Care Quality Commission Memorandum of Understanding
Preamble
1. The purpose of this Memorandum of Understanding (MoU) is to promote patient safety and high quality health and adult social care in England.
2. This MoU pursues its purpose by setting out a framework to support the working relationship between the Care Quality Commission (CQC) and General Medical Council (GMC).
3. The working relationship between the CQC and GMC is part of the maintenance of a regulatory system for health and adult social care in England which promotes patient safety and high quality healthcare.
4. The CQC is the regulator of health and adult social care in England. The GMC is the independent regulator for doctors in the UK. The responsibilities and functions of the CQC and GMC are set out at Annex A.
5. This MoU does not override the statutory responsibilities and functions of the CQC and GMC and is not enforceable in law. However, the CQC and GMC agree to adhere to the contents of this MoU.
6. In agreeing this MoU the CQC and the GMC recognise that, as the new regulator for health and adult social care, the CQC is in the process of reviewing, and where relevant revising, the tools and methods needed to deliver its statutory functions of registration and reviews.
7. The CQC and GMC also recognise that, following the merger of the Postgraduate Medical Education and Training Board (PMETB) with the GMC on 1 April 2010, the GMC is now responsible for regulating all stages of medical education in the UK. This is the first time a single organisation has been charged with overseeing all stages of a doctor's career.
Principles of cooperation
8. The CQC and GMC intend that their working relationship will be characterised by the following principles:
- The need to make decisions which promote patient safety and high quality health and adult social care.
- Respect for each organisation’s independent status.
- The need to maintain public confidence in the two organisations.
- Openness and transparency between the two organisations as to when cooperation is and is not considered necessary or appropriate.
- The need to use resources effectively and efficiently.
9. The CQC and GMC are also committed to a regulatory system for health and adult social care in England which is transparent, accountable, proportionate, consistent, and targeted (the principles of better regulation).
Areas of cooperation
10. The working relationship between the CQC and GMC involves cooperation in the following areas. A named contact with responsibility for each area is identified at Annex B.
Cross-referral of concerns
11. Where the CQC or GMC encounters a concern which it believes falls within the remit of the other, they will at the earliest opportunity convey the concern and relevant information to a named individual with relevant responsibility at the other. In the interest of patient safety, the referring organisation will not wait until its own investigation has concluded.
12. In particular, the CQC will refer to the GMC:
- Any concerns and relevant information about a doctor which may call into question his or her fitness to practise.
- Any concerns and relevant information about a healthcare organisation which may call into question its suitability as a GMC Approved Practice Setting.
- Any concerns and relevant information about a healthcare organisation which may call into question its suitability as a learning environment for medical students or doctors in training.
- Any concerns and relevant information about a healthcare organisation which may call into question the robustness of its systems of appraisal and clinical governance.
13. In particular, the GMC will refer to the CQC:
- Any concerns and relevant information about a health or adult social care organisation in which doctors practise or are trained which may call into question its registration with the CQC.
GMC approved practice settings
14. The CQC and GMC will exchange information in support of the system of approved practice settings which are a key feature of the GMC registration framework for newly registered doctors and those returning to the List of Registered Medical Practitioners after a significant absence.
Revalidation for doctors
15. In future doctors will have to demonstrate to the GMC on a regular basis that they remain up to date and fit to practise (a process termed revalidation). This will depend on local systems of appraisal and clinical governance and so these systems must be sufficiently robust to enable doctors to collect the information they need to revalidate.
16. The CQC will work in collaboration with the GMC in the GMC’s development and delivery of a process which quality assures the robustness of local systems of appraisal and governance while avoiding unnecessary regulatory burdens for healthcare organisations or individual doctors. However, the revalidation process will remain the responsibility of the GMC.
CQC led National Collaborative Group
17. The CQC leads the National Collaborative Group (NCG) of regulators, audit, and review bodies involved in the regulation of healthcare in England.
18. The GMC has been a member of the NCG since July 2009 and will continue to attend meetings and exchange information in support of its work programme.
