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From YouTube: CQC board meeting - February 2021
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A
Good,
so
can
I
start
the
february
meeting
of
the
cqc
board.
We
have
an
apology
for
absence
from
stephen
martin
had
a
prior
commitment
before
he
joined
the
board.
Otherwise
there
are
no
apologies
that
I'm
aware
of
everybody's
here.
Are
there
any
declarations
of
interest
anybody
needs
to
make?
A
Thank
you
very
much.
Indeed
we're
going
to
be
joined
by
latoya
tabazeva
from
our
race
equality
network
she's,
just
finishing
another
meeting
she'll
be
joining
joining
us
shortly.
A
She
will
be
very
welcome
when
she
gets
here,
and
I
just
want
to
say
that
some
months
ago
we
were
asked
if
it
was
possible
to
move
to
a
live
streaming
of
this
board
meeting
as
well
as
recording
it.
We
have
now
sorted
the
technology
out
to
be
able
to
do
that.
So
I
hope
that
people
are
are
pleased
and
will
be
tuning
in
at
11
o'clock,
every
every
board
meeting
going
forward.
A
Those
the
minutes
of
our
meeting
of
the
20th
of
january
are,
though,
through
an
accurate
record
of
everything
we
discussed.
Yes,
thank
you.
Take
those
as
approved
and
amazingly,
there's.
There's
no
outstanding
actions
on
the
action
log.
Is
there
anything
arising?
Anybody
needed
to
to
raise
that's
not
otherwise
on
the
agenda.
A
B
Thank
you
peter
good
morning,
everybody,
I
think.
At
last
the
last
meeting
I
talked
about
our
organizational
priorities
for
the
first
quarter
of
the
calendar
year
2021,
and
at
that
point
we
I
think
we
were
talking
about
our
priority
set
against
a
backdrop
of
of
of
significant
pressure
against
covid.
B
I
think
it's
fair
to
say
that
that
level
of
covert
pressure
continues,
but
it
is,
I
think
there
are
definite
signs
of
of
of
positivity
and
and
in
no
small
part,
I
think,
due
to
the
incredible
and
continued
efforts
of
of
everybody
that
works
within
and
around
and
volunteers
in
the
health
and
social
care
system.
So
you
know
I
I
know
all
board
members
would
want
to
join
me
in
in
our
thanks
for
the
incredible
stories
that
our
inspectors
see
day
in
day
out
in
in
the
field.
B
I
think
when
we
spoke
last
month,
I
was
making
the
point
that
we
were
using
our
regulatory
activity
primarily
focused
on
creating
capacity
in
the
system,
and
we
did
that
by
by
by
doing
inspections
which
which
in
some
cases,
upgraded
ratings,
which
meant
that
local
authorities
in
particular,
were
able
to
buy
additional
care
from
from
providers
who
traditionally
hadn't
been
seen
as
performing
well
enough.
By
going
back
and
looking
again
at
those
providers
and
seeing
their
improvement,
we
were
able
to
create
great
new
capacity.
B
We
were
also
doing
work
which
was
responding
to
risk,
and
I
talked
about
last
month
about
how
we
will
respond
to
risk,
and
I
also
talked
about
the
notion
of
us
of
supporting
the
wider
system
so
spending
time
with
colleagues
at
the
department
of
health
and
social
care,
nhs,
england
and
elsewhere
talking
about
policies
and
guidance
and
and
giving
a
perspective
from
cqc
on
on
on
contributing
to
the
development
of
that
sort
of
thing.
B
So
I
think
I
just
wanted
to
pick
out
some
headlines
in
terms
of
what
that
translates
to
in
real
terms
on
the
ground.
We've
reviewed
about
20
now
just
a
little
over
20
of
residential
homes
in
in
social
care,
particularly
with
a
focus
on
infection,
prevention
and
control,
and
that
gives
the
public
assurance
around
those
those
particular
locations.
B
There
are
now
155.
I
think
that
number
might
even
be
156
designated
settings.
The
these
are
settings
which
you'll
recall
are
locations
which
are
have
been
designed
for
people
who
are
coming
out
of
hospital
who
are
otherwise
medically
fit
to
be
discharged,
but
are
still
testing
covered
positive
and
they
themselves
are
asymptomatic.
B
So
it's
a
unique
group
of
people,
but
it's
what
what
what
government
wants
to
do
was
create
an
environment
that
was
safe
and
caring
for
those
groups
of
people
who
who
couldn't
go
home
but
equally
didn't
need
to
be
in
a
hospital
either.
We've
now
we've
increased
the
number
of
designated
settings
by
27
in
the
last
six
weeks.
So
again,
a
huge
tribute
to
kate
and
her
teams.
B
Who've
been
who've
been
at
this
working
incredibly
hard
along
with
colleagues
from
from
other
other
parts
of
the
organization
who
are
supporting
that
activity
and
there's
there
are
20
providers
in
other
social
care
have
had
their
ratings
uplifted
and,
of
course
that
translates,
as
I
said
earlier,
on
into
into
additional
capacity
in
the
system.
It
enables
local
authorities
to
to
start
to
commission
services
from
from
organizations
that
that
perhaps
had
had
too
lower
rating
before
and
in
primary
medical
services
and
in
hospitals.
B
Both
of
those
teams
have
been
focusing
their
efforts
on
on
looking
at
high-risk
services,
those
services
by
virtue
of
their
of
their
of
their
regulatory
history
or
because
we've
had
new
information
from
members
of
the
public
or
from
whistleblowers
that
give
us
course
for
concern.
That's
been
the
complete
focus
in
in
hospitals
and
primary
medical
services,
so
I
think
what
drops
from
that
is.
B
I
think
we
are
mindful
of
the
prime
minister's
announcements
earlier
in
the
week
and
we'll
be
looking
at
those
in
in
the
context
of
what
we'll
be
doing
during
the
second
quarter
of
of
this
year,
and
indeed
for
the
rest
of
this
of
this
calendar
year
and
we'll
be
coming
back
to
the
board
and
talking
more
publicly
about
our
priorities
for
the
rest
of
the
year
over
the
coming
coming
months.
B
The
second
thing
I
just
wanted
to
touch
on
was
the
health
and
care
bill.
We've
been
working
with
colleagues
at
the
department
of
health
and
social
care,
on
the
development
of
the
bill
and
and
the
development
of
the
the
white
paper,
and
now
we've
set
up
an
internal
project
team
to
make
sure
that
we
can.
We
can
contribute
to
the
development
of
the
detail,
particularly
around
assurance
for
for
the
around
assurance
of
systems.
B
We
were
very
pleased
to
see
the
creation
of
ics's
in
the
in
the
white
paper
and
we
were
pleased
to
to
see
the
the
the
remarks
about
needing
to
have
assurance
around
the
performance
of
those
ics
and
we're
we're
keen
to
develop
that
in
a
constructive
way,
with
the
department
and
and
of
course,
nhs
england
we're
doing
similar
work
around
local
authority
assurance,
kate
and
her
team
are
working
with
the
department
and
other
other
other
groups,
such
as
adas
and
the
local
government
association
are
on
on
what
that
the
bill
may
talk
about
in
terms
of
assurance
around
local
authorities
as
well.
B
So
I
just
wanted
to
say
that
I
think
we
see
that
we
see
the
white
paper
as
as
positive.
We
see
the
health
and
care
bill
as
a
positive
development
and
we're
working
closely
with
colleagues
on
on
the
next
steps
and
making
sure
that
the
detail
when
it
comes
when
the
when
the
bill
itself
actually
starts
going
through
committee
stages
later
in
the
spring,
then
then
we'll
we
will
have
been
part
of
that
development
process.
So
I'm
going
to
pause
there
peter
for
any
questions.
For
me,
before
handing
on
to
kate.
A
Thanks
ian,
I
must
say
that
the
conversations
I've
had
with
providers
have
been
very
welcoming
of
our
intended
role
around
systems.
They
were
very
concerned
that,
if
we
didn't
have
that,
then
we
were
going
to
be
out
of
step
with
where
they
were
going.
So
it's
very
positive.
C
Okay,
thank
you
peter.
So,
as
ian
said,
we've
committed
to
do
over
600
inspections
a
month
with
a
strong
focus
on
infection
prevention
control.
In
february
today,
we've
undertaken
698,
so
we're
exceeding
our
target,
as
we
did
in
december
and
january,
which
is
positive.
Our
work
on
designation
settings
so
that
the
number
continues
to
go
up.
C
Settings
is
equating
now
to
2169
beds,
so
a
big
thank
you
to
all
of
our
teams
who
are
out
there
inspecting
these
services.
When
it
comes
to
infection
prevention
control.
Generally,
we
are
finding
that
providers
are
doing
a
really
good
job.
C
There
are
two
main
areas
that
we
really
need:
providers
to
continue,
focusing
on
with
the
same
level
of
vigilance,
which
is
about
continuing
to
ensure
good
use
of
ppe
and
effective
use
of
ppe,
and
then
the
other
area
we
sometimes
see
providers
fall
down
on
is
about
the
need
to
have
up-to-date
risk
assessments
in
place
and
and
to
ensure
that
their
ipc
policies
are
really
effective.
