New CQC Guidance: The CQC digital record system guidance prioritises availability, security, and governance while adopting a person-centred approach

The Care Quality Commission (CQC) has issued guidelines on best practices for digital record systems. The focus is on the importance of “good quality records” in delivering safe, effective, compassionate, and high-quality care. The CQC shares four principles for providers to follow in order to maintain person-centred systems with an emphasis on availability, security, and governance.

The first principle highlights the need for systems to prioritise the individual receiving care and treatment. This includes involving users in decision-making, personalising care to their specific needs, and ensuring that their care records reflect their choices and preferences. Providers should be able to demonstrate how their system meets these requirements, how users are utilising the system, and that users understand the implications of the digital system for their care.

In terms of availability, the CQC stresses the importance of ensuring that the right people have access to information when they need it. Users should have access to their care records in a way that suits their needs and preferences. They should also be involved in decisions regarding the sharing of their personal information and be supported by staff who have access to their information in order to fully understand their needs. Providers should have a clear understanding of their role in providing appropriate access to information and supporting users in understanding and sharing this information.

Regarding security, the CQC believes that individuals should expect their information to be stored securely. They should be treated with dignity and respect and protected from avoidable harm. Providers should inform individuals if their privacy or confidentiality has been breached and ensure that information is used in their best interest or the general public’s best interest. Providers can demonstrate their commitment to security by ensuring that staff understand how to keep information safe, that information is stored in compliance with GDPR, that there is a plan in place for data breaches or cyber attacks, and that they adhere to the Data Protection and Security Toolkit or an equivalent standard.

Lastly, the CQC provides guidance on governance, emphasising the need for systems to be assessed and monitored to minimise risks and improve the quality of care. Digital record systems should contribute to keeping individuals safe and promoting positive outcomes. Providers should continuously improve their services by maintaining devices, updating software, and promptly addressing risks and quality issues.

Overall, the CQC’s guidance aims to ensure that digital record systems prioritise the individual receiving care, provide secure access to information, and contribute to the overall quality and safety of care.