The Government recently conducted a review of the level of regulation in the health and social care sector, entitled ‘Cutting Red Tape’. The review included a consultation with care homes and asked providers about the time spent responding to inspections and requests for information. The results of the consultation with providers suggests the monitoring functions of regulatory bodies, including CQC, local government and CCGs are being duplicated and are becoming excessive. Providers indicated that they find the increasing administrative burden of regulatory checks to be unsustainable, causing some providers to consider leaving the market.
The consultation revealed that businesses in the residential care sector spend around 16 days per year dealing with inspections. Eighty-seven percent of businesses that responded to the survey felt there was a duplication in inspections and that up to 11 days per year could be saved if there was no such duplication. The results suggest that if 11 days could be saved by each provider across the sector, a potential collective saving of £19 million per annum could be made.
The consultation furthermore indicated that residential care homes spend on average 25 days per annum collecting and collating data and revealed that businesses thought they could save 19 days per annum if there was no duplication of information requests. If those figures are representative of the sector as a whole, the sector could save £40 million per annum through more efficient data collection.
The perceived lack of coordination and information sharing between local authorities, CQC and CCGs leads to the duplication of inspections and information requests, requiring providers to report on the same topics and diverting staff from front line care. Local authority inspections alone can be problematic where homes have residents funded by more than one local authority, leading to additional scope for duplication. Where there is an inconsistency of approach between local authorities, there can be a lack of clarity about requirements and this leads to similar data being collected in multiple formats. Providers have reported that some local authorities refuse to accept data that has already been provided to other agencies unless it is provided in the local authority’s own preferred format.
Various initiatives have been introduced to improve data sharing between regulatory bodies in the healthcare sector which will help to improve regulatory practice. These include:
- Commissioning for Better Care Outcomes; a Department of Health/ADASS/LGA initiative designed to improve local authorities’ commissioning practice by providing a framework for local authorities to self-assess their progress and identify areas for further improvement.
- A national procurement strategy, led by the Local Government Association, that identifies a more joined up approach between local authorities could be key to obtaining a more standardised approach to contract management.
- A secure email project, led by the NHS, which encourages health care professionals to send confidential health and social care information by a secure email system.
- An information sharing pilot, led by CQC, which is underpinned by memoranda of understanding between CQC and other regulatory bodies to collaborate and co-operate.
In response to the Review, the Department of Health plans to start work over the course of the next two months to meet groups of providers and collect information to develop a strategy to identify barriers to more coordinated working and will consider whether there is scope to carry out more combined inspections or for agencies to make greater use of each other’s findings from visits and inspections.
If duplication of regulatory monitoring continues unchecked, the burden of regulation will continue to cost care providers and could lead to further providers leaving the market. Whilst resolutions to the problem are still in their inception, the fact that the issue has been recognised as being problematic is a positive step, which will hopefully lead to smoother regulation for both providers and regulatory bodies.
At Ridouts, we are aware that providers can become weighed down by the pressure of inspections – especially when things are not going well. At the very times when providers need to focus their resources on improvement, their staff can be diverted by the administrative demands of inspection. Until the regulatory environment becomes more synchronised, it is of particular importance for providers to ensure that their documentation is up to date and ready for when the inspectors visit, because it is simply a matter of time.