So
those
are
the
couple
of
issues
we
pick
up
when
we
have
concerns
around
ipc
and
where
those
concerns
arrive.
C
We
are
swift
to
take
action
and
there's
a
spectrum
of
actions
that
we
can
take,
depending
on
the
severity
of
what
we
find
from
issuing
a
warning
notice
through
to
changing
a
provider's
registration,
but
just
want
to
emphasize.
That
is
a
very
small
number
of
occasions
where
we
need
to
take
such
action,
because
generally
providers
are
out
there
doing
a
really
good
job
when
it
comes
to
infection,
prevention
and
control
just
going
to
move
on
to
briefly
mention
close
cultures.
C
It's
a
shorter
update
this
month
because
we
focus
on
this
very
heavily
at
previous
boards,
but
just
to
reassure
our
board
that
work
is
continuing.
There's
been
a
focus
in
february
about
developing
the
way
we
need
to
regulate
services
where
we're
concerned
at
close
culture
may
be
developing,
so
whether
we
call
it
an
intensive
inspection.
You
know
we
need
to.
We
need
to
clarify
the
the
description
of
it,
but
the
the
focus
is
about.
How
do
we
really
immerse
ourselves
in
these
services?
C
How
do
we
really
understand
what
it
feels
like
for
someone
who
is
receiving
care
in,
for
example,
an
inpatient
unit
following
a
crisis
in
the
community,
and
we
will
be
piloting
our
new
approach
through
march?
I
look
forward
to
giving
board
an
update
in
march
and
april
on
on
that
activity
and
then,
finally,
for
me,
market
oversight,
so
board
will
be
aware.
Market
oversight
was
established
back
in
2015.
C
at
that
point,
guidance
was
developed
to
enable
the
team
to
function
and
for
there
to
be
clarity
about
their
role
and
remit.
We're
over
five
years
on
now
and
there's
been
a
huge
amount
of
learning.
C
In
the
way
that
market
oversight
works
with
providers
and
with
local
authorities-
and
we
are
here
today
with
a
refreshed
guidance
for
border
sign
off-
this
has
been
following
consultation
with
providers
between
august
and
and
october
of
2020..
C
C
Of
them
having
a
sufficient
notification,
where
we
have
concerns
about
continuity
of
care,
because
ultimately
it
is
directors
of
social
services.
It's
local
authorities
who
helps
hold
a
safeguarding
net
to
ensure
that
people
get
get
their
care
delivered
safely.
So
just
want
to
flag
the
board,
to
revise
guidance
proposed
guidances
available
to
you
and
if
board
is
happy
to
support
the
proposed
changes,
we
will
publish
that
on
our
website
following
board
meeting
today,
and
that
will
be
effective
kind
of
immediately.
A
Thanks
kate,
it
might
be
a
good
moment
just
to
to
also
thank
stuart
dean
and
the
market
oversight
team
for
the
work
that
they
do,
because
it's
it
really
is
quite
important
but
pretty
difficult.
So
I
just
think
the
board
would
like
to
thank
them
any
any
questions
for
kate
or
fine
kate.
Your
lucky
day,
let's,
let's,
let's
move
on
ted.
E
Thank
you.
Peter
ian
has
already
referred
to
the
situation
in
hospitals,
but
just
to
remind
the
board
hospital
services
over
the
last
few
weeks
have
been
under
exceptional
pressure.
The
number
of
patients
with
covered
in
hospitals
is
now
beginning
to
fall,
but
it
is
still
at
a
very
high
level,
including
patients
in
intensive
care
on
ventilators.
So
the
pressure
continues
in
hospitals.
E
During
this
time,
we've
intensified
our
monitoring
of
services,
all
services
using
variety
of
means,
but
particularly
the
transitional
monitoring,
app
the
the
tool
we've
developed
for
this
to
gain
intelligence
around
areas,
particularly
independent
healthcare
and
the
new
vaccination
centers.
But
we
are
monitoring
the
intelligence
coming
in
on
all
services
across
the
board
where
necessary
and
where
we
identify
is,
we
are
taking
action,
and
that
is
often
working
with
other
parts
of
the
system
such
as
nhs
england,
to
make
sure
services
get
the
appropriate
support.
E
We
are
undertaking
a
few
risk-based
inspections
and
they
have
continued
throughout
this
period,
but
we've
always
been
very
mindful
about
not
adding
additional
pressure
on
services
already
under
pressure,
and
indeed
in
many
cases,
these
these
inspections
have
been
because
staff
have
raised
with
us
concerns
and
they've
asked
us
to
take
action
and
get
involved,
and
I
think
frontline
staff
often
welcome
our
presence
where
they
have
particular
concerns
about
quality
of
care
and
in
those
cases
we
will
produce
reports
and
take
action
as
necessary.
E
Delays
and
treatments
for
patients
is
a
great
concern
for
services
themselves
and
frontline
staff
are
very
concerned
about
their
ability
to
catch
up
with
some
of
this
backlog,
but
they
are
developing,
I'm
glad
to
say
detailed
plans
at
system
level
with
different
providers
working
together
in
a
very
joined
up
way,
which
I
very
much
welcome
and
we're
learning
from
how
they're
doing
it
and
willing
we'll
build
our
understanding
of
of
their
management
of
the
backlog
into
our
assessments
of
services
going
forward.
E
One
of
the
most
important
lessons
from
the
pandemic
is
the
importance
of
supporting
and
listening
to
the
workforce.
I
think
we've
learned
that
a
great
deal
in
terms
of
the
feedback
we've
had,
and
I
I
publicly
praised
the
workforce
of
speaking
up
about
concerns
and
raising
them
with
their
providers
and
with
us
and
at
the
height
of
this
wave
of
the
of
the
pandemic.
It
is.
E
It
is
clear
that
in
many
of
the
services
that's
been
badly
affected,
such
as
intensive
care,
medical
services,
emergency
medicine,
ambulance
services,
the
staff
have
been
been
very,
very,
very
deeply
affected
by
the
the
situation
they
found
themselves
in
and
the
care
they've
had
to
provide
in
very
difficult
circumstances,
and
it
is
vital
that
going
forward
the
staff
are
given
the
child
for
some
respite
and
in
the
immediate
future.
E
They
have
been
praised
often
by
the
services
they've
been
inspected
for
their
supportive
stance,
and
I
know,
as
I've
said
already,
the
staff
often
welcome
them
on
to
site.
I
am
convinced
that
our
regulatory
activity
is
having
a
big
impact
on
the
quality
of
care
and
is
helping
services
cope
with
the
pandemic
and,
and
I
think
it's
really
important-
we
recognize
the
contribution
of
our
staff
as
well
as,
of
course,
all
the
frontline
staff
and
clinical
services
who've
been
working
so
hard
over
the
last
few
months.
A
Can
I
very
much
support
what
you
were
just
saying
I
mean
the
having
a
recovery
plan,
for
the
backlog
is
really
important,
but
having
a
recovery
plan
for
the
staff
is
is
an
integral
part
of
that
I
mean
I,
I
people
are
exhausted
emotionally
and
physically,
and
not
only
do
they
as
human
beings
need
didn't,
deserve
to
be
able
to
recover,
but
from
our
point
of
view
when
people
are
exhausted,
that's
when
accidents
happen.
So
from
a
safety
point
of
view,
that's
really
important.
A
There
is
the
the
recovery
for
staff
as
well
as
then,
a
recovery
plan
for
the
backlog,
and
I
just
worry
that
there
will
be
a
a
public
or
political
expectation
of
things
happening
to
get
waiting
lists
down
and
so
on,
more
more
immediately
than
is
is
feasible.
So
I
think
we
just
need
to
have
a
an
eye
on
that.
Otherwise,
as
I
say
that
accidents
will
will
happen.
E
I
I
totally
agree
with
that
peter.
I
think
it
is
important.
We
do
remain
a
strong
voice
for
patients
who
are
who
need
care,
and
we
I'm
determined.
We
will
do
that,
but
we,
I
think,
we're
serving
their
best
interests
if
we
support
staff
as
well-
and
I
think
we
can
combine
the
two
and
we
need
to
we
need
to.
We
need
to
have
both
priorities
in
our
minds,
supporting
staff,
helping
them
recover
from
the
the
pressures
they've
been
under,
but
equally
supporting
patients
to
get
the
care
they
need.
F
Thank
you
well,
my
question
is
about
staffing
and
I
too
would
like
to
join
in
the
tribute
to
this
staff.
You're
working,
sometimes
under
quite
impossible,
almost
impossible
conditions,
and
it's
really
about
that.
I
want
to
ask
in
relation
to
our
approach
to
the
standard
of
care
provided
and
the
safety
of
care,
which,
of
course,
is
a
priority.
F
The
reality,
as
I
understand
it,
in
some
places,
particularly
some
cc
use
in
recent
days
times,
has
been
that
the
staffing
levels
have
not
been
possible.
The
normal
staffing
levels
have
not
been
possible
and
indeed
the
normal
qualifications
required
of
staff
providing
care
has
have
not
been
possible
either.
The
most
extraordinary
efforts
have
made
in
some
places.
Sometimes
I
hear
with
consultants
taking
the
place
of
nurses
at
bedsides,
doubling
up
and
so
on.
