Recommendation 58

Integrating patients into the Care Quality Commission’s structure

Patients, through their user group representatives, should be integrated into the structure of the Care Quality Commission. It should consider whether there is a place for a patients’ consultative council with which issues could be discussed to obtain a patient perspective directly.

The Care Quality Commission uses a wide range of means to engage people who use services in its work. It is holding a number of events and activities to ask people how they it can best involve patients, relatives and carers in its work. This includes looking specifically at a ‘People’s Panel’

Healthwatch England is the independent consumer champion for health and social care in England, and works closely with the Care Quality Commission.  The Chair of Healthwatch England sits on the Care Quality Commission’s board and is able to ensure a focus in the board’s considerations on the views of people who use health and care services.

The Care Quality Commission engages directly with people who use health and social care services to consult on its strategy and policy activity, as well as involving people who use services in the development of its regulatory methodologies. It also recruits, trains and supports people who use services to accompany its inspection staff on inspections (these people are known as ‘experts by experience’); the benefits of involving learning disabled experts by experience in the post-Winterbourne View hospital inspections of learning disability in-patient units were very clear. The Care Quality Commission works at a local level with overview and scrutiny committees, and foundation trust councils of governors, who scrutinise the different elements of the local system, to share information about the safety and quality of local services. The Care Quality Commission works with local Healthwatch and other local voluntary and community organisations, to share surveillance and intelligence to support the Commission’s regulatory function.


The Care Quality Commission recruits, trains and supports people who use services- known as ‘Experts by Experience’- to accompany its inspection staff on inspections of health and social care services and its visits to monitor the use of the Mental Health Act.

Experts by Experience also attend listening events, consultations and staff training events and take part in activities to develop the Care Quality Commission’s strategy and processes. The Care Quality Commission currently works with around 500 Experts by Experience covering a wide variety of backgrounds.

During inspections, Experts by Experience spend time talking to people who use the service and observing the environment. They have first-hand experience of receiving care so they know which questions to ask to get as much information from the visit as possible. Their findings are used to support the inspector’s judgment on the service and can also be included in the inspection report.

The Care Quality Commission has received a huge amount of applications to be an Expert by Experience and have currently paused recruitment. However, the Care Quality Commission has developed an online community that people can be a part of, called the Care Quality Commission Action Team. People who are members of the Care Quality Commission’s Action Team help the Care Quality Commission to develop our policies, processes and inspection materials. The Care Quality Commission Action Team members also receive a monthly news update which lets them know how to get involved in the Care Quality Commission activities and the promotion of listening events.