CQC's draft adult social care framework is materially different from the other three. It carries 24 topics rather than 26, it is the only one to remove environmental sustainability, and it differs from the mental health, primary care and hospitals frameworks on 8 of the 34 current quality statements. If you run adult social care services, the reform is not the same event it is for everyone else.
The finding that surprised us
When we built our crosswalk of all 34 quality statements against CQC's four draft frameworks, we expected four meaningfully different destinations. That is not what the documents show.
Comparing the four sector by sector, statement by statement:
| Comparison | Statements that differ |
|---|---|
| Mental health vs primary care and community | 0 |
| Mental health vs hospitals | 1 — and it is word order in a topic name |
| Primary care vs hospitals | 1 — the same one |
| Adult social care vs each of the other three | 8 |
In other words: three of the four draft frameworks are, in substance, the same framework. The fourth is adult social care. That is the story of this reform for most providers, and it is not how it has generally been reported.
For the full picture of what is changing, see our guide to CQC's new assessment frameworks.
The eight differences
1. Environmental sustainability is removed entirely
Every other draft framework carries environmental sustainability within Strategic direction. Adult social care does not carry it at all. CQC's draft is explicit that it has not been included in the adult social care framework.
This is the only place in the whole crosswalk where a current quality statement simply disappears for a sector rather than moving, merging or being renamed. If you have built evidence against the sustainability statement, that work has no successor in adult social care.
2. Outcomes folds into evidence-based care
Mental health, primary care and hospitals all keep a distinct Outcomes topic. Adult social care merges Delivering evidence-based care and treatment and Monitoring and improving outcomes into a single topic: Evidence-based care and equitable outcomes.
Two current statements become one. In practice that means outcomes evidence and practice evidence are assessed together rather than separately — you will not be able to be strong on one and quietly weak on the other.
3. Governance stays combined instead of splitting
The current Governance, management and sustainability statement splits in three of the four frameworks into Governance and Management of risk, performance and issues. Adult social care keeps a single combined Governance and management topic.
This is the mirror image of the point above. Elsewhere the reform separates governance from risk management; in adult social care it does not.
4. Medicines is worded differently
Medicines optimisation becomes Safe medicines and treatments in adult social care, against Safe delivery of treatments and medicines elsewhere. The scope broadens the same way in all four — from medicines alone to treatments as well — but the label differs.
5–8. The remaining four
The rest are naming and scope-boundary differences rather than structural ones: Listening to and involving people, Providing information, Independence, choice and control and Care provision, integration and continuity all resolve slightly differently in the adult social care draft. Our crosswalk tool shows each one side by side, filtered by sector.
Why 24 topics and not 26
The compression is arithmetic, not editorial. Adult social care loses one topic by dropping environmental sustainability, and one more by folding outcomes into evidence-based care, while declining to split governance the way the others do. Fewer topics is not a lighter framework — the same ground is covered, assessed in fewer places.
What this means in practice
- If you are adult social care only, read the adult social care draft and ignore commentary written from the others. Most of what is published about this reform describes a framework that is not yours.
- If you hold registrations across sectors, this is the item to plan for. The five key questions stay common, but the topics beneath them and the rating characteristics will not. Map the differences before implementation rather than after.
- Do not retire your sustainability evidence yet. These are drafts. If it survives consultation in the other three frameworks, a multi-sector provider still needs it.
- Watch the merged topics. Where two statements become one, the assessment is combined — outcomes and evidence-based care in adult social care being the clearest case.
A caution on status
Everything above comes from CQC's draft frameworks published 24 March 2026, with consultation closing 12 June 2026. CQC is piloting them over summer 2026 with implementation expected at the end of the year. CQC has published no official mapping between the current quality statements and the new topics — the crosswalk this analysis is built on is our interpretation of topic scope, not CQC's. We update it monthly and will rebuild it when the finals land.
Frequently asked questions
How many topics are in CQC's draft adult social care framework?
24, against 26 in each of the other three draft frameworks. The five key questions remain common to all four.
Is environmental sustainability being removed from CQC assessment?
From the draft adult social care framework, yes. The mental health, primary care and hospitals drafts retain it within Strategic direction.
Are the four draft frameworks very different from each other?
No — and this is the surprise. Mental health and primary care differ on none of the 34 statements; hospitals differs from them on one, which is word order. Adult social care differs from all three on eight.
Do I need to rewrite my evidence library?
Not yet. These are drafts in pilot. The sensible preparation is to know which of your evidence maps to a topic that is merging or disappearing, not to rebuild anything.
When does the new framework apply?
Implementation is expected at the end of 2026. Until then the Single Assessment Framework remains in force — and if your rating is ageing, your next assessment may well come before the new frameworks land.
Related: everything changing in 2026–27 · rating characteristics explained · what the CQC is and how it regulates
Sources: CQC, our March update (the four draft sector frameworks); CQC, the assessment framework. Sector-by-sector comparison derived from our own crosswalk of CQC's draft documents — the mapping is our interpretation, not CQC's. Last reviewed: 30 July 2026.