CQC's new assessment frameworks — everything changing in 2026–27

New to any of this? Start with what the CQC is and how it regulates, then come back — this guide assumes you know the basics.

Note the distinction: this reform changes CQC’s ASSESSMENT FRAMEWORK, not the fundamental standards. Regulations 8 to 20A are unaffected.

Wondering about KLOEs specifically? We have written the full story of why key lines of enquiry are coming back — including what CQC’s own review said about why the quality statements did not work.

Looking for where a specific quality statement lands? Use our free CQC framework crosswalk tool — all 34 quality statements mapped to the topic replacing them, by sector. You can also download your sector’s crosswalk as a spreadsheet you can work in, or a PDF you can share.

This page is our running reference for CQC’s assessment reform. We update it monthly, and whenever CQC publishes something material. Everything below is sourced to CQC’s own publications — links at the foot of the page.

CQC’s Better regulation, better care consultation, which ran at the end of 2025 and drew over 1,600 responses, proposed moving away from a single assessment framework to separate frameworks “more specific and relevant to the health and care sectors that we regulate”. CQC reported “overwhelming support” for the proposal and published four drafts:

• Adult social care
• Mental health care
• Primary care and community services
• Hospitals (secondary and specialist care)

This mirrors a structural change CQC had already made to itself. During 2025 it restructured into operational inspectorates built around sector expertise, led by four Chief Inspectors: Professor Bola Owolabi CBE (Primary Care and Community Services), Dr Toli Onon (Hospitals), Chris Badger (Adult Social Care and Integrated Care) and Dr Arun Chopra (Mental Health).

What it means if you operate across sectors

The working assumption that one internal assurance model serves every registration may not survive four frameworks. If you hold registrations in more than one sector, map the differences before implementation rather than after — the five key questions will still be common, but the questions beneath them and the rating characteristics will not be.

CQC’s March 2026 update records that “feedback from the consultation also showed support for our proposal to remove scoring from our assessment methodology and make rating judgements directly at key question level. The rating characteristics will therefore support this change.”

How ratings work today

Under the current framework, evidence is scored on a four-point scale; those scores build a score for each quality statement; quality statements build a score for each key question; and the five equally-weighted key questions aggregate into an overall rating. A rating limiter can cap an otherwise-strong result where one area is weak. We break this down in CQC ratings explained.

How ratings will work

Scoring goes. An inspector will judge each key question directly against the published rating characteristics for your sector, and those judgements produce the rating.

This is not a sudden reversal

Worth knowing, because it changes how alarmed you should be: CQC had already stopped scoring at evidence-category level in December 2024. Its own change history records “our decision to stop scoring at evidence category level” on 6 December 2024. The 2026 reform completes a step back from score arithmetic that began eighteen months earlier.

The practical consequence

Scoring gave ratings the appearance of objectivity, but someone always had to decide whether a piece of evidence was a 2 or a 3. The scores packaged the judgement rather than removing it.

What changes is that the packaging goes — and with it, the arithmetic you could point at. Under the new approach, ambiguity in your evidence becomes ambiguity in the judgement. Providers with complete, dated, owned and retrievable evidence are in a stronger position than before; providers whose evidence is scattered are more exposed. We set out that argument in full in why this reform makes your evidence matter more.

Running alongside the framework reform — and more immediately relevant to most providers — CQC is working through an assessment backlog. It says it remains “on track to meet our target to publish reports for at least 9,000 assessments across all sectors by September 2026”.

In its May 2026 update CQC published the criteria it is prioritising by. Aged ratings feature in every sector.

Two programmes worth knowing about

Returning to Good and Outstanding. Began March 2026. Focused assessments of lower-risk NHS GP practices rated good or outstanding whose last inspection report was published between 2017 and 2022 — reviewing, in CQC’s words, “non-clinical quality statements safely and robustly”.

A lighter-touch route in adult social care. For services rated good across all five key questions, with a registered manager, ratings over six years old, no significant risk in the data and no ongoing enforcement. It leans on “people’s experiences and outcomes, supported by observation and targeted, risk-based review of records” — with the explicit caveat that “if concerns arise during planning, we will revert to the usual approach”.