The ‘CQC Way’: What it Means for Health & Social Care Providers

A New Era for CQC: Will Sir Julian Hartley’s Vision Restore Trust in Regulation?

The appointment of Sir Julian Hartley as Chief Executive of the Care Quality Commission (CQC) in December 2024 came at a pivotal time for health and social care regulation. With an extensive track record in NHS leadership, workforce transformation, and governance reform, Hartley’s arrival at CQC signaled a fresh start for a regulator facing mounting criticism over delays, inefficiencies, and a crisis of confidence.

As former Chief Executive of NHS Providers (2023-2024) and CEO of Leeds Teaching Hospitals NHS Trust (2013-2023), Sir Julian led major cultural and operational transformations, demonstrating an ability to turn around large, complex organisations. He also played a crucial role in shaping the NHS People Plan (2019), reinforcing his strong focus on workforce engagement, leadership, and governance. These experiences now shape his vision for CQC, branded as "The CQC Way" - a redefined approach to regulatory effectiveness, transparency, and collaboration.

But will this new regulatory vision succeed in fixing the deep-rooted issues within CQC? And how does it align with the wider political and systemic challenges facing health and social care?

What is "The CQC Way"?

Announced on 24 February 2025, The CQC Way is an ambitious framework to restore trust, improve regulatory efficiency, and ensure timely assessments. At its core, the initiative seeks to redefine CQC’s purpose, values, and operational approach in response to widespread dissatisfaction from providers, stakeholders, and the public.

Key elements of "The CQC Way"

A reaffirmed purpose

• CQC’s renewed mission is to ensure safe, effective, high-quality care while driving continuous improvement.

Strategic goals

• Addressing immediate failings (inspection backlogs, delays in registration, outdated provider ratings).
• Setting long-term regulatory priorities that align with the evolving health and social care landscape.

Cultural and behavioural change

• Strengthening openness, transparency, and engagement with providers and stakeholders.
• Implementing shared values and behavioural expectations for both CQC staff and regulated organisations.

Co-design with stakeholders

• Thousands of providers, professionals, and public representatives are being consulted to reshape how regulation should work in practice.

Immediate actions to fix CQC’s failures

Sir Julian has acknowledged critical weaknesses within CQC and pledged immediate reforms in four areas:

1. Publishing overdue assessment reports to give providers and the public up-to-date ratings.
2. Increasing monthly inspection volumes to reduce uncertainty for organisations and patients.
3. Clearing the backlog of service registrations to ease pressure on care capacity.
4. Acting promptly on concerns and notifications to improve regulatory responsiveness.

What does this mean for providers?

While the co-design approach sounds promising, providers remain sceptical about whether these changes will translate into tangible improvements. The sector is already grappling with staffing shortages, financial constraints, and heightened demand, all of which regulation must account for rather than exacerbate.

Challenges in implementation

The trust deficit:

• After a period of CQC inaction and inefficiencies, many providers doubt whether these reforms will materialise.
• Providers have long called for fair, timely, and transparent regulation - can CQC now deliver?

Workforce and leadership scrutiny:

• Given Sir Julian’s workforce-centric background, we may see stricter expectations on leadership, culture, and staff engagement within regulated services.
• The "Well-Led" domain could become a greater determinant of overall ratings, pushing providers to prioritise workforce development and governance.

Regulatory overhaul in a changing political landscape:

• With the government’s health and social care ambitions, regulatory reform must align with staff retention and fair pay in social care, reduce bureaucracy while maintaining high patient safety standards, and integrate health and social care services to improve outcomes.
• The government’s broader agenda could see CQC’s role evolve in ways that demand greater accountability from private providers and NHS services.

A regulatory reset amidst leadership turmoil

The timing of "The CQC Way" is particularly significant in light of Amanda Pritchard's recent resignation as CEO of NHS England. This signals deep challenges at the heart of NHS leadership, including funding pressures, workforce shortages, and delivery failures, all of which impact the wider regulatory environment.

With NHS England now in leadership flux, can CQC step up as a stabilising force in the sector? Or will it remain another bureaucracy struggling to keep pace with the rapidly evolving demands of health and social care?

Conclusion: Will "The CQC Way" deliver?

Sir Julian Hartley’s intentions are clear - to rebuild confidence in CQC and establish a regulatory model that is fair, transparent, and effective. The challenge, however, lies in execution.

For providers, the key questions remain:

1. Will CQC deliver on its promises, or will systemic inertia stall real progress?
2. How will regulatory expectations shift under the government’s priorities?
3. Will providers see a regulator that supports improvement, or one that continues to impose unrealistic burdens?

The coming months will be crucial in determining whether "The CQC Way" marks a genuine turning point or another chapter of unfulfilled regulatory ambitions.

What’s next?

The CQC has invited further engagement from providers, professionals, and the public. Now is the time for frontline voices to shape the future of regulation.

What do you think about "The CQC Way"? Will it improve health and social care regulation, or are deeper reforms needed? Let us know your thoughts in the comments.

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