Recommendation 22

Standard procedures and practice for compliance

Accepted in principle
The National Institute for Health and Clinical Excellence should be commissioned to formulate standard procedures and practice designed to provide the practical means of compliance, and indicators by which compliance with both fundamental and enhanced standards can be measured. These measures should include both outcome and process based measures, and should as far as possible build on information already available within the system or on readily observable behaviour.

A range of guidance, indicators and measures will be provided to support the implementation of quality standards. Guidance, technology appraisals and standards provided by the National Institute for Health and Care Excellence make an essential and key contribution to how the Care Quality Commission assesses the quality of NHS services, alongside bodies accredited by the National Institute for Health and Care Excellence and other appropriate sources of guidance and standards. The National Institute for Health and Care Excellence, the Care Quality Commission and NHS England will work together on the objective of ensuring that authoritative guidance is available on fundamental and enhanced standards. The National Institute for Health and Care Excellence already develops indicators to go alongside quality standards, and the National Institute for Health and Care Excellence and NHS England develop tools to support commissioners in commissioning for quality.

The Department of Health will shortly consult on new regulations that will set out fundamental standards of care. The Care Quality Commission will then consult on sector-specific statutory guidance for providers that it will take into account when enforcing those regulations, including prosecution, and how it decides a rating. In this guidance the Care Quality Commission will signpost guidance and measures by the National Institute for Health and Care Excellence and other appropriate bodies.

Update

The National Institute for Health and Care Excellence has introduced developmental statements in its quality standards where appropriate.  Between June and September 2014 it published the National Institute for Health and Care Excellence quality standards – the process guide, a consultation on its updated quality standards process guide which made detailed proposals for how developmental statements would be identified and produced.

At the end of 2014, the Care Quality Commission and the National Institute for Health and Care Excellence published a Memorandum of Understanding that sets out how the two organisations work in partnership to encourage improvement in the quality of care. This includes the guidance, advice and other tools that the National Institute for Health and Care Excellence provides for the health and care system, the support the Care Quality Commission provides for the development and implementation of the National Institute for Health and Care Excellence guidance, quality standards and indicators, and the support the National Institute for Health and Care Excellence provides to the Care Quality Commission in order for the Care Quality Commission to fulfil its role in the regulation of health and social care services.

In July 2014, the Care Quality Commission consulted providers, health care professionals and other key stakeholders on proposed guidance on meeting new fundamental standards regulations. The draft guidance referenced the National Institute for Health and Care Excellence’s technology appraisals, guidelines and quality standards. The Care Quality Commission has published final guidance on how organisations may comply with the duty of candour and the fit and proper person requirement for NHS bodies which came into force in November 2014. The Care Quality Commission will publish guidance on meet the remaining fundamental standards prior to them coming into force in April 2015.