F
Bearing
in
mind
all
that
and
the
difficulties
are
we
saying
we
require
the
same
standard
of
care,
the
same
safety
levels
as
always
or
but
and
therefore
something
needs
to
be
done
or
are
we
saying
we
recognize
that
in
these
extraordinary
times
that
can't
necessarily
be
done
and
we're
doing
the
best
we
can
and
do
we?
How
do
we
make
those
decisions
when
we
get
expressions
of
concern
or
whatever?
E
What
we
have
said
very
clearly
is
we
expect
services
to
give
the
safest
possible
care
they
can
within
the
resources
available
to
them,
and
I
think
we
all
recognize
that
services
have
been
enormously
stretched
in
resources
terms
and,
most
importantly,
in
terms
of
staffing,
I
think
some
of
the
staffing
flexibility
we've
seen
in
response
to
the
pandemic
has
been
really
very
innovative
and
I
I
wouldn't
necessarily
always
cite
it
as
a
diminution
standards.
E
But
but
equally
we
have
recognized
and
we
did
work
with
nhs,
england
and
providers
to
to
to
establish
new
standards
around
their
staffing
and
intensive
care,
etc,
where
the
one-to-one,
the
normal
one-to-one
approach,
could
not
be
maintained
just
because
of
the
the
enormous
expansion
in
expanding
in
intensive
care
patients
going
forward.
E
So
so
I
I
think
it's
a
very
balanced
view.
I
think
there's
some
real
positives
come
out
of
this
in
terms
of
using
staff
in
a
flexible
way.
I
think
it's
something
we
want
to
carry
forward
because
the
service
is
under
pressure
every
winter,
but
we're
getting
later
on
in
the
agenda
to
talk
about
winter
pressures
and
actually
some
of
that
flexibility,
we've
seen
in
response
to
covid
would
be
very
welcome
in
in
the
normal
settings
of
winter
pressures
and
other
times
where
service
services
are
facing
increased
increased
workload.
F
F
They've
been
told
it's
different
and
and
so
on,
and
the
stress
and
strain
in
relation
to
a
staff
feeling
perhaps
isolated
in
that
way,
and
perhaps
feeling
indeed
the
cq
inspector
might
be,
or
some
other
regulator
might
come
becoming
calling
is,
is
part
of
the
stress
that
from
which
they
are
going
to
need
to
recover,
and
I
wonder
I
do
hope,
we're
able
somehow
to
mitigate
that.
So
staff
can
be
reassured
in
these
circumstances.
They
are
doing
what
we
recognize
as
their
best.
E
I
I
think
what
we've
seen
in
terms
of
staff
contribution
has
been
tremendous
and
I
and
I
think,
we're
all
very
impressed
by
the
work
the
staff
have
been
doing.
As
I
say,
often
flexible.
You
talked
about
the
surgeon
being
the
assistant
on
the
intensive
care
which
I've
heard
of
you
know
in
many
places.
That's
not
that's
not
a
unique
happening.
E
It's
been
very
wide
where,
where
staff
actually
been
taking
on
roles
they
wouldn't
normally
take
on,
I
I
think
one
of
the
things
this
has
been
really
encouraging
during
the
pandemic
has
been
that
staff
have
been
willing
to
speak
up
about
their
concerns,
and
I
think
that
reflects
the
the
flexibility
they're
being
asked
and
if
they,
if
they
feel
that
they're
being
asked
to
do
things,
are
not
providing
the
safest
care
under
the
circumstances,
then
it
is
only
right.
They
should
raise
those
concerns.
E
A
G
Thank
you
very
much
peter.
So
just
a
couple
of
things
to
mention
from
me.
Firstly,
general
practice
is
as
well
under
huge
demand
like
many
other
parts
of
the
system,
but
I
just
wanted
to
take
this
opportunity
to
send
my
congratulations
and
thanks
to
primary
care.
G
Colleagues
who,
I
think,
have
pulled
out
all
the
stops
with
the
vaccination
program
and
have
been
doing
a
tremendous
job
on
top
of
already
a
very
busy
busy
workload
and
a
huge
demand-
and
I
think
we
what's
been
happening
with
the
vaccination
programme-
has
been
hugely
impressive.
So
so
I
that
that
was
the
first
thing
I
just
wanted
to
mention.
G
The
the
what
ted's
been
talking
about
about
backlogs
affects
the
whole
system,
so
that
has
a
huge
impact
on
on
primary
care
as
well
as
people
are
waiting
for
treatment,
and
that
is
also
having
an
impact
on
demand
in
primary
care.
And
so
we
are.
We
do
need
to
see
a
whole
system
approach
to
the
system,
recovery
and
and
backlogs
and
make
sure
that
all
parts
of
the
all
parts
of
that
pathway
are
very
joined
up
as
a
result
of
the
huge
demand.
G
We
continue
to
take
a
risk-based
approach
in
all
of
the
sectors
in
pms
and
we
are
following
up
concerns
and
acting
accordingly,
as
required
just
to
move
on
to
the
items
in
the
report.
The
reporter
highlights
two
areas.
The
first
is
around
the
work
we've
just
started
recently
in
safe
houses.
I'm
pleased
to
say
that
program
is
now
up
and
running
and
going
very,
very
well.
As
the
report
says,
this
is
the
first
first
time
anywhere
in
the
world.
G
We
believe
that
safe
houses
have
had
this
scrutiny,
so
we're
very
pleased
to
be
undertaking
that
work.
The
second
area
I
just
want
to
mention
is
the
provider
collaboration
reviews.
As
the
board
is
aware,
we've
undertaken
two
rounds
already
of
the
provider
collaboration
reviews,
one
that's
been
looking
at
the
care
and
the
interface
between
health
and
social
care
that
was
published
last
autumn.
We've
then
undertaken
the
round
with
urgent
emergency
care.
G
We've
published
a
report
around
the
interim
findings
of
that
I've
got
a
letter
going
to
ccgs
this
week
to
highlight
some
of
those
really
good
examples
that
we've
picked
up,
because
I
think,
there's
a
real
opportunity
for
ccgs
to
be
considering
and
systems
to
be
considering
these
innovations
that
we've
seen
across
the
country
and
learning
from
them
and
seeing
what
will
work
in
those
areas
and
what
they
can
do
to
to
prepare
themselves
for
future
future
demands
on
their
services.
G
So
that
is,
is
going
out
and
we're
looking
at
publishing
the
final
urgent
emergency
care
report.
In
the
spring,
we
did
pause
the
work
we
planned
on
cancer
due
to
the
pressures
in
the
system
we're
now
working
through
how
we
can
continue
the
work.
The
field
work
of
the
cancer,
the
mental
health
and
the
learning
disabilities
provide
a
collaboration
review.
G
These
are
all
areas
we
know
that
have
had
significant
impact
due
to
the
pandemic,
and
we
want
to
be
able
to
pick
up
the
learning
and
share
that
widely
and
work
with
those
local
systems,
so
that
that
is
very
much
the
next
stage
and
we've
done
a
lot
of
preparation
in
the
background,
so
we're
in
a
really
good
position
to
be
able
to
roll
those
out
as
soon
as
we
feel
it's
appropriate
with
the
local
systems.
A
G
Oh
sorry,
peter
I've
missed
that
we
were
talking
about
it
earlier
so
there.
Yes,
the
dna
cpr
review
the
do
not
attempt
cardiopulmonary
resuscitation
review.
We
I'm
pleased
to
say
we
have
now
undertaken
all
of
the
field
work
for
that
review.
As
the
board
is
aware,
we
published
the
interim
report
in
november,
which
hopefully
everyone's
had
chance
to
to
read.
G
We
are
planning
to
publish
the
final
report
in
march
and
we'll
be
looking
forward
to
sharing
our
findings
at
that
stage.
A
H
Thank
you
peter,
so
just
a
couple
of
updates
from
me
in
this
section.
Our
vaccine
program
rosie's,
already
mentioned
the
amazing
work-
that's
been
going
on
there,
but
our
inspection
teams,
the
hospital
teams,
have
started
to
monitor
the
trust
vaccination
centers
this
month
and
gp-led
vaccinations
are
being
monitored
through
our
normal
routine
activity.
H
We
are
creating
data
and
we
will
anticipate
that
we
will
be
putting
out
some
intelligence
reports
on
that
over
the
over
the
coming
months
as
we
as
we
as
we
do
more
work
in
this
space.
H
The
in
terms
of
just
one
other
thing
for
me,
our
annual
reports
from
accounts,
so
I'm
pleased
to
announce
that
we've
finally
managed
to
get
the
reporting
accounts
laid
before
parliament
on
the
11th
of
february,
and
these
have
been
delayed
significantly.
We
would
normally
expect
to
do
that
back
in
the
summer,
but
we
were
waiting
on
the
nao
to
finalize
some
in
some
audit
some
audit
bits
on
their
behalf
in
terms
of
local
government
pension
schemes.
That's
now
been
done
so
please
to
account
those
have
all
been
laid
and
are
okay.
I
I
was
just
going
to
make
the
point
about
local
government
pension
schemes
and
the
fact
that
the
delay
isn't
due
to
covid
it's
actually
due
to
audit
of
those
pension
schemes
and
that
that's
an
issue
that
isn't
just
for
cqc.
