CQC Changes Explained: What Providers Need to Know for 2026–2028

It can seem like the CQC is in a constant state of flux nowadays. The ‘Single Assessment Framework’ only came into force two years ago, and since then the CQC has itself been rated as ‘inadequate’ by the Dash Review and undergone significant restructuring. As we enter 2026, we are hearing yet again that change is afoot, so let us summarise what differences we are going to see over the next couple of years (insofar as we can predict!).

Firstly, it is important to note that these are merely proposals for now and the plan seems to be to implement these by 2028, after some pilot work. Therefore, for the next couple of years, the Single Assessment Framework as it currently stands will continue to be what all providers are inspected against. It is still quite common for providers to refer to ‘KLOEs’ when looking at their CQC compliance, but please do be aware that these no longer exist and were replaced by (different) targets called ‘quality statements’ in 2024. 

The Medicines Management Team produced this free one hour Webinar summarising the CQC, its role, the current framework, and pitfalls to avoid, so do watch the recording of this now if you would like to stay up to date with the current framework and inspection process. 

The CQC states that the proposed changes aim to create a ‘clearer, simpler, and more trusted framework, built through engagement, collaboration, and co‑design with those who deliver services and the public’. The proposed changes fall into two main categories: those that affect the framework we are inspected against, and those that affect the inspection process itself. 

From a framework perspective, the greatest difference will be a move away from the ‘single’ assessment model against which every provider of health and social care services is inspected, to sector-specific frameworks. You may recall that the ‘single’ one-size-fits-all framework was only introduced two years ago, so there appears to be a constant tension - similar to the one we see in NHS reorganisations - of ‘standardisation and consistency is better’ versus ‘specific is better’. 

The jury is out on whether this will result in the improvements everyone is looking for. We hear from providers in primary care that they often feel it is unfair for a practice to be set the same standards as a large hospital trust, so on the face of it, this proposal may be welcome. However, since the Health and Social Care Act has not changed, and therefore nor have the fundamental standards the CQC inspect against, this proposal is unlikely to result in the change most are looking for - which is for smaller providers to be set a lower, more realistic standard than larger better-resourced providers. These proposals will also do nothing to address the perceived variability within our specific sector, and the different experiences practices have of the inspection process. 

The second most relevant change is that the Quality Statements in each Key Question (which replaced KLOEs) are now going to be replaced by something yet again different; ‘Supportive Questions’. Providers will need to keep their eye out for these and amend all of their policies and compliance strategies accordingly to make sure they are fulfilling these. 

In some good news however, ‘ratings characteristics’ are to be introduced which aim to give a clearer expectation of what is required for each section from each Key Question, for each of the four ratings. Providers have long been asking for more clarity over what exactly the CQC are looking for, and reflecting on the fact that CQC compliance can often feel like a riddle or a trick trying to establish what is being asked for in the first place.

Finally, there are going to be some changes to the inspection process itself. Firstly, some written feedback will be given within two days of the inspection. This should be useful for providers in terms of helping them to prepare for any remedial work they may have to do, but also for having some awareness of what the full report may say - the long period of uncertainty after an inspection is frustrating and can even result in business decisions being postponed pending the report outcomes. 

When the report is then published, it is proposed that it will contain less detail than previously; there will be no scoring of quality statements/KLOEs/supportive questions, just a rating at the Key Question level. It is unclear whether we will find this helpful or not as providers. Reports will be shorter and less granular, but it will presumably be less easy for a provider to identify why they may have been given the rating that they have, and what specific issue was identified as being below the expected standard. 

The final change that is relevant to general practice, is that it is proposed that there be clearer/tighter inspection cycles, with each provider receiving an inspection every 3-5 years. This should help with planning (notwithstanding the mantra that we must always be ‘CQC ready’), give a sense of fairness, and avoid the situation of some providers having a rating that is ten years old and therefore possibly irrelevant to their current service provision. 

In summary therefore, there are a lot of changes coming in the medium term that may address some of the challenges we have had with the CQC process in general practice, but for now it is important that we stay focussed on the present, and the current albeit less than ideal framework. The Medicines Management Team will be producing monthly Free Webinars across 2026 to help providers understand the current system and make sure they are as prepared as possible for their inspections.

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