CQC Launches Major Consultation on Regulation Reform

The Care Quality Commission has launched a comprehensive public consultation seeking views on proposed changes to how it assesses, rates and regulates health and care services across England.

The consultation, titled “Better regulation, better care”, was published on 16 October and runs until 11 December 2025. It follows extensive engagement with stakeholders, including five external roadshows and numerous workshops designed to shape the proposals through co-design.

The regulator is responding to concerns raised in external reviews by Dr Penny Dash, Professor Sir Mike Richards, and the Care Provider Alliance, with the aim of creating what it describes as “a clearer, simpler, and more trusted framework”.

The consultation focuses on two main areas of reform. Firstly, CQC proposes to develop its frameworks and guidance for assessing providers by re-introducing rating characteristics. These will provide clear descriptions of what each rating level means in practice, helping providers better understand the standards required for ratings such as “good” or “requires improvement”.

The current quality statements would be replaced with assessment questions, similar to the previous key lines of enquiry. The regulator also plans to develop sector-specific frameworks with tailored content and guidance for different health and care sectors, whilst maintaining consistent core content across all frameworks. The overall aim is to simplify the frameworks by removing duplicate content and using clearer language.

Secondly, CQC is proposing changes to how it makes judgements and awards ratings. Under the new approach, judgements would be made directly at the key question level with reference to rating characteristics, rather than awarding lower-level scores to drive ratings. This change aims to strengthen the role of professional judgement in the assessment process.

For NHS trusts specifically, the consultation seeks feedback on potentially re-introducing an overall quality rating for each trust, introducing trust-level ratings for all five key questions, and whether to remove location-level ratings.

Care home providers and professionals are encouraged to participate in the consultation. The quickest way to respond is through CQC’s online form, available on its website. The consultation is open to everyone, including providers, professionals, partner organisations, people who use services, and members of the public.

In addition to the public consultation, CQC will hold focused engagement sessions with people with lived experience and those working across regulated sectors. This targeted consultation will focus on developing sector-specific frameworks and informing rating characteristics.

The regulator has also published an equality impact assessment alongside the consultation, in line with its duties under the Equality Act 2010.

CQC will analyse all feedback received and publish a response explaining how it has shaped final decisions. The consultation forms part of the regulator’s wider work to strengthen regulation and ensure people receive safe and effective care.

The deadline for responses is 5pm on 11 December 2025. Full details and the consultation document are available on the CQC website.