It's
actually
for
many
organizations
across
the
public
sector.
So
I
wouldn't
want
people
to
think
that
we'd
had
a
different
delay
to
many
others.
Thanks.
A
Thank
you
sally.
Any
questions
for
kirsty
gosh,
we're
doing
well
famous
last
words
mark.
Is
it
your
normal
nil
report
on
cyber
security?
He
said,
hopefully,
I'm
very
pleased
to
report
nil
report.
Yes,
absolutely
peter.
K
Good
chris
strategy,
great
just
two
bits
of
update
on
the
strategy.
First
of
all,
we've
been
supplementing
our
usual
conversations
with
stakeholders,
with
a
particular
focus
on
building
engagement
with
seldom
heard
groups
and
key
stakeholders.
We've
already
had
close
to
300
formal
responses,
but
we
know
there's
many
more
due
to
come
in.
K
There's
been
really
strong
support
for
our
four
themes
in
the
strategy,
in
particular
around
the
people
and
communities,
strong
support
for
the
idea
of
building
a
robust
mechanism
for
collecting
and
sharing
information
from
patients,
carers,
their
families
and
to
make
sure
we
can
build
that
monitoring.
K
Alongside
the
data
information
we
collect
from
other
sources
in
terms
of
smarter
regulation,
particularly
strong
support
for
the
idea
of
linking
data
information
to
site
visits,
to
have
a
sort
of
a
better
and
always-on
view
of
quality
safety
through
learning
a
really
strong
emphasis,
particularly
from
providers
on
how
we,
how
we
provide
support
for
learning
from
within
organizations
potentially
systems
and
also
nationally
in
terms
of
accelerated
improvement,
building
the
right
coalitions
in
the
right
sectors.
Some
sectors
have
different
support
mechanisms
for
driving
change
and
improvement.
K
The
responses
have
indicated
that
they
want
to
make
sure
that
people
secrecy
recognizes
those
and
works
with
those
different
groups
to
support
change
and
improvement,
but
a
really
strong
support
for
the
themes
and
strategies
so
far.
A
K
L
K
Thank
you
thanks
mark,
okay.
Chris,
do
you
want
to
move
on?
Yes,
so
just
just
some
quick
updates
on
some
of
our
work
in
parliament
recently
and
we
had
a
meeting
with
alex
norris
who's,
the
shadow
minister
for
public
health
and
patient
safety,
particularly
in
relation
to
maternity
services.
What
was
really
good
about
the
meeting
was
particularly
focused
on
on
nottingham
university
hospitals,
but
we,
we
representatives
and
cbc
met
with
the
regional
chief
nurse
and
a
regional
medical
director
for
nhs,
england
and
improvement.
K
I
think
the
importance
of
that
is.
It
gives
a
sense
of
the
system
working
together
to
support
change
in
an
area.
I
think
that's
going
to
be
really
important,
particularly
as
we
come
out
of
a
copic
crisis
that
we
can
demonstrate
that
we,
the
work
that
we
do
is
translated
into
the
work
that
nhsei
and
others
will
do
to
support
local
systems
and
local
services
to
change.
So
that's
a
really
it's
a
good
meeting,
but
I
think
it's
a
really
important
signal
that
we
send
about
how
we
work
with
other
partners
to
support
change.
K
We've
also
written
to
the
health,
health
and
social
care
select
committee
to
offer
a
further
update
on
our
progress
on
the
close
cultures
program.
That
kate
mentioned
earlier
and
there's
also
been
a
strong
support
for
our
position
regarding
the
regulation
of
ld
autism
services
from
from
government
and
parliament
and
there's
a
letter,
the
the
conversation
that
we've
had
with
the
again
with
the
health
and
social
care
committee.
K
K
Lastly,
just
to
give
you
a
sense
of
where
we
are
in
terms
of
our
support
for
the
bill,
there's
a
team
of
people
working
from
across
the
organization
on
the
bill,
just
to
make
sure
that
both
our
formal
response
and
also
the
way
in
which
we'll
work
with
the
dhse
will
ensure
that
we
can
deliver
part
of
our
strategic
ambition
in
the
strategy
through
through
the
building
as
it
as
it
develops
over.
The
coming
weeks
and
months
have
to
take
any
questions.
A
A
Perfect
so,
as
I
say
exactly
on
time,
we'll
move
on
to
the
quarterly
performance
and
finance
report,
I'm
not
sure
kirsty,
whether
you
or
chris,
is
starting.
A
B
Thanks
peter
so,
yes,
this
is
performance
report.
At
the
end
of
quarter,
three
we've
tried
to
include
some
some
additional
performance
and
indicators
in
relation
to
our
priorities
between
january
and
march,
just
for
a
bit
more
of
an
up-to-date
performance
position,
I'll
run
through
some
highlight
areas
and
then
invite
discussion,
questions
from
board,
so
in
terms
of
delivering
an
effective
and
efficient
registration
service.
B
This
is
slides
four
to
five
in
the
report
and
during
the
pandemic,
we've
we've
aimed
to
prioritize
registration
applications
that
help
support
the
system's
response
to
covert.
We
wrote
to
providers
with
applications
in
progress
in
the
middle
of
january
to
alert
them
to
possible
delays
to
ensure
being
open
and
transparent.
B
We
continue
to
monitor
the
impact
of
these
decisions
and
aim
to
minimize
any
delays.
This
is
included
redistributing
internal
resource
to
help
manage
our
response
in
terms
of
our
actual
business
plan.
Performance
quarter,
three
shows
we're
taking
on
average
100
and
just
under
114
days
to
com
process,
complex
applications
which
are
the
the
smaller
in
volume
in
19.8
days
for
simple,
simple
applications
which
are
of
greater
volume
in
in
terms
of
we.
We
use
our
intelligence
to
regulate
registered
services,
which
is
slides
six
to
ten.
B
Ninety
seven
percent
of
safeguarding
alerts
have
been
processed
within
one
day
against
the
target
of
95
percent
and
for
safeguarding
concerns.
That's
where
other
key
stakeholders
are
already
involved.
We
aim
to
record
our
action
within
five
days.
B
94
percent
of
recording
in
this
time
scale
against
a
target
of
95
we've,
seen
no,
a
gradual
increase
in
in
the
volume
of
whistleblowing
inquiries
that
received
each
month
with
just
over
11
000
received
by
the
end
of
quarter
three
and
then
in
january,
that's
recorded
the
highest
volume
received
within
18
months
period
and
represent
a
58
increase
from
january
2020,
so
safeguarding
and
whistleblowing
information.
B
It
continues
to
be
a
key
part
of
our
intelligence
to
identify
risk
as
that
9th
of
february
54
percent
of
inspections
triggered
by
risk
response
to
information
of
concern,
and
during
quarter
3,
we
ceased
to
use
our
csus
of
our
emergency
support
framework
and
expand
our
regulatory
actions
by
implementing
the
transitional
monitoring
application
at
ama,
as
the
9th
of
february
46
of
registered
locations
had
have
have
had
regulatory
action
from
us
during
the
year,
be
it
esf,
tma
or
or
inspection,
and
that
includes
just
over
5
000
inspections.
B
As
kate
mentioned
in
ac,
we
continue
to
undertake
ipc
inspections
to
support
establishment
of
designated
settings
designated
sized
name
of
freeing
up
capacity
in
the
system,
as
at
the
9th
of
february,
156
designated
scenes
have
been
approved
equating
to
just
over
2
000
beds
in
terms
of
enforcement,
where
we
use
enforcement
to
keep
people
safe.
B
We
where
we
decide
to
take
urgent
enforcement
action.
We
aim
to
save
notice
within
three
days
and
seventy
percent
of
situations
at
quarter.
Three
we're
achieving
this
for
93
of
situations
and
and
lastly,
for
me,
in
terms
of
we
equipping
our
people
and
organization
to
deliver
on
our
purpose
now
and
in
the
future,
which
is
slides
13
to
14
in
terms
of
turnover,
that's
tracking,
at
7.4
percent
against
10
target,
with
turnover
for
those
under
two
years
service
tracking,
slightly
higher
at
10.81
sickness.
B
Your
day
is
3.29
against
a
target
of
being
under
5
and
on
our
budget
revenue
budget
is
forecast
to
be
11.9
million
under
spent
at
the
end
of
the
year.
That
includes
a
potential
1.5
million
shortfall
on
provider.
Income
with
capital
is
now
forecast
to
be
0.3
million
under
spent
allays
concerns.
We
previously
had
that
that
could
potentially
be
overspent
for
the
year,
so
I'll
pause
there
and
open
up
for
any
questions
or
comments
or
would
have.
A
Thank
you,
chris
just.
A
To
congratulate
you
and
and
your
executive
colleagues
for
for
managing
the
financial,
the
budget
and
the
financial
performance
extremely
well
in
the
circumstances,
sally.
I
Thanks
peter
thanks
chris,
I
agree
about
performance,
given
we
will
have
an
underspend
and
obviously
the
pressure
on
public
finances.
