immediate risk of harm as outlined by the Health and Social Care Act 2008.  The Act states that where the Care Quality Commission has ‘reasonable cause’ to believe that unless it acts people may be exposed to the risk of harm, it may impose or vary a condition of a provider’s registration or suspend it from the point written notice is given as part of an urgent response.

In addition, subject to the passage of regulations, during 2014 the Care Quality Commission will also have new powers to prosecute a provider for failing to provide fundamental levels of care, without having to issue a formal warning first. See recommendation 28 for further details.

No update required. Please see response to the recommendation above