Well-led · KLOE 3
Capable and compassionate leaders
Do leaders at all levels have the capacity and capability to deliver high-quality care effectively, with accountability and empathy?
CQC wording, secondary and specialist hospital care draft v0.6, pages 56 to 59.
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:
- Leadership competency, support and development
- Safe recruitment of leaders / Fit and proper persons requirement (FPPR)
- Role expectations and personal accountability
- Succession planning and talent management
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 56 to 59. 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
- Leadership is collaborative, supportive and people-focused, with leaders at all levels empowered to act and work together to deliver excellent and sustainable care.
- Leaders are proactively visible, accessible and responsive. They embody integrity, honesty and openness, and build strong, respectful relationships with staff, people and local communities through inclusive and transparent engagement. This results in demonstrable improvements in people’s access to care, and their experience and outcomes, including for those in marginalised and under-served groups.
- There is a deeply embedded system of leadership development and succession planning, aligned to strategic priorities and future risks. It reflects the diversity of the workforce and supports staff to feel safe, speak up, and grow through learning and development opportunities.
- Leaders operate confidently at system level, shaping shared priorities across the health system and modelling compassionate leadership beyond organisational boundaries. They embrace opportunities to have a positive impact on the wider health and care system.
- There are comprehensive and successful leadership strategies to ensure and sustain service delivery. Leaders analyse feedback from staff, performance data, talent metrics and lived experience to develop these strategies. There is strong collaboration, team working and support across all functions. Staff are engaged, empowered and united by shared values, with a clear sense of belonging and a common focus on improving the quality of care and people’s experiences.
- Leaders actively create and sustain a culture of psychological safety, where staff feel confident to speak up, challenge and innovate. Leadership behaviours enable continuous improvement and high levels of staff engagement and morale.
Good
- There is compassionate, inclusive and effective leadership at all levels.
- Leaders at all levels have the experience, capacity, capability and integrity to ensure that the organisational vision can be delivered.
- Leadership is supportive, inclusive and people-focused, enabling the delivery of safe, effective and compassionate care. Leaders demonstrate empathy and act to champion high-quality care and improvement.
- Leaders are held to account for delivering high-quality care and for modelling inclusive, compassionate behaviours, with clear expectations and consequences where expectations are not met.
- Leaders at every level are visible and lead by example, modelling integrity, honesty and openness, and encouraging mutual trust between staff, leaders and the systems they work in.
- Leaders are knowledgeable and use engagement, performance data and research to understand the issues and priorities for the quality of services, including social and cultural contexts that affect staff and people who use the service.
- Leaders at all levels can identify and access appropriate support and development in their role.
- High-quality leadership is sustained through safe, effective and inclusive recruitment and succession planning.
- The service meets the requirements of the Fit and Proper Persons regulation.
- Leaders encourage a culture of openness, learning and improvement, sharing lessons transparently with staff, people and partners to prevent recurrence.
Requires improvement
- Leaders do not have all the necessary experience, capacity, capability or integrity to ensure the organisational vision can be delivered.
- Staff do not consistently know who their leaders are or how to gain access to them. Leaders do not prioritise modelling integrity, openness and mutual trust between staff, other leaders, people and their communities, and the systems they work in.
- Leaders are not always aware of the risks, issues and challenges in the service and do not always make effective use of engagement, performance data and research to do so.
- Leaders are not always clear about their roles and their accountability for quality. Social and cultural contexts are not always considered as contributing factors to quality, or this is not embedded practice.
- The need to develop leaders is not always identified. Action is not consistently taken to support high-quality leadership through safe, effective and inclusive recruitment and succession planning.
- The service does not consistently meet the requirements of the Fit and Proper Persons regulation.
- Leaders are not consistently supportive or empathetic, which has a negative impact on the quality of services.
- Leaders do not consistently encourage a culture of openness, learning and improvement, sharing lessons transparently with staff, people and partners to prevent recurrence.
Inadequate
- Leaders do not have the necessary experience, capacity, capability or integrity to lead effectively, including in a culturally sensitive and non-discriminatory way. The leadership team is not stable, and it is characterised by high unplanned turnover and/or vacancies.
- Staff do not know who their leaders are or what they do or are unable to get access to them. Staff, people and communities lack trust in leaders and there are no external system relationships in place.
- Leaders are out of touch with what is happening on the front line, and they cannot identify or do not understand the risks, issues and challenges described by staff. This includes wider social and cultural contexts that may be affecting the quality of care.
- There is little or no attention to succession planning and to the development of leaders.
- The service fails to meet the requirements of the Fit and Proper Persons regulation.
- There are few examples of leaders making a demonstrable impact on the quality or sustainability of services.
- Leaders fail to encourage a culture of openness, learning and improvement, sharing lessons transparently with staff, people and partners to prevent recurrence.
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.