Are
we
discussing
with
the
department
whether
we'll
be
required
to
return
that
money
or
whether
we'll
be
able
to
use
it
for
obviously
a
huge
level
of
transformation
program
that
we
will
have
in
21,
22.
A
So
can
I
can
I
appointment
christmas
want
to
comment
as
well?
No
doubt
maybe
in
as
well.
This
is
not
the
department's
money.
This
is
fees,
so
this
is
not
money
that
could
go
back
to
the
department
and
it
would
be
wrong
if
it
did,
because
about
half
of
it
has
come
from
independent
providers.
A
So
it's
it's
a
mixture
of
public
and
private
money
so
that
that
the
money
belongs
to
the
the
cqc
and
in
previous
board
meetings
sally
before
you
were
on
the
board.
We
we've
had
discussions
and
made
it
fairly
clear
that
you
know
over
time.
We
obviously
we're
not
not
a
for-profit
organization
so
over
time
either.
Any
any
any
surplus
in
one
year
is
is
used
for
for
future
work.
A
That
is
important
or
it
goes
back
to
providers
through
either
a
reduction
of
future
fees
or
or
avoiding
an
increase
that
would
otherwise
have
been
there.
So
he's
really
important,
because
I'm
glad
you
raised
it
because
other
people
raise
it
from
time
to
time,
but
it
really
is
important.
This
is
not
the
department's
money
or
it
belongs
to
the
cqc
and
ultimately
to
the
providers
who
paid
the
fees.
A
A
Yeah,
I
know
it
is
important
because
you're
not
first
person
to
have
asked
it
sally
mark
saxton.
L
Thank
you
chairman,
chris
thanks
for
the
performance
report,
regulatory
action
response
to
risk
that
chart
there.
I
think
that's
telling
me
that
we
are
accessing
a
whole
range
of
data
from
different
sources
in
order
to
take
make
a
response
in
terms
of
regulatory
action.
L
So
you
know,
I
think,
that's
what
the
chart
tells
me,
and
so,
as
such,
it
really
is
a
reinforcement
of
our
strategy
about
being
an
intelligence-led
organization,
because
we
we
are
already
gathering
from
different
sources
and
as
we
go
forward,
we
will
gather
more
and
more
and
we'll
be
able
to
refine
it
more.
I
think
that's
what
that
chart's
telling
me.
I
hope
that's
the
case.
C
I
just
wanted
to
use
that
as
an
opportunity
also
to
plug
our
give
feedback
on
care.
So
when
people
do
take
the
time
to
tell
us
about
the
quality
of
their
care,
be
it
good,
bad
or
mixed.
It
absolutely
does
inform
our
inspection
activity
so
on
that
chart
mark
it
talks
about
54
of
our
risk-based
inspections
being
triggered
by
information
that
is
given
to
us
by
people
who
use
services,
their
families
or
or
staff.
C
So
just
wanted
to
use
this
as
another
opportunity
to
say
to
people
keep
on
telling
us
about
the
quality
of
your
care,
because
it
absolutely
informs
and
makes
a
difference
to
how
we
direct
our
efforts
and
our
energies
as
well.
When
it
comes
to
inspection.
K
Day,
just
to
build
on
that,
and
also
to
thank
the
partnerships
that
we
have
with
organizations
case
exactly
right,
but
robert
obviously
is
on
the
call.
K
Healthwatch
is
a
really
strong
partner
in
the
in
our
work
and
give
feedback
on
care,
as
are
a
number
of
other
organizations,
and
I
think
it's
a
testament
to
the
partnership
that
we've
been
able
to
grow
and
still
understand
how
services
are
are
operating
outside
and
we've
seen
not
just
people
use
services,
but
also,
as
ted
mentioned
earlier,
people
in
services
providing
that
information
that
feedback
and
it
is
vital
if
we
are
going
to
drive
learning
and
we
are
going
to
drive
improvement,
which
are
key
parts
of
the
strategy.
M
It's
a
general
point
and
we're
not
going
to
put
chris
on
on
the
spot,
but
as
you
look
through
the
data,
it's
very
good
data
very
insightful
and
haven't
been
on
the
board
for
a
few
years
now.
I
think
we're
getting
much
more
insights
than
we
were
previously.
So
congratulations
to
the
team
of
being
able
to
provide
this
level
of
of
insight,
but
going
forward
as
we
become
more
intelligence,
driven
or
insights
led
then
do
we
see
this
sort
of
cause
and
effect
sort
of
data
coming
together.
M
So
if
we
were
seeing
more
whistle
blowing
or
safeguarding
or
slower
registrations,
would
that
lead
to
you
know
some
form
of
lack
of
service
or
or
degradation
of
service?
I'm
just
wondering-
and
I'm
not
sure
who
I'm
directing
the
the
question
too,
but
I'm
just
wondering,
as
we
become
sort
of
this
holistic
sort
of
intelligence-led
organization,
if
we
could
sort
of
connect
the
dots
and
actually
say
actually
we're
seeing
a
trend
here.
M
And
but
I
haven't
seen
it
sort
of
put
in
those
terms
as
we
become
intelligence
later,
I've
seen
that
we're
doing
data
collection
and
we're
putting
the
data
together
in
the
registration.
But
I
haven't
really
seen
from
a
strategic
perspective.
If
that's
the
direction
we're
going
or
if
I'm
just
reading
it
incorrectly
and
assuming
that
that's
the
direction,
we're
going
so
you're
getting
lots
of.
B
Thanks
jim
thanks
gerard
and
I
guess
to
answer
your
questions
specifically,
ultimately,
I'm
the
one
who's
who
you
should
devote
the
question
to,
but
but
but
I
think
that
the
serious
point
is,
I
think,
if
you
look
at
the
investments
we've
made
in
technology
over
the
last,
the
last
18
months,
in
particular,
our
ability
now
to
bring
together
dashboards
and
data
is
in
part
reflected
here,
but
actually
on
a
you
know.
B
On
a
day-to-day
basis,
we've
been
able
to
stand
up
dashboards,
look
at
particular
topics,
so
I
think
we're
at
that
stage
of
producing
dashboards,
but
part
of
the
transforming
our
organization
process
is
to
start
to
look
at
our
our
intelligence
and
data
handling
capabilities
more
more
broadly,
and
I
think
we
will
be
starting
to
look
at
multiple
different
data
attributes
types
of
data.
What
is
if
a
plus
b
plus
c
equals
it
comes
together.
B
So
I
think,
I
think,
there's
a
there's
a
skill
set
and
a
capability
that
we're
building
as
part
of
the
transformation
program
over
the
next
year
or
so
which
which
will
start
to
bring
some
of
these
things
together
in
an
innovative
way,
and
I'm
really
keen
that
that
we
see
that
we
use
for
the
research
and
development
we've
got
a
research
and
development
committee
which
is
headed
up
by
rosie.
B
That
will
start
to
look
outside
our
organization
outside
our
sector
and
start
to
look
for
for
lessons
and
hypotheses
from
outside
the
sector
that
we
can
then
use
our
our
own
data
to
look
at,
and
I
think
that
the
technical
platforms
we've
built
give
us
an
ability
to
do
that
quite
quickly.
Now,
in
a
way
that
you
know
12
18
months
ago,
we
probably
wouldn't
have
been
able
to
do
so.
Definitely
it's
the
direction
of
travel
thanks
gerald
thanks
peace.
A
M
Guess,
well
I'm
happy
with
that.
First
of
all,
but
I
guess
it
would
be
sort
of
good
to
see
it
sort
of
written
down.
Hence
what
I'm
saying
is.
I
think
this
isn't
listening
to
you.
M
It
sounds
like
we
are
going
in
that
direction,
but
at
the
moment
it
seems
more
of
a
a
process
of,
and
you
have
to
start
somewhere
by
collecting
your
data,
but
I
don't
quite
see
the
vision
and
then
then
we
could
say
you
know
these
bits
of
work
like
the
registration
work
and
and
the
sort
of,
and
some
more
of
the
insights
with
how
it's
I
don't
see.
M
What
the
end
goal
is,
and
maybe
I've
just
missed
a
paper
on
it,
but
it
would
be
good
to
see
that
and
then
sort
of
work
backwards
to
see
if
we've
missed
anything
and
also
you
talked
about
the
capabilities
within
the
organization.
I
know
that
sort
of
data
led
sort
of
predictive
analysis
of
you
know.
You
know,
as
we
assess
risk.
It's
probably
gonna.
Take
skill
sets
that
we
may
or
may
not
have
in
the
organization,
and
I'm
not
quite
sure
if
we
do
or
do
not.
M
But
it
would
be
good
just
to
see
that,
even
if
we
can't
achieve
it
today
and
we're
a
year
and
a
year
and
a
half
right,
it'd
be
good
to
see
where,
where
the
north
star
is
is
heading
and
what
roughly
it
would
look
like.
B
I
think
kirsten
wants
to
come
in,
but
I
I
suspect,
she's
going
to
say
some
version
of
it's
a
it's
a
piece
of
work
within
the
target
operating
model
that
helen
laurens
is
currently
currently
leading
on
to
do
exactly
as
you've
just
described,
and
I
think
I
was
only
speaking
to
helen
yesterday
about
this
around
recognizing
there's
a
set
of
capabilities
and
capacity
that
we
would
want
to
have
internally,
and
we
would
want
to
to
to
invest
in
people
both
in
terms
of
the
intelligence
group,
but
also
more
broadly
so
that
every
single
inspector
is
is,
is
capable
of
understanding.
