Emergency Waiting Times (4 Hour Standard), 18 Week RTT Incomplete and Cancer 62 Day have been key targets for NHS providers for a long time and are a point of focus for regulators, politicians, media and members of the public. From analysis of the last 12 months public data via Public View, these performance standards do appear to also have potential as a guide to CQC rating.
Table 1 and Figures 1,2 & 3 show ‘Outstanding’ trusts consistently outperforming ‘Good’ who outperform ‘Requires Improvement’, which in turn have stronger performance than ‘Inadequate’ trusts.

Table 1: 12 month rolling performance for CQC rating groups

	Outstanding	Good	Requires Improvement	Inadequate
4 Hour	90.1%	88.8%	85.5%	84.1%
18 Week	92.2%	91.5%	89.3%	85.2%
62 Day	87.2%	84.9%	84.1%	78.8%

Figures 1,2 & 3: Monthly performance for CQC rating groups

Perhaps there is something in this. After all timely access to healthcare for emergency, routine and cancers services are important aspects in the delivery of high quality healthcare. Additionally, an organisation’s ability to demonstrate compliance against key indicators may be indicative of a whether a Trust is ‘Well Led’.

However, a quick look at the Public View ‘Ranking Charts’ shows that this can not be the whole story. In April 2018 one ‘Outstanding’ trust and nine ‘Good’ rated trusts’ performances fell below the median ‘Inadequate’ performance value for the A&E 4-hour standard (see figure 4).

Figure 4: Ranking chart for April 2018 4 Hour Standard

This variation is also observable for the 18 Week RTT Incomplete and Cancer 62 Day standards where six and nine trusts, respectively, had worse performance than the median ‘Inadequate’ value.

There are many potential explanations for this including;

• time from last inspection (have some good rated trusts got worse in the 2-3 years since they were last reviewed?),
• a single months snapshot may not be reflective of an organisation
• CQC ratings are about more than just waiting times

In part two we will be exploring some of the 'quality' indicators.  To get early sight of the CQC groups performance for these indicators click here to register for an account.