With an ever-changing regulatory landscape, the administrative burden of maintaining a robust quality management system within a health or care organisation is high. And this administrative burden doesn’t just impact administration staff –it filters out to clinicians too.

Manually documenting and reporting compliance data takes a significant amount of time and so, there needs to be a focus on how healthcare organisations can lessen the impact of paperwork on clinical time and how data from new processes can be managed and accessed to evidence compliance both internally and for regulatory bodies.

In 2016, the CQC published its Burden Reduction Plan in response to the Department for Health & Social Care’s concordat for reducing the administrative burden of information requests.

The CQC’s plan centred around the core principles for the collection of data across the health and social care system which in summary includes:

• collecting data which is proportionate and with a clear business purpose
• not duplicating other data collections
• working with a national base for all data
• reviewing the need to collect the data regularly

However, as with many health and care transformation plans, change does not happen overnight and there has been slow progress towards reducing the CQC reporting burden over the last few years.  

But there’s nothing like a global pandemic to accelerate change. Out of necessity, digital transformation within the industry has accelerated at a pace we never thought possible. Regulatory organisations like the CQC were forced to readdress their inspection regimes overnight; moving to a risk-based protocol to ensure that areas with patient safety issues were prioritised; leaving those that were low risk to continue managing the Covid-19 response.  

From a provider perspective, this less disruptive inspection regime has unearthed efficiencies – providing the perfect opportunity to explore how technology and automated data feeds can facilitate ongoing monitoring. This enables the CQC to obtain a holistic view of data that demonstrates healthcare organisations' efforts towards patient safety, and not just a snapshot of a service on the day of an inspection. It also puts more emphasis on continuous compliance rather than delivering evidence on one-off inspections.

In March 2021, the CQC formalised it’s view on how the regulatory landscape will change through its new strategy for the changing world of health and social care which outlined a ‘smarter’ approach to regulation, focusing less on lengthy reports and more on data driven insights.

Inspections will still be an important part of how the CQC operates. But the use of data and insights through automated feeds is a positive move towards proactive compliance checking, whilst still enabling the CQC to maintain a reactive risk-based approach for those organisations that need it. For instance, CQC inspections may be prioritised for providers where there is little or no data to evidence compliance and a face-to-face visit may therefore be required to observe the delivery of care.

Many NHS trusts have responded well to this strategy with nine in ten (89%) stating they are supportive of the proposal. There is however a clear concern that the CQC’s intention “needs to be matched by practical changes to the way they experience regulation from CQC, with a reduction in burden.”

Automating credentialing and pre-employment reporting

One of the CQC reporting requirements is centred around Regulation19 of the Health and Social Care Act 2008 which mandates “providers must operate robust recruitment procedures, including undertaking any relevant checks. They must have a procedure for ongoing monitoring of staff to make sure they remain able to meet the requirements, and they must have appropriate arrangements in place to deal with staff who are no longer fit to carry out the duties required of them”. The importance of this was highlighted in a recent landmark CQC case where an NHS Trust was fined£733,000 for failing to provide safe care and treatment resulting in avoidable harm. Recruitment and pre-employment assessment processes for the locum doctor involved were cited as key reasons for prosecution.

To support the improvement of patient safety, providers need to consider software solutions which can support the digitalisation and automation of processes such as recruitment, onboarding and training; ensuring patient safety is at the fore of all HR decisions, that mandatory requirements are fulfilled, and that data is easily accessible to the organisation and the CQC. Software can be used to remotely measure compliance areas such as right to work checks, effective inductions, and ongoing monitoring of performance, ensuring the provision of safe, effective, and well-led care by a competent and compliant workforce. Additionally, improved automation will free up staff time, reducing excessive admin tasks and enabling them to focus on more important activities.

The key will be balancing innovative, tech-driven solutions employed in the monitoring and inspection of health and social care services with human intervention when required. This reflects an industry-wide drive to improve automation, streamline processes, reduce paperwork, relieve pressure on staff and generally improve administrative and operational efficiency within health and social care services.