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CQC New Framework Approach: Well Led for NHS Trusts

CQC New Framework Approach: Well Led for NHS Trusts

As part of introducing their new approach, the CQC plans to initiate work on well-led assessments for NHS trusts, developed in collaboration with NHS England. This marks a significant step forward in their commitment to ensuring high-quality healthcare services across the board.

What’s Happening and When?

The CQC will utilise their new assessment framework to align with broader objectives, focusing on the quality statements under the well-led key question. Concurrently, they are introducing changes to how they rate NHS trusts, as outlined in a 2021 consultation. These proposals aim to simplify ratings by publishing a single rating at the overall trust level. This holistic rating will emphasise the culture and leadership of the organisation, alongside the
quality of care services provided.

For NHS Trusts, the CQC’s initial focus will be on service-level assessments. Assessing quality at the core service level is crucial for obtaining a comprehensive view of quality at the trust level. By updating their service-level view of quality, they can better identify risks to patients and reflect an overall view of quality in their trust-level assessments and ratings.

Anticipated Assessment Process

The CQC anticipates that trust-level assessments will commence in the coming months, with updated guidance for trusts available on their website shortly.

How The CQC Will Assess and Rate the Well-Led Key Question

The CQC are simplifying ratings for NHS trusts by publishing a single trust-level rating, streamlining the assessment process. Utilising the 8 quality statements under the well-led key question, their assessments will maintain a strong focus on leadership, culture, and governance.

Scope of the First NHS Trust-Level Assessments

The first trust-level assessments under the single assessment framework will be based on an evaluation of the 8 quality statements under the well-led key question. This approach provides a starting point for issuing a first rating based on a comprehensive assessment at the trust level. By ensuring thorough consideration of both leadership and organisational performance, the CQC aim to make confident and informed judgments.

Addressing Complexity and Ensuring Accuracy

This approach acknowledges previous challenges in updating overall trust ratings over several years. By utilising the new quality statements under the well-led key question, they can effectively assess organisational leadership, culture, and management, ensuring that their ratings accurately reflect the quality of care provided by NHS trusts.


The CQC’s new approach to assessing NHS trusts underscores its unwavering commitment to enhancing quality standards in healthcare. By focusing on leadership, culture, and governance, they aim to promote a culture of excellence and accountability within the healthcare system. Through collaborative efforts with NHS England and other stakeholders, the CQC are confident in their ability to drive positive change and improve healthcare outcomes for all.