B
The
data
and
information
is
put
in
front
of
them,
but
I
think
more
broadly,
as
what
other
the
third-party
relationships
that
we
want
to
build
to
keep
us
at
the
cutting
edge
of
of
some
of
this.
Some
of
this,
which
at
the
moment,
we
have
some
some
relationships,
but
we
need
to
probably
formalize
those
and
have
a
structured
sense
of
what
we
want
to
what
we
want
to
make
and
what
we
want
to
buy,
which
I
think
is
what
I
guess
at
the
heart
of
your
your
question
but
kirsty.
B
I
think
you
perhaps
want
to
comment
on
this.
H
I
think
you've
probably
said
everything
I
was
going
to
say
ian,
but
I
think
just
in
terms
of
the
timeline
for
this
stuff
this
this
is
a.
This
is
a
sort
of
the
key
enabler,
I
suppose
for
our
strategy
going
forward,
and
it's
a
bit
that
we've
prioritized
around
our
transformation
delivery
plan.
H
Anderson
said
we
all
become
data
generators,
as
well
as
data
consumers
within
within
the
organization,
and
I
think,
there's
a
there's,
a
there's,
a
big
cultural
piece
around
that
in
terms
of
how
we
collect
data,
how
we
store
it
and
how
we
use
it,
recognizing
that
it's
not
just
a
piece
of
paper
that
goes
into
the
system,
it's
actually
a
piece
of
intelligence
that
we
will
use
and
use
again
going
forward.
So
I
think
we'll
happily,
I
think
we're
going
to
bring
this
to.
H
I
think
the
business
case
for
ideas
coming
to
a
subcommittee
not
too
too
far
away,
so
we
can
spend
a
bit
of
time
doing
a
deep
dive
on
that
which
hopefully
will
answer
all
the
questions
that
you
may
have
on
this
space.
A
A
Great
good,
thank
you
chris
very
much
indeed
so
kirsty
it's
over
to
you
for
the
change
portfolio
update
and
I
think
amy's
joining
us
for
this
as
well.
H
Thanks,
I'm
not
sure
if
amy
is
coming,
but
I
I
will
I
will.
I
will
crack
on
with
this.
So
this
is
both
the
change
update
and
our
people
update
we've
rolled
them
into
one.
So
I'll
pick
up
the
change,
the
change
update
first,
so
over
the
last
quarter.
I
think
we
have
continued
to
make
good
progress
with
our
extensive
programme
of
change.
It
is
a
it
is
a
fairly
large
and
complex
beast
that
we're
dealing
with,
but
we
are,
we
are
continuing
to
push
to
push
forward.
H
Some
of
the
key
highlights
that
we
have
now
developed
we're
now
the
best
of
developing
our
business
case
to
support
the
work
to
deliver
on
our
new
target
operating
model,
and
this
is
based
on
the
high
level,
design
and
implementation
plan
that
we
agreed
both
with
the
executive
and
the
board
over
the
last
last
few
months,
we've
also
managed
to
open
our
new
london
office,
where
we
have
now
created
a
shared
space
with
partner
organizations.
This
is
a
new,
a
really
modern
working
environment,
with
lots
of
collaborative
space.
H
In
terms
of
some
of
the
people
highlights,
we've
also
introduced
the
workforce,
disability
equality
standard
setting
our
commitment
to
improving
the
experience
of
our
disabled
colleagues
and
we've
refreshed
our
approach
to
talent,
management
across
the
organization
and
we've
introduced
the
mind
workplace
well-being
index
to
promote
positive
mental
health
and
identifies
areas
of
focus
to
improve
our
approach.
So
just
a
little
bit
of
highlighting
some
of
the
some
of
the
a
bit
more
detail
on
some
of
the
programs.
H
The
transitional
regulatory
approach
is
a
program
which
we
set
up
in
in
directly
in
response
to
covid,
to
ensure
that
we
could
continue
to
monitor
and
support
providers
during
the
pandemic.
What
we
did
was
we
built
a
a
new
platform
to
help
us
with
intelligence
and
a
new
it
tool
to
support
this
approach.
We've
managed
to
we've
really
got
that
embedded
now
in
terms
of
our
ways
of
working
and
we've
rolled
that
out
across
the
business
now.
So
we
have
closed
that
program
as
it's
now
fully
fully
placed
into
business
and
working
really
well.
H
So
that's
that's
one.
That's
come
through
the
process
and
out
the
other
side
in
terms
of
the
target
operating
model
work.
As
I
said,
we
we've
now
signed
off
our
new
operating
model
and
ways
of
working
and
that
business
we're
now
focused
on
on
putting
the
business
case
together
for
that
piece
of
work,
we're
following
the
treasury
five
case
model
in
order
to
build
that
business
case,
and
it
will
be
a
portfolio
level
business
case
at
a
high
level
with
all
the
individual
programs
nested,
underneath
that
as
individual
as
individual
programs.
H
The
other
thing
we've
done
around
our
target
operating
model
work.
This
this
month
is
commenced,
as
organizational-wide
conversation
around
our
future
ways
of
working.
Those
conversations
have
been
led
by
by
ian
and
supported
with
the
executive
team,
and
then
we've
cascaded
those
messages
down
through
the
organization,
with
each
layer
of
management
being
informed
and
given
a
packs
that
they've
then
been
able
to
cascade
through
their
teams.
I
think
that's
gone
really
well,
and
we've
had
some
really
good
feedback
from
from
from
colleagues.
H
In
terms
of
the
way
the
messages
have
have
been
handled
and
how
we've
how
we've
managed
to
support
the
various
levels
of
the
organization
to
be
able
to
communicate
effectively.
H
Our
registry
platform,
which
is
going
to
basically
provide
our
new
operating
system
for
the
organization,
has
has
continued
to
make
progress.
I
think
this
is
going
to
be
a
key
tool
for
us
going
forwards
in
terms
of
how
we
drive
effective
and
efficient
working
practices
over
the
last
month.
We
have
focused
this
program
mainly
on
building
our
data
architecture
and
the
foundational
capabilities
of
the
platform,
so
things
like
architecture,
taxonomies
and
we've
also
used
it
to
support
the
capabilities
required
to
support
our
covered
work
and
the
the
piece
I
talked
about
earlier
on.
H
The
trans
transitional
regulatory
approach
has
really
utilized
this
new
technology
over
the
coming
months.
What
we
want
to
do
with
this
program
is
really
focus
on
embracing
taking
a
service
design
approach
to
really
embracing
our
process.
Redesign,
really
looking
to
simplify
and
streamline
our
key
processes
to
to
become
really
into
users
of
really
modern
ways
of
working
to
be
able
to
harness
the
information
and
make
it
really
easy
for
our
colleagues
to
use
use
the
data
in
an
effective
way.
H
Our
registration
transformation
program
now
continues.
We
have
we
have
launched
our.
We
launched
our
new
digital
register
with
cqc
a
while
back
we're
continuing
to
scale
and
iterate
that
and
we're
now
focusing
on
the
final.
The
next
phase,
which
is
to
allow
separate,
registered
manager
applications
to
be
made
through
the
new
system.
H
Feedback
from
users
has
been
really
positive.
So
far
with
assist
people
saying
the
system
is
quicker
and
simpler
to
use
and
the
same
feedback
is
coming
from
our
own
internal
colleagues
who
are
now
processing
the
information
that's
coming
in
in
terms
of
ide
mark,
I
don't
know,
do
you
want
to
talk
about
that
intelligence
driven
enablers
piece.
J
Yeah
carry
on
yes,
so
I've
got
so
I've
got
a.
If
I
come
to
you
at
the
end
courtesy,
I've
got.
I've
got
just
a
a
few
things
for
updates
on.
If
that's,
okay,.
H
I
Thanks
peter,
I
was
going
to
follow
on
from
the
point
that
jorah
made
a
few
minutes
ago,
actually
around
goals.
So
it
feels
like
we've
done
an
amazing
piece
of
work
on
the
strategy
and
we're
getting
very
positive
feedback
and
we've
clearly
got
a
well-organized
change
program.
I
And
I
just
wanted
to
reassure
people.
I
think
there'll
be
more
scrutiny
at
the
auditing
corporates,
government,
audit
and
corporate
governance
committee
of
how
that
fits
together
and
how
we
look
at
risk
because
we're
clearly
in
a
very
pressured
situation,
aren't
we
as
part
of
the
health
and
social
care
sector
as
well.
So
I'm
conscious
of
the
the
pressure
on
our
staff
to
deliver
both
business
as
usual,
with
the
huge
efforts
they're
making
and
also
deliver
the
change
program.
So
I
kirsty
mentioned
it,
but
I
just
wanted
to
reiterate
bringing
all
of
that
together.
H
We
can
make
sure
that
we're
managing
those
interdependencies
to
ensure
that
we
are
delivering
things
in
the
right
order
to
enable
the
next
bit
of
work
and
the
next
bit
of
work.
