CQC factual accuracy check: challenging a draft report

We know how this feels

Reading a draft report about your own service is horrible. Sometimes it describes a place you barely recognise: a comment taken out of context, a record nobody asked to see, a finding built on one bad morning.

The urge is to write back angrily, today. Please don't. CQC works from evidence. In our experience, an angry reply with nothing behind it changes nothing.

Keep it in proportion, too. A draft report isn't enforcement, and nobody is taking your registration today. But this is the last point where you can correct the record before it goes public. If the draft says Inadequate or Requires Improvement, that matters for a long time, and the draft may not be the only thing that needs your attention.

What is a CQC factual accuracy check?

The factual accuracy check is your chance to correct a draft CQC report before CQC publishes it. You have 10 working days from the date of CQC's email to submit comments. It covers facts and evidence from the time of the assessment. It won't reopen a rating just because you disagree with it.

CQC sends the draft to each registered person, for example the nominated individual and the registered manager. For most assessments the email links to an online portal where you enter comments against each section and upload evidence. For assessments that need both location and service type ratings, such as NHS acute trusts, independent health hospitals and independent single-speciality services, the draft comes by email with a Microsoft Word form.

This page is general information, not legal advice.

Why does the factual accuracy check matter so much?

Because facts can still move the result. CQC says it may change draft ratings or judgements if the evidence behind them is inaccurate or incomplete. After publication, that door closes. The only CQC route left is a rating process review, and a factual error is not a ground for one.

What you send also travels further than the report. CQC says it considers information shared at the factual accuracy check when deciding whether to take enforcement action. If the draft rates you Inadequate overall, CQC's 2015 special measures guidance (now under review) says the draft will also propose placing the service in special measures.

Bring evidence for every point. If CQC has evidence for a point in the draft, it's entitled to rely on it. If you dispute a point and send nothing to back it up, CQC may ask you for it, and that eats into ten days you don't have.

If CQC has also served a Notice of Proposal, the factual accuracy check does not answer it. Representations on a notice are a separate process with their own deadline, so put anything relevant in the representations as well.

Why is it so hard to get right in time?

Ten working days is two weeks on paper. In practice it's a handful of evenings, because the service still has to run. In that time you need to read every line, sort what CQC can consider from what it can't, and find dated records from weeks ago.

It's also hard to read criticism of your own work and stay factual. In our experience, the strongest responses come from someone who wasn't in the room for the assessment and can test each point coldly against the records.

And the rules are narrow. Improvements you've made since the assessment usually won't count towards the rating. Arguments about the rating itself won't count at all. In our experience, telling which is which under time pressure is where responses go wrong.

How we support your factual accuracy response

We take the process off your shoulders while keeping you in control of what's said. Our team reviews the draft report line by line, identifies the inaccuracies and omissions, and finds the dated evidence behind each one.

Then we prepare evidence-backed responses that CQC can check quickly, one point at a time, and support your engagement with CQC: requests for evidence extracts, questions about the process and the tone of everything you send.

We also tell you honestly which points are worth making. Where a finding is fair, we say so, and we help you start fixing it.

Can you ask CQC for its evidence?

Partly. CQC won't release the inspector's full notes. It will consider a request for extracts about a specific issue, where you need them to understand the basis for a statement you believe is wrong.

Keep the request short and specific, and say why you need it to raise a point of factual accuracy. Send it to your assessor, or to enquiries@cqc.org.uk quoting your assessment reference, which starts with AP. Ask on day one. CQC's guidance doesn't say the deadline stops while you wait.

CQC also won't identify anyone who shared concerns with it, so don't spend your ten days trying to find out who said what.

What happens after you submit?

CQC considers your points and decides whether to amend the draft. Another member of CQC's staff, independent of the original assessment, reviews every factual accuracy response. If changes affect a judgement or rating, the assessor explains them in CQC's response. CQC then sends you that response and publishes the final report.

If there are no errors, you can confirm you've reviewed the draft, and CQC can publish the final version.

After publication: the rating process review

If the report is published and you believe CQC did not follow its process for making rating decisions, you can ask for a rating process review. You have 15 working days from publication. The registered manager or nominated individual submits it on CQC's online form, within a 500-word limit, and you get one request per assessment.

CQC aims to finish a review within 50 working days. The rating stays published while it runs, with a message displayed. Scores and ratings can go down as well as up as a result of a review. CQC describes it as the final CQC process for challenging a rating. Older CQC pages call this a request for review, so check the name on CQC's current form.

When the draft is part of a bigger problem

If an inspection has gone badly, the factual accuracy check is often just one part of a much bigger regulatory concern. It's natural to focus on challenging the errors in the draft. Meanwhile there may be more significant compliance issues needing immediate attention, and potentially further regulatory or enforcement action to prepare for.

Our involvement doesn't have to stop at the factual accuracy response. We support the immediate response to CQC while we assess your wider regulatory position, address the underlying concerns and put improvements in place.

That means acknowledging the findings that are fair, fixing them, evidencing the change and embedding it, so you're ready for whatever CQC does next. CQC considers what you send at the factual accuracy check when it decides on enforcement, so correcting the record and improving the service need to tell one story.

Why providers call HLTH

We deal with CQC inspections, reports and enforcement day in, day out, with decades of collective experience. Adam Duncan, our Managing Director, has served as a Specialist Advisor with CQC. Helen Stevenson, on our team, is a former CQC inspector. They know how CQC weighs evidence in a draft because they've seen it from CQC's side. Kath Cox, a former Registered Manager, knows what the records look like on the floor.

If a Warning Notice or a Notice of Proposal sits behind the draft, we prepare the compliance response to it while we work on the factual accuracy comments. Where legal representation is needed, we work with our trusted legal partners.