GGI NED webinar recap: CQC developments

On 28 February, GGI hosted the latest webinar for NHS non-executive directors (NEDs) in a session chaired by GGI principal consultant Aidan Rave. Our guest speaker was Claire Alexander, a non-executive director, school trustee, independent safeguarding lead, and associate to GGI, MIAA, IMAS, and the North West Leadership Academy.

Aidan opened the session by acknowledging the significant challenges facing the regulator, including leadership changes and external criticism. "The CQC has had a difficult 12 months," he noted, referencing both internal restructuring and political scrutiny.

Claire Alexander offered her analysis of the CQC’s evolving role and the impact of recent reforms. She outlined the regulator’s shift towards a risk-based assessment model and highlighted the implications for NHS trusts. "Governance leaders need to be proactive in demonstrating compliance and quality improvement," she said. Claire also addressed concerns about the CQC’s operational challenges, discussing the balance between regulatory oversight and sector-wide learning.

Here are some of Claire's key points:

• CQC inspections reflect everyday governance: CQC ratings should not be seen as one-off events but as reflections of an organisation’s everyday governance and culture. Claire encouraged NHS boards to embed a continuous improvement mindset rather than a reactive approach to inspections.
• The role of NEDs in effective oversight: NEDs have a critical role in both supporting and challenging executive teams. Claire noted that NEDs must ensure governance structures are robust and aligned with regulatory expectations.
• Importance of board assurance frameworks: Well-structured board assurance frameworks (BAFs) are essential in demonstrating compliance with CQC standards. Claire recommended that boards actively review their assurance mechanisms to ensure they are fit for purpose.
• Engaging with frontline staff: NEDs should not rely solely on board reports but should actively engage with frontline staff to gain an authentic understanding of service quality. Informal visits and direct conversations can provide valuable insights beyond formal documentation.
• Mock inspections as a readiness strategy: Internal mock inspections can help identify areas for improvement well in advance of a formal CQC review, to lessen the risk of being caught off guard.
• Workforce challenges and impact on ratings: Claire acknowledged the ongoing workforce shortages in the NHS and their potential impact on CQC ratings. She stressed the importance of recognising and mitigating workforce risks through governance and strategic planning.
• Adapting to changes in CQC’s approach: The CQC's assessment criteria continue to evolve, and NHS boards must stay informed and adaptable to these changes. Claire stressed the importance of maintaining strong governance practices that align with shifting regulatory expectations.

During the Q&A session, attendees raised questions about the practicalities of navigating CQC expectations, the role of board assurance frameworks in regulatory compliance, and how non-executive directors can support cultural change within their organizations.

Claire underscored the importance of transparency and data-driven decision-making, stressing that "good governance is not just about meeting standards but about embedding continuous improvement."