Article

CQC's proposed 2026 assessment framework: what is changing, what is not, and what providers should do now

Four draft sector frameworks, one shared architecture. What actually changes, what does not, and why the right move is to remap your evidence rather than rebuild around a draft.

By Klaudiusz Zembrzuski, ex-CQC inspector.

Draft framework. These are CQC drafts, issued for feedback. They are not the framework your service is inspected and rated against today.

Current position. The existing published framework remains in force while CQC tests and evaluates the proposed approach.

Last reviewed. 23 July 2026.

The position today

CQC's four sector assessment frameworks are still drafts. They do not replace the framework against which services are currently inspected and rated.

CQC is testing the proposed frameworks and assessment method between June and October 2026, with final evaluation planned for November. Pilot assessments run alongside existing inspections, and pilot judgements have no legal standing and no effect on a provider's rating or regulatory status.

Feedback on the drafts closed on 12 June 2026. CQC may still change their wording, structure and scope before implementation. It has even said it is considering whether primary care and community services should remain one framework or become two.

That uncertainty matters.

Do not rebuild your governance system around a draft.

What providers need to know

The five key questions are staying:

Safe. Effective. Caring. Responsive. Well-led.

The underlying regulations are staying.

Most of the evidence you already collect remains relevant.

What is changing is how CQC organises that evidence, describes the difference between rating levels, and makes its final rating judgement.

This is a meaningful change. It is not a fresh start.

Four sector frameworks, one shared structure

CQC is moving away from a single framework and developing separate drafts for:

At first sight, that sounds like four completely different assessment systems.

It is not.

Our comparison of the four drafts found the same underlying set of 26 assessment concepts across all of them.

Hospitals, mental health, and primary and community services display all 26 separately. Adult social care displays 24 headings because two pairs are combined:

The structure is therefore better understood as one common assessment spine with four sector-specific overlays.

The sector differences are real, but they sit mainly in:

They do not create four unrelated definitions of quality.

What is not changing

The five key questions

Safe, effective, caring, responsive and well-led remain the main level at which CQC intends to make its rating judgements. The proposals retain these questions across all four sectors.

The four rating levels

Services will still be rated outstanding, good, requires improvement or inadequate. What changes is the level of detail CQC provides about what each rating looks like.

The fundamental standards

A revised assessment framework does not rewrite the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Safe care and treatment, safeguarding, consent, staffing, good governance and the duty of candour remain legal requirements regardless of how CQC groups its inspection questions.

Do not confuse a change in assessment structure with a change in the law.

Your underlying evidence

Your incidents, complaints, safeguarding records, audits, risk assessments, training records, meeting minutes, action plans and outcome data do not suddenly become obsolete. The headings under which CQC considers them may change. The evidence itself still shows how your service operates. The same is true of your written framework: the sample policy library is anchored to the five key questions and the statutory regulations, both of which survive this transition.

The correct transition is therefore to remap evidence, not recreate it.

What is changing

Quality statements become supporting questions

The current framework uses quality statements written as descriptions of a good service. The proposed drafts return to direct assessment questions, similar to the previous key lines of enquiry.

Instead of reading a statement and working backwards to what CQC might ask, providers see a question such as:

Is there a positive and equitable safety culture where risks are proactively managed, concerns are listened to, incidents are thoroughly investigated, and lessons are learned to improve care?

Each question is supported by a defined scope, relevant topic areas, and characteristics for all four ratings. That should make the framework easier to interpret.

Rating characteristics return

One of the clearest weaknesses of the Single Assessment Framework was that its quality statements mainly described what good looked like. They did not clearly explain when inconsistency would tip a service into requires improvement, what separated good from outstanding, or how serious a weakness had to be before a service became inadequate.

The draft frameworks restore detailed characteristics for every rating level. In the consultation this drew some of the strongest support of any proposal, with 94% agreeing that CQC should publish clear rating characteristics for each rating.

This may be the most useful change for providers. It lets a service compare itself not only with the description of good, but with the rating above and below it.

Numerical scoring is being removed

Under the current approach, evidence category scores feed into quality statement scores, which then contribute to key-question and overall ratings. CQC intends to remove those separate scores. Inspection teams will instead review the evidence across each key question and award a rating directly through structured professional judgement, using the published rating characteristics and supporting guidance.

That is simpler on paper. It also places more weight on the experience, consistency and sector knowledge of the inspection team. The consultation response reflected that tension: 79% agreed with awarding ratings at key question level, the lowest agreement of the framework proposals, and support was conditional on inspectors having the expertise to exercise judgement credibly.