So
it's
for
build
cumulative,
but
it
also
gives
us
a
really
good
understanding
of
the
interdependencies
between
the
program
and
that
delivery
risk
in
terms
of
if
one
bit
gets
delayed.
What
does
that
mean
here?
H
J
I
think
so,
perhaps
if
I
come
in
on
the
digital
update
just
before
cursing
moves
on
to
on
to
people,
then
that
might
fit
in
well
it's
okay,
and
so
so
very
briefly,
I
think
in
the
last
quarter
for
digital,
it's
been,
it's
been
a
it's
been
a
quarter
of
working
on
really
foundational
work
across
the
key
programmes,
so,
as
scarcity
said,
regulatory
platform
and
the
intelligence
driven
enablers
work,
but
also
continuous
improvement
work
in
our
technology
service
and
that
what
is
actually
pretty
groundbreaking,
pioneering
technology
in
that
in
our
new
shared
london
office
in
stratford
on
the
regulatory
platform,
as
kirsty
said,
there's
that
this
is
this
is
kind
of
core
foundational
work.
J
So
what
we've
delivered
is
a
a
new
data
architecture
that
sits
there
and
we've
synchronized
this
data
between
a
new
platform
and
our
old
platform.
So
that's
that
provides
a
really
good
grounding
for
us
to
continue
to
develop
in
in
our
new
system
and
have
have
data
flowing
between
between
new
and
old
and
and
that
will
that
will
really
underpin
a
number
of
streams
that
we
are.
We
are
running
in
tandem
alongside
that
service
design
approach
that
kirsty
talked
about.
That
will
make
a
significant
digital
transformation
for
our
providers.
J
We've
we've
also,
of
course,
continued
to
extend
out
that
traditional
transitional
monitoring,
app,
which
supports
our
current
regulatory
monitoring
activity
and
we've
over
the
last
quarter,
continue
to
extend
that
functionality
to
cover
areas
like
infection
prevention,
control
assessments,
designated
settings
in
adult
social
care,
and
now
the
monitoring
of
of
vaccination
centers
as
well.
J
But,
as
you
said,
that's
now,
that's
now
closed
and
we're
focused
on
our
on
our
regulatory
program.
Activity
going
forwards
and
the
the
main
work
around
intelligent,
different
enablers
is,
that
is
building
a
business
case.
That's
going
to
go
through
the
approach
approval
process
now
for
the
full
business
and
technology
work
to
support
our
strategy
to
become
an
insight
driven
organization.
J
But
in
the
interim,
we've
been
progressing
a
proof
of
concept
and
we've
built
a
foundation
of
microsoft,
azure
based
components
to
collect
and
manage
data
that
will
provide
and
does
provide
a
working
analytics
model
and
that
showcases
how
we
can
bring
the
relevant
insight
to
our
regulatory
work
in
the
next
couple
of
months
and
to
the
point
you
were
making
drawer.
This
is
the
underpinning
technology
that
will
support
that
future
ambition
and
the
work
that
helen
lorenz
is
doing
to
to
to
build
out
the
ido.
J
On
the
on
the
continuous
technology
improvement.
We've
successfully
concluded
that
digital
foundations
program,
but
we've
now
embarked
upon
what
is
continuous
improvement
and
new
service
desk
and
security
operations
center
are
settling
in
really
well
with
customer
satisfaction
levels
on
that
service
desk
over
90
and
we're
we're
now
halfway
through
a
roll
out
of
a
new
windows,
10
laptop
image
to
further
increase
the
stability
and
resilience
of
colleagues
technology,
which
has
been
a
challenge
with
everyone
working
from
home.
J
And
finally,
just
just
a
word
on
that
on
that
new
technology
to
support
the
london
office.
What
we've
implemented
is
something
which
is
quite
challenging
because
we've
got
not
just
the
cqc,
but
we've
got
four
arms
length
bodies
in
the
healthcare
arena
who
are
occupying
that
new
office
and
we've
built
out
the
technology
from
a
bare
office
to
support
all
of
that,
but
also
to
support
five
organizations
who
are
all
on
different
levels
of
technology.
J
And
what
we've
built
is
something
that's
actually
pretty
unique
to
to
government
hubs,
which
is
a
completely
secure
setting.
That
is
dynamically
configurable.
So
you
could
actually
go
to
any
desk
plug
in
with
your
machine,
and
it
would
dynamically
recognize
you
as
a
as
a
cqc,
individual
or
one
of
the
other
arms
length
body
organizations
and
provide
you
the
services
that
are
relevant
for
you
and
just
only
give
you
access
to
those
things
that
are
relevant
for
your
organization.
J
So
it's
not
only
fit
for
purpose
for
now,
but
also
will
support
new
ways
of
working,
agile,
flexible
spaces
and
any
changes
that
we
want
to
make
to
that
setup
in
the
future.
J
A
Thanks
peter,
thank
you.
No
thank
you
mark
any
any
questions
for
mark
so
mark
can
I
just
say,
as
a
as
somebody
who
was
dreading
having
to
get
a
a
different
laptop,
having
actually
managed
to
make
my
existing
one
work
quite
well.
A
The
new
one
arrived
and
the
the
the
whole
way
it's
been
managed
and
the
ease
for
which
you
you
move
to
the
new
one
when
you're
not
in
the
office,
I
thought
it
was
fantastic
and
you
might
just
pass
that
back
to
colleagues
really
well
done
I'll
pass
that
on.
Thank
you
peter
right,
nobody's
coming
in
with
anything,
that's
excellent
good.
So
kirsty
is
back
to
you.
I
think.
H
Yes,
thanks
so
in
terms
of
our
people
update,
so
we
I
think
we
first
say
that
we
have
a
a
lot
of
activity
happening
across
our
people
agenda.
I
think
we've
got
a
a
number
of
programs
and
activities
which
which
give
us
a
holistic
approach
to
building
both
the
skills
and
capabilities
we
need
in
the
organization
not
just
for
now,
but
but
also
into
the
future,
and
we
have
continued
to
make
some
really
some
really
good
progress
with
this
over
the
last
quarter.
H
So
some
of
the
things
that
we've
been
doing,
we
have
we're
about
to
launch
our
new
talent
talent
program
within
the
organisation
and
what
we've
been
doing
before
the
launch
of
that
is
working
closely
with
colleagues
across
the
organizations
and
our
networks,
so
that
we
can
really
develop
a
new
approach
to
talent
and
all
the
supporting
materials
that
go
alongside
that.
H
So
we
want
to
be
able
to
use
this
to
not
only
just
encourage
a
more
diverse
talent
pipeline
and
a
really
good
succession
plan
through
the
organization,
but
actually
to
use
our
talent
program
to
really
ensure
that
we
can
help
everybody
develop
their
career
whilst
at
cqc
and
tailor
that
for
people's
own
personal
ambitions.
So
that's
going
to
be
launched
this
this
month.
I
think
it's
a
really
good
development
piece
and
we'll-
and
hopefully
I'm
confident
will-
will
help
contribute
towards
our
towards
our
dni
agenda.
H
H
This
has
really
sort
of
codified
that,
and
it's
been
a
really
really
positive
piece
of
work
and
we're
now
starting
to
put
that
into
practice,
and
what
we're
now
doing
is
is
building
that
into
our
recruitment
process,
which
gives
us
a
much
more
structured
framework
to
for
our
recruitment,
both
in
terms
of
able
to
understand
our
candidate
stability
and
fit
for
the
role,
but
also
to
give
people
who
are
applying
for
roles.
A
really
good
idea
of
the
sort
of
skills
and
capabilities
that
we're
looking
for
on
a
sort
of
standard
level.
H
H
We've
found
we've
had
some
findings
there
that
we've
now
fed
into
the
recommendations,
fed
those
recommendations
into
our
diversity
and
inclusion
plan
to
make
sure
that
we
really
are
you
taking
that
learning
to
to
address
some
of
the
deficits
that
we
have
in
terms
of
our
our
diverse
our
diverse
workforce,
particularly
at
some
other
senior
levels.
In
the
organization
we've
had
an
ongoing
review
of
our
processes
of
our
policies
to
really
make
sure
that
we
bring
those
up
to
date
and
modernize.
H
Those
we've
been
working
on
these
over
the
last
year,
taking
a
chunk
at
the
time
and
over
the
last
quarter.
We've
we've
now
reviewed
seven
key
policies
and
put
those
into
action.
That
sounds
like
a
a
quick
statement,
but
there's
a
huge
amount
of
work
that
goes
involved
involved
in
those
process.
Reviews
really
engaging
with
our
colleagues
and
unions
to
make
sure
that
those
policies
are
fair
and
fit
really
set
for
purpose.
H
As
I
said,
we've
continued
to
focus
on
our
dni
agenda
and
this
time,
for
the
first
time,
we
have
now
talked
participated
in
the
workforce,
disability,
equality
standards
and
we
are
also
continuing
to
participate
with
the
workforce,
race
quality
standard,
and
we
are
focusing
on
the
key
issues
that
have
emerged
through
those
processes
and
feeding
those
into
our
dni
strategy.