19. CQC will involve the GMC in triggered risk summits as appropriate.
Media, publications, and evidence to parliamentary committees
20. The CQC and GMC will seek to give each other adequate warning of and sufficient information about any planned announcements to the public that the other may need to know of.
21. The CQC and the GMC will when appropriate share with each other details of any relevant evidence provided to any Parliamentary Committees in relation to the operation of the regulatory regime or the exercise of their functions.
22. The CQC and GMC will respect the confidentiality of any documents shared in advance of publication and will not act in any way that would cause the content of those documents to be made public ahead of the planned publication date.
Exchange of information
23. The cooperation outlined in paragraphs 10 to 22 will often require the CQC and GMC to exchange information. All arrangements for collaboration and exchange of information set out in this MoU and any supplementary agreements will take account of and comply with the Data Protection Act 1998, section 76 Health and Social Care Act 2008, the Medical Act 1983, and any CQC and GMC codes of practice, frameworks or other policies relating to confidential personal information.
24. This MoU will be supplemented by a separate Information Sharing Agreement (ISA) which will set out the detailed arrangements for sharing information between the parties.
25. Both the CQC and GMC are subject to the Freedom of Information Act 2000. If one organisation receives a request for information that originated from the other, the receiving organisation will discuss the request with the other before responding.
Resolution of disagreement
26. Any disagreement between the CQC and GMC will normally be resolved at working level. If this is not possible, it may be brought to the attention of the MoU managers identified at Annex B who may then refer it upwards through those responsible, up to and including the Chief Executives of the two organisations who will then jointly be responsible for ensuring a mutually satisfactory resolution.
Duration and review of this MoU
27. This MoU will have effect for a period of 14 months commencing on the date on which it was signed by the Chief Executives of the two organisations.
28. Both organisations have identified a MoU manager at Annex B and these will liaise as required to ensure this MoU is kept up to date and to identify any emerging issues in the working relationship between the two organisations.
29. The MoU managers will also coordinate a formal review of this MoU which will take place no later than 12 months after the date it was signed.
30. The named contacts with responsibility for each area of cooperation identified at Annex B will liaise as required to carry out day-to-day business.
Signatures
Signed: ___________________________ Date: ______________________
Cynthia Bower
Chief Executive
Care Quality Commission
Signed: ___________________________ Date: ______________________
Niall Dickson Chief Executive and Registrar
General Medical Council
Memorandum of Understanding between the Care Quality Commission and General Medical Council – Annex A
Responsibilities and functions
1. The Care Quality Commission (CQC) and the General Medical Council (GMC) acknowledge the responsibilities and functions of each other and will take account of these when working together.
Responsibilities and functions of the CQC
2. The responsibilities of the Care Quality Commission (CQC) are set out primarily in the Health and Social Care Act 2008 (the 2008 Act).
3. The CQC is an independent, corporate body established under the 2008 Act. It is responsible for the regulation of the quality of health and adult social care services.
4. CQC undertakes four main activities to fulfil its responsibilities:
- Registration and enforcement: a new system of registration was introduced in 2010 as the cornerstone of CQC’s regulatory activity. It means that people can expect services to meet essential standards of quality and safety that respect their dignity and protect their rights.
- Improving health and adult social care: CQC encourages improvement by providing independent, reliable and up-to-date information about the quality of providers' care, as well as carrying out special reviews and studies about particular types of care.
- Mental Health Act visits: CQC monitors the care of people whose rights are restricted under the Mental Health Act, and makes sure that their interests are protected.
- Reporting health and adult social care information: in all of CQC’s work, it publishes information on the quality of care to help people make decisions about their care.
Responsibilities and functions of the GMC
5. The responsibilities and functions of the GMC are set out primarily in the Medical Act 1983 (the Medical Act).
6. The purpose of the GMC under the Medical Act is to protect, promote and maintain the health and safety of the public by ensuring proper standards in the practice of medicine.
7. The Medical Act gives the GMC four main functions:
- controlling entry to and maintaining the list of registered and licensed medical practitioners.
- fostering good medical practice.
- promoting high standards of medical education and training.
- dealing firmly and fairly with doctors whose fitness to practise is in doubt.