Sector context becomes more visible

The questions are largely shared. The scope beneath them is where the sector differences become significant.

Adult social care places greater emphasis on independence, positive risk-taking, delegated healthcare activities, relationships, care in a person's own home and quality-of-life outcomes.

Hospitals place greater emphasis on deterioration, early warning systems, admissions, discharge, patient flow, increased demand, virtual wards and clinical outcome benchmarking.

Primary and community services focus more heavily on longitudinal follow-up, access, population risk, long-term conditions, internal pathways and digital exclusion.

Mental health services include more detailed expectations around Mental Health Act governance, restrictive practice, seclusion, segregation, crisis planning, trauma-informed care, sexual safety and physical-health monitoring.

The practical lesson is simple:

Read the scope beneath the question, not just the question itself.

That is where a provider is most likely to find an expectation it does not currently evidence well.

Why some published counts may be wrong

Adult social care visibly contains 24 headings. That does not mean CQC has created a national framework of 24 common questions.

The adult social care draft combines two pairs of concepts, while the other sectors present them separately. The contents pages create two further traps:

Counting only the first contents page produces the wrong totals. Our count from the document bodies is:

This is our analysis of the drafts, not a formal count published by CQC.

What the drafts tell us about evidence

The drafts contain far more detail than the current quality statements, but they do not fundamentally ask providers to create more documents. They ask providers to demonstrate a complete assurance chain.

Across the rating characteristics, the same pattern appears repeatedly:

  1. A proportionate control exists.
  2. People use it in ordinary practice, including under pressure.
  3. It reaches everyone it should, including people at greater risk of exclusion or harm.
  4. The service monitors whether it is working.
  5. Findings result in clear, owned and timely action.
  6. The service checks whether that action worked.
  7. Outcomes improve.
  8. Learning is retained and, where appropriate, shared.

This is our interpretation of the common pattern across the four drafts, not wording used by CQC. It is also the most useful preparation providers can undertake now.

An audit report shows that an activity happened. It becomes assurance when the service can show what the audit found, what decision was made, who owned the action, whether the action was completed, whether it worked, and what changed as a result.

That distinction survives any final wording changes.

What providers should do now

Do not rename or rebuild everything

Do not rename every register, policy or audit to match draft terminology. Those names may still change, and the underlying evidence is more durable than the framework wording.

Maintain the evidence and build a cross-reference between the current quality statements, the proposed supporting questions, and the regulations the evidence helps demonstrate.

Close incomplete assurance loops

Look for audits with findings but no action. Look for actions marked complete without an effectiveness check. Look for incident learning that was discussed once but never revisited. Look for policies that exist but cannot be connected to records showing that staff follow them.

These weaknesses matter under the current framework and are likely to matter even more under the proposed rating characteristics.

Review your weakest interfaces

Referrals, handovers, shared care, discharge, delegated activities and information transfer appear repeatedly across the drafts. CQC's wording recognises that some failures originate elsewhere in the system. But the provider will still need to show what it identified, what it escalated, what it did to reduce the risk, and whether it followed the matter through.

"Another organisation failed" is context. It is not the end of the evidence trail.

Read the draft for your sector

Do not begin with every outstanding characteristic. Begin with the scope lists beneath each supporting question, and compare those topics with the evidence your service currently holds. That is the fastest way to find a genuine blind spot.

Do not buy "2026 framework compliance"

There is no final 2026 framework yet. No consultant, software provider or policy seller can make a service compliant with wording that CQC is still testing and may change.

Including us.

What happens next

CQC is piloting the proposed method until October 2026, with evaluation planned for November, and intends to publish supporting guidance describing the key standards and sources of evidence relevant to each sector. We cover the pilot itself in CQC's new assessment framework pilots; the framework in force today is set out in the single assessment framework explained.

This page will be updated when CQC publishes final sector frameworks, supporting evidence guidance, implementation and transition dates, any mapping from the current quality statements, changes resulting from the pilots, or final decisions about the number and scope of the sector frameworks.

Until then, the sensible preparation is not to chase draft wording. It is to make sure your existing governance evidence shows that risks are identified, action is taken, effectiveness is checked and outcomes improve.

The framework may change. That test will not.

Related guidance

Sources

Percentages and the description of the scoring change are from the consultation response document. Counts of supporting questions are our own, from the bodies of the four drafts. Where this page says what the drafts are likely to mean in practice, that is our reading as an ex-CQC inspector, not CQC guidance, and we have marked it as such.

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