Effective · KLOE 3
Outcomes
Does the service monitor outcomes and compare performance to improve the effectiveness of care for all?
CQC wording, secondary and specialist hospital care draft v0.6, pages 26 to 28.
Draft, not the current assessment framework
CQC's secondary and specialist hospital care draft v0.6, published March 2026. The current quality statements remain in use.
CQC draft scope
What this proposed KLOE covers
Scope of this key line of enquiry and topic areas include:
- Clinical audits
- Research and clinical trials
- Peer review
- Benchmarking
- Quality improvement initiatives
- Inequalities in outcomes
How would this apply to your service?
The draft applies one framework across secondary and specialist hospital care, but useful evidence depends on your service and people.
Source: CQC, Hospitals (secondary and specialist care) assessment framework, draft v0.6, 19 March 2026, pages 26 to 28. Contains public sector information licensed under the Open Government Licence v3.0.
CQC draft rating characteristics
How the draft describes each rating
These are CQC's draft characteristics. CQC says rating characteristics guide judgements, they are not a mechanical checklist.
Outstanding
- Outcomes for people who use services are consistently better than expected, when compared with other similar services.
- Approaches to monitor and improve people’s outcomes are rigorous and inclusive.
- The service is an exemplar in its actions to improve outcomes for people likely to experience health inequalities and those with protected equality characteristics.
- There are comprehensive, effective, and inclusive approaches to monitoring and improving, treatment and outcomes. People’s strengths, cultures and histories are recognised to achieve the best possible outcomes.
- Staff work proactively to enable equally good outcomes for all by recognising barriers that prevent this. They act on information by taking purposeful steps to listen and respond to people’s experiences of discrimination or inequality. They allocate resources and embed continuous learning and innovation to reduce inequalities in outcomes.
- The service uses audits, benchmarking, and quality improvement initiatives creatively and innovatively to support consistent improvement in outcomes.
- Staff are empowered to initiate activities to monitor and improve quality and outcomes. Opportunities to participate in benchmarking and peer review are proactively pursued, including participation in approved accreditation schemes.
- The service’s high performance is recognised by credible external bodies and is shared to inspire improvement on a local and national scale.
- Continuous improvement and evaluation is embedded throughout the service.
Good
- People consistently experience positive outcomes from their care and treatment. Outcomes are in line with agreed expectations (as set out in legislation, standards and evidence-based clinical guidance) and are comparable with similar services.
- The service continuously monitors and takes action to improve outcomes for people who are likely to experience health inequalities and those with protected equality characteristics.
- Staff work proactively to achieve equitable outcomes. They do this by recognising barriers that prevent this, collecting and acting on relevant information, and allocating resources to reduce barriers and improve people’s outcomes.
- The service continually participates in local and national clinical audit cycles and other monitoring activities such as reviews of services, benchmarking and peer reviews. The results are used to improve quality effectively.
- The service monitors and evaluates the effectiveness of any improvement actions and initiatives.
Requires improvement
- People’s outcomes are below expectations, when compared with similar services.
- Delivery against expectations as set out in legislation, standards and evidence-based clinical guidance is variable.
- Accurate and up-to-date information about people’s care and treatment and their outcomes is not routinely collected, monitored and shared.
- The outcomes of people’s care and treatment are not monitored regularly or thoroughly. The results of monitoring are not always used effectively to improve the quality of care.
- The service takes an inconsistent approach to monitoring and improving outcomes for people likely to experience health inequalities and those with protected equality characteristics.
- Staff are not consistently aware of discrimination and inequality that could lead to differential outcomes for people using their services.
- Participation in external audits, benchmarking and peer reviews is limited. Results from these initiatives are not consistently used to improve quality.
Inadequate
- People’s outcomes are very variable or significantly worse than expected, when compared with other similar services.
- People’s care is ineffective or there is insufficient assurance to demonstrate otherwise.
- Monitoring of care and treatment outcomes is either very limited or does not happen at all. Necessary action is not taken to improve people’s outcomes, including for people likely to experience health inequalities
- The service does not participate in external audits, benchmarking and peer review activities, aimed at improving quality.
- The service does not monitor or take action to improve outcomes for people likely to experience health inequalities and those with protected equality characteristics.
- Staff are not aware of discrimination and inequality that could lead to unequal outcomes for people using their services, and this is not a focus in planning and delivering the service
Want to know how your service would fare?
Book a mock inspection run against the draft KLOEs, or call 020 8090 5346 to speak to one of our experts.