Well-led · KLOE 1
Strategic direction
Is there a clear vision and strategy that addresses the changing needs of the population and communities served?
CQC wording, primary care and community services draft V6.0, pages 44 to 46.
Draft, not the current assessment framework
CQC's primary care and community services draft V6.0, 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:
- Strategy and vision
- Values
- Organisational sustainability
- Addressing social impact
- Environmental sustainability
How would this apply to your service?
The draft applies one framework across primary care and community services, but useful evidence depends on your service and people.
Source: CQC, Primary care and community services assessment framework, draft V6.0, 19 March 2026, pages 44 to 46. 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
- The vision, strategy and supporting objectives are clear and well-understood across the organisation. They are co-produced and respond to the changing needs of the population served.
- The strategy is delivering on the organisation’s high standards for equality, diversity and inclusion.
- A fully person-centred approach is at the heart of the organisation and is evident in everyday interactions with staff, people who use the service and the public. People feel respected, listened to and safe, and services are designed around what matters most to communities served.
- Leaders provide visible, values‑driven leadership, actively shaping and testing the strategic direction through curiosity, constructive challenge and learning. They triangulate data, lived experience, staff insight and research evidence to ensure that the strategy remains relevant, equitable and impactful.
- Staff are proud of the organisation as a place to work and consistently report high levels of engagement and trust in leadership. They feel alignment and ownership of the organisation’s culture, vision and values.
- Strategies and plans are fully aligned with the wider health and care system, including at neighbourhood level. There is a demonstrated commitment to system-wide collaboration and leadership.
- The strategy and vision are ambitious, challenging and innovative, yet grounded in a clear understanding of risk, capacity and resources.
- Feedback from staff and people using the service is consistently taken into account to measure outcomes against the strategy and to support its ongoing evaluation.
- There is strong collaboration, team working and a common focus on improving the quality, experience and sustainability of people’s care and experiences.
- Environmental sustainability is embedded within strategic decision-making. Leaders recognise its role in improving population health, delivering value and ensuring the long-term sustainability of services. Staff understand how sustainability relates to their roles and take pride in initiatives that reduce waste, minimise energy use and support greener models of care.
Good
- Leaders ensure there is a shared vision and strategy that responds to the needs of the population and communities served. The vision and values are communicated effectively, and staff across the organisation understand them and how their role contributes to delivering them.
- The strategy is achievable, promoting high-quality, person-centred, and non-discriminatory care. There is clear intent to reduce health inequalities supported by identified priorities and improvement actions. Progress in outcomes is evident.
- The vision, strategy and supporting objectives have been developed through a structured planning process, in collaboration with people who use the service, staff and external partners. Equality, diversity and inclusion are reflected within the strategy.
- Staff and leaders ensure any risks to delivering the strategy, including relevant local factors, are understood and have an action plan to address them. They monitor and review progress against delivery of the strategy and relevant local plans.
- The strategy has clear, time-bound equity goals, with resourced plans and key performance indicators.
- Environmental sustainability is embedded within strategic decision making, and leaders recognise its role in improving population health, delivering value and ensuring the long-term sustainability of services. Staff understand how sustainability relates to their roles and take pride in initiatives that reduce waste, minimise energy use and support greener models of care.
- Staff are empowered to know how environmental sustainability relates to their role, including through planning and delivering care, preventing diseases and good practice in medicine usage.
Requires improvement
- The organisational vision, strategy and plans have some significant gaps or weaknesses that undermine their credibility. They are either incomplete, out-of-date, or not well-understood.
- Equality, diversity and inclusion are not consistently promoted, and they are not necessarily central to the organisational vision, values and strategy.
- The organisational strategy and vision may not have been co-developed with people, staff and stakeholders, so there is no feeling of co-ownership felt among these groups.
- Feedback from people, staff and stakeholders is not always taken into account in developing and evaluating strategies or plans.
- The plan and strategy do not fully reflect the health economy in which the service operates.
- System-wide collaboration and leadership are not necessarily visible or consistent.
- Leaders at all levels are not always held to account for delivering the strategy.
- Staff do not always feel actively engaged or empowered. They do not always feel pride in their organisation and do not always trust its leadership.
- Sustainability is not a primary consideration for the service. Even where there is a plan in place to support sustainable practice staff feel limited ownership of it.
Inadequate
- There is no credible statement of organisational vision and guiding values. These are either outdated or not underpinned by realistic plans and objectives.
- Equality, diversity and inclusion considerations are often neglected, if not altogether absent from the organisational strategy and vision.
- Key stakeholders have not been engaged in creating the organisational strategy.
- Staff do not understand the organisational vision and values and do not understand how their role contributes to achieving the strategy.
- Strategies and plans are not aligned with the wider health economy in which the service operates.
- There is no effective approach to monitoring, reviewing or providing evidence of progress against delivery of the strategy or plans.
- Leaders at all levels are not held to account for delivering the strategy.
- Staff feel disengaged, disempowered and often feel no pride in their organisation.
- Sustainability is either completely absent from the organisational strategy and vision, or it is poorly or ineffectively communicated.
- Staff are unaware of their responsibilities or contribution in relation to sustainability.
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.