Governance and regulation

Our work on governance, accountability and regulation across health and social care

CQC impact

Impact of the Care Quality Commission on provider performance: room for improvement?

The CQC introduced a new approach to inspecting and rating health and social care providers in 2013. Our report with the Alliance Manchester Business School is the first major evaluation of this approach.

The capped expenditure process explained

In response to significant financial pressures in the NHS, a capped expenditure process has been introduced to provide tighter controls on spending. We explain how the process works and what it involves.

New care models: Emerging innovations in governance and organisational form

This report looks at the different approaches being taken by MCP and PACS vanguards to contracting, governance and other organisational infrastructure.

How is the NHS structured?

How is the NHS structured?

A series of diagrams explaining how the NHS is structured, including how providers are regulated and commissioned, and how the money flows.

Managing health services through devolved governance: A perspective from Victoria, Australia

In 2014 The King's Fund was approached by the health department in the Australian state of Victoria to undertake an independent review of the model of the state's devolved governance of health services. This report presents the findings of our review.

How can the performance of local health systems be assessed?

Chris Ham reflects on the findings of our review for the Department of Health, which recommends radical simplification and better alignment of existing frameworks for assessing performance in the NHS.

NHS performance frameworks need radical simplification and alignment, The King’s Fund review finds

The approach to performance assessment in the NHS requires radical simplification and alignment in future, a review by The King's Fund finds.

Should we be worried about CCG conflicts of interest?

Are conflicts of interest affecting the services patients receive? Or is this inherent feature of clinical commissioning being managed appropriately through common-sense decision-making?

Foundation trust and NHS trust mergers: 2010 to 2015

This report reviews 20 mergers involving NHS trusts and foundation trusts between 2010 and mid-2015 and asks whether mergers are always the best way forward.

Is the purchaser–provider split dying?

Is the purchaser provider split dead? No. Is it dying? Quite possibly, says Nicholas Timmins.

Local Healthwatch: progress, promise and power

The coalition government outlined a framework for a network of local Healthwatch organisations, with the aim of creating a credible, representative and influential public voice in the system. So how have these organisations been developing?

Regulation, targets and transparency: The first 100 days of the new government

The reliance on regulation to drive performance is set to continue, albeit with some subtle but important changes.

Understanding care quality: confronting complexity

Will drawing on a whole range of information about care quality take us a bit closer to a meaningful understanding of what care is like in practice?

Ellen Armistead: Regulating community health services

Ellen Armistead, Deputy Chief Inspector of Hospitals at CQC, discusses CQC's new approach to community health care services and what they found in the first year.

The case for professionalising and validating medical leadership

One of the priorities of our medical leadership work is to support those attracted to medical leadership and management. One way of encouraging medical leaders is to give them the same professional status that the medical profession gives to education, training and clinical practice.

Andrea Sutcliffe: Findings of the review into the quality of care for people living with dementia

Andrea Sutcliffe, Chief Inspector of Adult Social Care at CQC, speaks at our event on leading change in dementia diagnosis and support. Andrea describes the findings of the Review into the quality of care people living with dementia receive.

Making sure health professionals are supported: untangling supervision and regulation

Is it appropriate for regulators to be responsible for providing functions under the umbrella of 'supervision', including clinical support, development, and mentorship?

Completed project

Midwifery regulation in the United Kingdom

In 2014, the Nursing and Midwifery Council (NMC) commissioned The King's Fund to undertake a review of midwifery regulation in the United Kingdom.

Has Dalton found a way forward for struggling organisations?

Encouraging leaders to take on new responsibilities will be challenging at a time when financial pain is driving many organisations to focus inwards rather than outwards, says Chris Naylor.

Creating change from within

Dr Tracey Batten, Chief Executive of Imperial College Healthcare NHS Trust, reflects on the challenges of working in two very different health care systems and tells us how she thinks we can reform the NHS from within.

Redesign the failure regime for struggling providers

Richard Murray looks at the issues to consider when designing a better approach to financial failure.

Rachael Addicott and Kieran Walshe: new-style CQC inspections

Rachael Addicott and Kieran Walshe talk about their evaluation of the CQC's model for inspecting and regulating NHS acute hospitals.

How do Care Quality Commission hospital inspections measure up?

Over the past few years we have seen several high-profile failures of care in NHS acute hospitals in England, leading many in the system to question the ability of performance management and regulatory mechanisms to identify and act on poor performance.

Completed project

Dalton review

Sir David Dalton's review on new options for providers of NHS care considered issues such as single leadership teams for networks of hospitals and services.