Reporting and rating Use of Resources assessments


NHS Improvement and the Care Quality Commission (CQC) are seeking feedback on our proposed approach to reporting and rating how trusts are using their resources.

On 8 November 2017, NHS Improvement and the Care QualityCommission (CQC) published a joint consultation inviting all interested stakeholders to comment on our proposed approach to reporting and rating how efficiently and effectively NHS trusts and foundation trusts are using their resources to provide high quality, sustainable care. 

The consultation follows previous work by NHS Improvement and CQC seeking stakeholders’ views on our proposed methodology and framework for assessing how trusts are using their resources. We published our response to this consultation and the final Use of Resources framework and methodology in August 2017.

This new consultation covers the final steps in the process. Specifically, we are seeking sector-wide feedback on our approach to two key questions:

  • How will CQC turn NHS Improvement’s proposed Use of Resources rating into a final CQC rating?
  • How will we combine CQC’s trust-level quality ratings (ie safe, caring, effective, responsive and well-led) with NHS Improvement’s Use of Resources rating to produce an overall trust-level rating?

We invite all interested stakeholders to submit their views by 10 January 2018. 

More information on the proposals and how to submit a response can be found here

Implementing Use of Resources assessments

We are now carrying out Use of Resources assessments in non-specialist acute trusts. By the end of 2019, all non-specialist acute trusts will have undergone a Use of Resources assessment.

For most non-specialist acute trusts, the assessments will take place alongside but not on the same day as CQC undertakes its core services and well-led inspections.

Brief guide

We've prepared this brief guide to help you better understand the Use of Resources assessments. It includes the agenda for the onsite visit and other useful information.

The assessments will help us identify your support needs, as part of the Single Oversight Framework, as well as being a useful improvement tool for you. They will also enable us to identify good practice to spread and drive improvement across the sector. 

If you have any questions about Use of Resources assessment, please refer to the framework document or email

How the assessments work

As the starting point of a Use of Resources assessment, our assessment team will undertake an analysis of your performance against:

  • a selection of initial metrics 
  • local knowledge of the trust  
  • other relevant evidence, such as Model Hospital data 

A small senior team from NHS Improvement will then carry out a one-day site visit to interview a selection of the your senior leadership on the organisation’s use of resources. Following this, our assessment team will compile a brief report and propose a rating to CQC. 

Publishing the Use of Resources report and rating

The CQC will initially publish the Use of Resources reports and ratings separate from their other trust-level ratings.

In autumn/winter 2017/18, CQC will pilot the way it links Use of Resources assessments with its current inspection, rating and reporting processes as outlined on the CQC website. As part of this, CQC may publish some of the initial use of resources assessments alongside its existing inspection reports, which will include indicative or ‘shadow’ ratings. 


We developed the assement framework following sector-wide feedback to a joint NHS Improvement and CQC consultation on the approach. 

You can read our response to the consultation here.

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