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Smarter Regulation through Digital Transformation at the Care Quality Commission

The Registration Service is most health and social care providers’ first interaction with the Care Quality Commission (CQC). The Regulator wants to improve the experience for both providers and their own colleagues, increasing the efficiency of processes, systems and working practices.

by David Lawton, Technical Director at Informed Solutions

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The Care Quality Commission (CQC) is an independent regulator of health and social care provision across England. They ensure services provided to citizens are safe, effective, compassionate and of high-quality. 

The Registration Service is most health and social care providers’ first interaction with CQC.  It handles the collection of sensitive, complex and detailed data about organisations, which is then rigorously assessed to ensure that only those organisations that are able to provide high quality care become registered.  CQC currently complete around 40,000 registration processes each year and, at present, most of these are via email.

Currently, the vast majority of applications involve filling out a number of complex forms - user research has shown that applicants find this complicated and confusing, and as a result a significant amount of initial applications are rejected because the information they contain is not complete or relevant enough to enable assessment.  This causes significant wasted effort for CQC’s people, and frustration for those applying.

CQC want to improve the experience for both providers and their own colleagues, increasing the efficiency of processes, systems and working practices, and reducing waste and unnecessary manual effort.  They wanted to run an Alpha phase, engaging with users and business stakeholders to develop, test and refine a much more effective end-to-end design for the registration service, applying user-centred design principles and best practice content and interaction design to demonstrate that user’s needs could be met, and that the solution was technically feasible.

Our people worked together with CQC’s multi-disciplined digital team and subject matter experts (as ‘one team’), building relationships with key stakeholders including CQC’s Data, Policy and Legal experts to support a genuine transformation of the service.  The team were able to develop a design which ensures compliance with legislation and regulations, whilst positively challenging and adapting policy and question protocols to better meet user needs.

The team undertook a comprehensive User Research exercise, covering 4 regions across England involving over 70 individuals in iterative testing and refinement of the emerging design, including engaging users with assisted digital needs.  Alongside testing with personal care providers, we carried out 10 internal workshops with CQC colleagues across multiple office locations to understand and consider their needs: resulting in an improved end-to-end service capturing better data to aid more effective and efficient decision making.  Our User Research experts used a range of remote and face-to-face User Research techniques, including card sorting, low to high fidelity prototyping, and usability sessions using UX lab techniques on operational prototypes.

Prototyping was critical in developing a service that met user needs, and we used a range of prototyping tools to test hypotheses with users, iteratively learning, taking on-board feedback and improving the user experience.  We used the GOV.UK Design Kit to test a full range of scenarios and dynamic journeys through the application process.  Our interaction designers used proven GDS design patterns to develop a highly usable and intuitive user journey.

Given the complex and detailed nature of the information being collected, our content design experts undertook a comprehensive, user-centric review of content and guidance throughout the service (including the questions asked of users, and the manner in which information is captured and validated).  They worked together with CQC’s Data, Legal and Policy Subject Matter Experts as well as users to reduce complexity and improve both usability and the quality of the information that people submit.

As part of this work, we helped shape the plan for taking the service to the Beta Phase, helping to prepare for and successfully pass the Government Digital Standards (GDS) Assessment at the end of the Alpha Phase; demonstrating adherence to the service standards.

The new application service aims to reduce complexity and uncertainty for users, avoid collection of unclear or unnecessary information and introduce intelligent flows and validation to collect the right information up-front, so demonstrating clear benefits for users.

CQC wanted to work with a supplier that could also help support skills transfer and coaching in best practice digital service design and agile delivery, helping them develop a strong foundation of skills and practices for their own digital future.  Tracy Drabble, CQC’s Senior Product Owner for the Service notes:

“Informed Solutions brought the digital skills not yet fully embedded in CQC to help us to successfully deliver an Alpha in a highly complex and sensitive space.  We’ve enjoyed their highly collaborative and engaging approach to support a great new service design for Registration”.

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