Well-led · KLOE 7
Improvement, innovation and learning
Are there effective systems that enable continuous improvement, innovation and learning to drive high-quality, sustainable services?
CQC wording, secondary and specialist hospital care draft v0.6, pages 65 to 67.
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:
- Innovation
- Learning and improvement
- Research
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 65 to 67. 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
- There is a fully embedded and systematic approach to continuous quality improvement, which leaders understand is key to delivering high-quality care.
- Learning is a continuous process, embedded through reflection, collective problem-solving, and sharing both mistakes and good practice. Learning is systemically shared internally and with other organisations to support measurable improvement in the system and innovation in the sector.
- People and communities, particularly those who are more likely to have poor health outcomes, are actively involved in research opportunities, and in developing and co-producing innovative concepts to improve care.
- Leaders foster an open culture of trust, which is honest about challenges and mistakes, and uses these as opportunities for learning. Leaders actively listen to staff, monitor and assess improvement and innovations, and enable collective problem-solving and continuous improvement.
- The service invests in its people to ensure quality improvement is embedded in the work of all its staff. There is a clear strategy for developing staff capabilities.
- Staff are strongly encouraged to consider where innovation can improve outcomes, and are given the time and opportunity to learn, create and adopt these innovative ideas.
- There are strong external relationships that support research, improvement and innovation. Staff and leaders regularly proactively engage with external partners, including those in research, and embed evidence-based practice into the service. The service leads on national improvement initiatives and research.
- The service continuously innovates across multiple services, which results in demonstrable improvement in people’s outcomes and to services.
Good
- Staff and leaders understand how to make improvement and innovation happen. Their approach is consistent and includes measuring outcomes and impact. They are able to provide examples of where innovation and learning have resulted in demonstrable improvements to services.
- Learning is a continuous process, where mistakes and good practice are openly discussed and shared internally and externally.
- Innovations are monitored to support continuous improvement.
- People using services, families, and carers are actively involved in shaping and evaluating improvement and innovation.
- Leaders actively listen to staff and encourage collective problem-solving and innovative solutions.
- Staff are supported and given sufficient time to develop their skills around quality improvement and innovation. They are consistently encouraged to contribute to improvement initiatives.
- Staff and leaders engage with external partners, including those in research, and embed evidence-based practice into the service that can improve care and treatment.
Requires improvement
- Staff and leaders have limited understanding about how to make improvement happen. Their approach is often reactive and focused on short-term solutions.
- Areas for improvement are not always identified, and action is not always taken to address deficiencies. Where changes are made, the impact may not be fully understood or monitored.
- People using services are inconsistently involved in improvement and innovation.
- Leaders don’t always listen to staff or co-operate with them to improve the service. There is weak or inconsistent investment and insufficient time to develop the skills of staff around quality improvement and innovation.
- Engagement with external partners to improve and innovate the service is limited.
Inadequate
- There is little innovation or service development.
- There is minimal evidence of learning and reflective practice. The impact of service changes on the quality of care is not always understood.
- People using the service are rarely involved in improvement and innovation.
- Leaders do not work with staff to improve the service. There is minimal investment or insufficient time to develop the skills of staff skills around quality improvement and innovation.
- There is no engagement with external partners to improve and innovate 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.