User involvement in regulation: A qualitative study of service user involvement in Care Quality Commission inspections of health and social care providers in England


Background High profile failures of care in the NHS have raised concerns about regulatory systems for health‐care professionals and organizations. In response, the Care Quality Commission (CQC), the regulator of health and social care in England overhauled its regulatory regime. It moved to inspections which made much greater use of expert knowledge, data and views from a range of stakeholders, including service users. Objective We explore the role of service users and citizens in health and social care regulation, including how CQC involved people in inspecting and rating health and social care providers. Design We analyse CQC reports and documents, and 61 interviews with CQC staff and representatives of groups of service users and citizens and voluntary sector organizations to explore the place of service user voice in regulatory processes. Results Care Quality Commission invited comments and facilitated the sharing of existing service user experiences and engaged with representatives of groups of service users and voluntary sector organizations. CQC involved service users in their inspections as “experts by experience.” Information from service users informed both the inspection regime and individual inspections, but CQC was less focused on giving feedback to service users who contributed to these activities. Discussion and conclusions Service users can make an important contribution to regulation by sharing their experiences and having their voices heard, but their involvement was somewhat transactional, and largely on terms set by CQC. There may be scope for CQC to build more enduring relationships with service user groups and to engage them more effectively in the regulatory regime.

Publication DOI:
Divisions: ?? 53981500Jl ??
College of Business and Social Sciences > Aston Institute for Forensic Linguistics
College of Business and Social Sciences > School of Social Sciences & Humanities
Additional Information: © 2018 The Authors. Health Expectations published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Uncontrolled Keywords: Care Quality Commission,health care,inspection,regulation,social care,user involvement,Public Health, Environmental and Occupational Health
Publication ISSN: 1369-7625
Last Modified: 17 Jun 2024 07:45
Date Deposited: 03 Oct 2019 09:45
Full Text Link:
Related URLs: https://onlinel ... .1111/hex.12849 (Publisher URL)
http://www.scop ... tnerID=8YFLogxK (Scopus URL)
PURE Output Type: Article
Published Date: 2019-04-07
Published Online Date: 2018-12-07
Accepted Date: 2018-10-23
Authors: Richardson, Emma (ORCID Profile 0000-0003-0399-2343)
Walshe, Kieran
Boyd, Alan
Roberts, Jill
Wenzel, Lillie
Robertson, Ruth
Smithson, Rachael



Version: Published Version

License: Creative Commons Attribution

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