CQC quietly scraps ‘overall’ ratings for trusts

The Care Quality Commission (CQC) is no longer giving “overall” ratings to trusts, it has emerged – instead only issuing a leadership rating at organisational level.

The new system was introduced last year, alongside other changes to the Care Quality Commission’s assessment framework, and so far has only been applied to a handful of trusts. Eventually, it is due to be applied to all trusts, and none will have an “overall” rating.

The CQC webpages for these trusts now state: “Our assessments of NHS trusts now focus on leadership. We no longer rate trusts overall for their safety, effectiveness and responsiveness or how caring they are. We do still publish those ratings for the services they provide.”

The providers are also expected to display the “well-led” overall rating on their website.

Previously, trusts were rated for all five domains (well-led, safety, effectiveness, caring, and responsive) at the trust level, and given an “overall” rating based on these.

Over the past decade, the trust-level “overall” rating has been used in the health system as a significant barometer of organisational success.

However, there has been an ongoing debate about the use of the single word/phrase ratings, ranging from “inadequate” to “outstanding”.

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Source: HSJ, 27 June 2025