This research looks at learning for CQC from the evidence about what good regulation looks like.
Overview
- We are currently making changes to our regulatory model following the findings of multiple reviews. We asked The King’s Fund to do a project that will help us bring evidence and learning into the development of the new model.
- We’re sharing findings from this project. In this work, The King’s Fund reviewed evidence and engaged with experts and staff to understand what good regulation looks like.
- They identified opportunities for the CQC as it rebuilds its regulatory model.
- They also set out 5 key pieces of learning for CQC to consider in rebuilding our model.
What The King’s Fund did
In 2024, CQC established a research partnership with The King’s Fund. As part of this partnership, between February – June 2025 they have undertaken a project to identify learning for CQC from the evidence about what good regulation looks like. To do this, they:
- reviewed existing literature and research
- interviewed experts in regulation.
- engaged with CQC staff through conversations, workshops, and roadshows.
What The King’s Fund found
The King’s Fund worked with CQC to identify five challenges where evidence can help shape an effective regulatory model:
1. Setting regulatory expectations
Some regulated organisations are unclear what standards they’re expected to meet or how they’ll be assessed. The evidence shows the need for clearer communication, especially around what good quality care looks like – doing this well is one of the key ways a regulator can have an impact.
Effective regulatory models should:
- align with the regulator’s mission and purpose
- use a range of regulatory methods to deliver that purpose
- be tailored to different types of organisations
- be co-designed with providers to support improvement.
2. Ensuring expertise in the regulatory workforce
Inspectors are the public face of CQC, but recent reviews found gaps in their sector knowledge, which affects credibility and impact. Evidence highlights the 3 key skills sets inspection teams need:
- sector-specific expertise
- regulatory knowledge
- strong relational skills.
To support this, inspectors need enough training and support. Inspection teams should include staff with diverse experience and be empowered to use professional judgement. Without this, they may miss risks or make inconsistent decisions.
3. Adopting risk-based regulation
A risk-based approach to regulation was central to CQC’s latest strategy but was difficult to make work in practice. The evidence shows that it can be difficult across different sectors for several reasons. This includes gaps in data which can make risk modelling difficult.
To help,
- data should be combined with direct engagement with people to understand what is really going on in services
- inspectors should be given time, tools, and support to use data effectively
- data models should be continually evaluated and developed.
4. Developing relationships and trust
Problems with the current regulatory model have damaged relationships with stakeholders. CQC needs to invest in developing better relationships with the people they regulate, by:
- being flexible in how it works with providers
- using different styles of engagement.
It is important that a regulator is trusted by people, so they feel safe in their care, and providers, to support improvement.
5. Changing the regulatory model
When making changes to the regulatory model, the evidence is clear that it is important to test and pilot new approaches. Changes should also:
- be continuously evaluated to assess impact
- be supported by training and time for staff to learn between phases
- ensure piloting is distinct from staged rollout – it must allow space for reflection and adaptation.
Together, this also helps to embed a culture of evaluation and learning.
What this means
The King’s Fund outlined five learning points for CQC as it develops and implements its future model:
- Make sure the purpose of regulation, and its impacts, are central to the design of the regulatory model.
- Communicate clearly the thinking behind the regulatory model. Including how different areas like registration and inspection affect organisations, patients and users.
- Use existing evidence thoughtfully. There is a lot of evidence CQC can draw on to inform the design of the future regulatory model. It is important that any learning is thoughtfully adapted to its context.
- Invest in the staff who do the work and support them. The focus should be on developing and maintaining sector-specific, regulatory, and relational expertise. For a regulator and its workforce, how you work matters as much as what you do.
- Embed testing and evaluation into the rollout. A culture of learning is essential for ongoing development and understanding impact.