Care Quality Commission

On 1 October 2014, the Care Quality Commission (CQC) introduced a new regulatory model for health and social care service providers. This will apply to hospices from 1 January 2015.


In June 2013 the CQC published 'A new start - consultation on changes to the way we inspect, regulate and monitor care services' which set out the new regulatory approach.

Summary of the new model

The CQC has been organised into three inspectorates covering hospitals, adult social care and primary care. Each inspectorate will ask the same five key questions of services, which replace the current 28 regulations and 16 outcomes:

  • Is the service safe?
  • Is the service effective?
  • Is the service caring?
  • Is the service responsive?
  • Is the service well led?

The new model will also introduce a number of further key changes:

  • A shift from 'compliance’ to professional and intelligence-based judgements.
  • A new ratings systems for all providers based on the five questions.
  • A shift from 'generic' to 'specialist' inspectors.
  • The greater use of 'experts by experience' in inspections.

What will this mean for hospices?

Hospices will fall within the remit of the Inspectorate for Adult Social Care. The inspectorate has recognised the unique nature of hospice care, stating "We recognise that hospice services cross health and social care. Our Chief Inspectors will work together to make sure we regulate these in the best way”.

Following our lobbying efforts, the inspectorate has committed to develop an approach that is tailored to hospice services. 

What will the inspection process look like?

The new inspection process will include three broad phases:

  • Inspectors will use different sources of information to plan and prepare for an inspection.
  • Teams including specialist inspectors and experts by experience will conduct a site visit.
  • Inspection teams will produce a judgement and report within a specified period (the current aim is 10 days).

What will shape the inspection process? 

The new inspection process will be shaped by four components.

Provider handbook

The inspectorate will produce three handbooks, including one for hospice services. The handbook will be available to inspectors, experts by experience and providers of regulated services to support a common understanding of the new inspection process.

Provider information return (PIR)

The inspectorate will produce three PIRs, including one for hospice services. The PIR will be web based and will help in the planning and preparation stages of an inspection by asking providers to supply information and data in line with the five key questions.

Key lines of enquiry (KLOE)

The inspectorate will produce three key LOE, including one for hospice services. Each LOE will reflect the five key questions and include prompts to guide inspectors and experts by experience.


The CQC will produce ratings for services based on the judgements and reports generated by the inspection process. The ratings will be made publicly available.   

Get in touch with our policy and advocacy team if you need further information on the new regulatory model.


After the new regulatory approach was announced, we produced a briefing for members on the new model and submitted a joint response with Together for Short Lives to the consultation.  We also published an update briefing for members in January 2014.

  • An update on the Care Quality Commission
    Published in January 2014, this paper briefly outlines what is known about the new regime, the details of which are still in development, and what it will mean for the inspection, monitoring and rating of hospice services
  • The Care Quality Commission - a new start
    Member briefing providing an overview of the proposals contained in 'A new start: a consultation on changes to the way CQC regulates, inspects and monitors care'

What does hospice care mean to you?