Tackling Inequalities Rapid Evidence Review


As the national independent regulator for health and adult social care in England, tackling inequalities in health and care is a core ambition for the Care Quality Commission (CQC). To support this ambition, CQC commissioned SQW to deliver a rapid evidence review focusing on ‘what works to tackle inequalities by regulators, oversight, and supervisory bodies, from other sectors and countries’.

Working with support from the King’s Fund Library Service and Dr Tammy Boyce, the review involved a rapid evidence search and review of the most relevant literature, and interviews with regulators in other sectors and countries.

The report of the review findings has been published by CQC, and is available here.

The review identifies common approaches regulators take to tackle inequalities for people who need the services they regulate. These are rarely delivered as stand-alone activities; multiple approaches are often delivered at once. Approaches centre around working with partners and service users, the effective use of and contribution to the evidence base, and using regulatory levers to assess and address inequalities.

However, regulators face both enablers and challenges in tackling inequalities. Four themes are identified in the review:

  • Regulator leadership, culture and workforce knowledge
  • Collaboration and engagement
  • Capacity and resourcing
  • The quality and availability of data.

Perhaps most importantly, the review recognises a key cross-cutting challenge - regulators are one step removed from people who need services, and therefore they have less direct influence on inequalities than providers.

In response to these findings, the study identified a series of implications for regulators of services, which are available to read in the report.

For more information about the review or SQW’s wider work on inequalities in health and social care, please contact Lauren Roberts at lroberts@sqw.co.uk.