H
As
part
of
that
work,
we've
also
been
well
challenged
by
our
newly
established
action
for
race,
equality
group
and
they're
there
to
make
sure
that
we
we
are
ambitious
in
our
in
our
targets
around
our
dni
agenda
and
they've,
been
really
really
positive
and
helped
really
ensure
that
we,
we
are
being
ambitious
in
in
what
we're
looking
to
do
around
around
this
really
important
agenda.
H
The
other
thing
that
we've
really
that
we've
done,
which
is
really
quite
exciting,
I
think,
is
to
to
help
us
improve
understanding
and
cultural
awareness
at
a
senior
level
in
the
organization
we've
implemented
a
reverse
mentoring
program.
So
now
every
senior
leader
within
cqc
is
being
monitored
by
a
black
and
ethnic
minority,
a
black
or
ethnic
minority.
Colleague,
it's
been
a
really
insightful
place.
I
I
have
my.
I
have
a
mentor,
as
does
everyone
else
on
the
board,
and
it's
been
a
really
insightful
process.
H
Our
well-being
continues
to
be
important,
particularly
at
the
moment
we've
got.
We've
got
a
lot
on
our
plate
in
terms
of
both
responding
to
to
the
pandemic,
but
also
ensuring
that
we
can
keep
the
sort
of
business
as
usual,
work
going
and
also
continue
to
develop
the
organization
for
our
future.
So
we
have
a
clear
focus
on
our
well-being
and
working
with
the
people
leads
to
make
sure
that
we
are.
H
Pathway
and
as
part
of
that
work
we'll
be
not
just
looking
at
some
basic
management
skills
and
sort
of
things
about
how
to
have
difficult
conversations,
but
also
things
about
building
resilience
and
coping
with
coping
with
stress
and
things
like
that.
So,
as
I
said,
overall,
we
have
a
huge
amount
happening
across
our
agenda.
We
are
tackling
this
holistically
so
that
we
really
can
continue
to
build
and
support
the
organization.
Now
and
in
the
future.
H
We
have
a
big,
a
big
programme
of
organizational
development
that
we're
kicking
off
as
part
of
an
organizational
design
that
we're
kicking
off
as
part
of
our
target
operating
model
work
and
really
looking
at
the
skills
and
capabilities
that
we
need
to
build
for
the
future
and
working
out
how
we,
how
we
start
to
do
that
and
align
that
with
the
transformation
program
as
well.
So
that's
a
very
a
brief
run
through
of
some
of
the
activities
that
we've
been
doing
on
the
people
front
over
the
last
quarter.
A
M
You
want
to
come
in
just
one
just
one
question:
kirsty,
yeah
and
and
mark
and
ian
you
know
when,
when
you
have
like
a
transformation,
when
you
know
you
guys
have
done
transformations
and
I've
done
a
couple,
it
seems
like
the
goal
is
so
far
away.
It's
a
bit
like
well,
my
football
team's
never
going
to
win
the
premiership,
but
but
they
at
least
may
celebrate.
You
know
the
odd
occasional
win
that
they
get.
M
How
do
we
make
sure
as
part
of
the
engagement
that
we're
we're
also
celebrating
the
small
successes,
but
we
know
we're
moving
towards
this
north
star?
How
do
we
you
know?
How
do
we
sort
of
I
mean
in
that
I'm
sort
of
yeah,
just
listening
to
kirsty
and
mark.
I
was
like
wow,
you
know,
but
how
do
we
ensure
that
sort
of
engagement
there's
so
much
going
on
in
the
cqc?
M
That's
so
good
right
now
and
we
need
to
make
sure,
but
it's
it's
it's
tricky,
because
you
don't
want
it
just
as
a
sort
of
thanks-
and
you
know
you
move
on
to
the
next
project
and
now
you've
read
on
this
and
now
you're
amber
on
this,
and
and
so
it
isn't.
M
B
Yeah
thanks
peter
my
football
team
did
win
the
league,
the
premier
league
last
year,
but
they
may
not
again
this
year.
They,
I
think,
I
think
the
serious
point
is.
I
think
we've
got
a
no.
We
spent
a
lot
of
time
and
kept
cursing
touched
on
it
earlier
on.
We
spent
a
lot
of
time
over
the
last
two
to
three
years
on
projects
which
were
bringing
us
up
to
a
level
that
was
solving
problems.
So,
in
terms
of
the,
what
do
we
show
people
internally
around
what's
different?
B
Well,
we
show
them
the
la
you
know.
The
laptop
they've
now
got
on
their
hand
that
laptop
now
works
consistently.
It
now
runs
a
full
suite
of
digital
services.
It
doesn't
yet
give
them
access
to
advanced,
analytics
and
sorts
of
things
that
we
were
talking
about
earlier
on.
That
is
the
next,
the
next
phase.
So
I
think
I
think,
to
some
extent
we
can.
We
can
talk
about
problems
that
that
people
recognize
in
their
in
their
day,
job
which
we
have
now
solved.
B
There's
a
there's,
a
win,
I
think
in
in
there,
but
it's
also,
I
think,
about
drawing
colleagues
into
the
into
the
into
the
programs
themselves,
and
all
of
the
programs
have
got
engagement,
strategies
that
go
with
them
and
and
getting
them
involved
in
conversation
to
say.
Well,
you
know
these.
B
This
is
where
this
is
going
to
go
in
terms
of
your
north
star
point,
but
there
are
a
series
of
steps
to
get
there,
and
this
is
what
the
physical
things
might
be
and
those
steps-
and
sometimes
you
know
the
conversation-
might
go
something
along
the
lines
of
well
actually.
B
Can
we
deliver
this
at
this
thing
a
bit
earlier,
so
so,
there's
probably
no
completely
clean
answer
to
what
your
to
the
question
you're
asking,
but
I
think
it
is
absolutely
something
we're
aware
of,
and
it
was
something
that
when
we
were
running
the
the
engagement
activity
over
the
last
two
three
weeks
around
the
wider
transformation
activity
and
what
some
of
the
feedback
from
some
people
was
yeah.
This
is
all
very
interesting,
but
it
doesn't
look
like
it's
gonna
impact
on
me
for
the
next
12
18.
In
some
cases.
B
24
months
and-
and
that's
it
true
in
part,
but
I
think
from
our
point
of
view,
we
need
to
be
thinking
about
how
to
get
a
series
of
drops
of
delivery,
that
people
can
put
their
arms
around
and
see
and
touch
and
think
actually
that
is
making
a
difference
to
me.
Even
if
you
know
a
change
in
line
management
or
whatever
is
is,
is
a
way
away.
So
I
I
think,
I'd
like
that
sort
of
that's
some
of
it.
I
think,
but
peter
I'm
sure.
J
Thank
you,
I
mean
just
to
echo
what
ian
said
there
in
terms
of
you
know,
it's
absolutely
our
focus
to
get
a
regular
drumbeat
of
delivery
so
that
we
can.
We
people
can
see
and
touch
the
things
that
that
that
are
now
some
things.
Of
course,
I've
got
to
have
a
a
finance
system
has
got
to
have
a
start
and
an
end,
and-
and
we
won't
see
anything
until
the
end,
but
but
most
of
the
things
that
we're
working
on
we're
building
iteratively
and
we
will
have
things
to
show
people.
J
So
I
mean
example
of
that
is
on
the
tma
delivery.
We've
just
introduced,
something
which
is
a
portfolio
review
which
allows
people
to
record
inspectors
to
record
the
outcome
of
their
review
of
of
data
and
particular
monitoring
activity.
That's
something
we've
introduced,
as
part
of
you
know,
close
working
with
inspectors,
the
things
that
would
be
most
useful
to
them
in
in
their
work
and
that's
something
just
been
introduced
and
gone
live
very
recently.
J
We
also
have,
I
think,
which
is
which
is
helpful
as
part
of
that
engagement
journal
is,
is
regular
show-and-tell,
so
we're
showing
the
stuff
that
we're
developing
and
people
can
feed
into
that
and
and
that
there'll
be
the
opportunity
for
them
to
see
the
things
that
are
just
coming
up
and
and
see
them
as
they
as
they
as
they
land.
J
And
I
think
this
you
know.
The
important
thing
is
for
us
to
think
about
the
different
stakeholders
groups
as
well.
So
we
will
be
looking
across
all
the
different
aspects
of
our
regulatory
colleagues,
but
also
providers
and
also
the
public
as
well
and
looking
at
what
what
drops
we
can
make
at
various
times
to
show
and
demonstrate
progress
as
we
as
we
go
through
this
thanks
mark
kirsty.
H
So
so,
thank
you
so
just
to
add
a
little
bit
more
color
to
some
of
that.
I
think
yeah
we,
this
is
we've
set
this
out
over
the
next
five
years,
that's
a
long
long
time
as
a
program
and
there's
a
huge
amount
of
activity
and
I
think
to
bring
it
to
life.
We
talk
about
a
target
operating
model,
people
go.
What
does
that
mean
and
we've
broken
it?
H
I
think
we've
got
a
number
of
transition
states
where
we're
going
to
do
a
bit
of
work
and
there'll,
be
some
really
clear,
outputs
from
that
and
then
the
next
bit
and
the
next
bit.
I
think
we've
got
four
or
five
of
those
transition
states
over
the
next
five
years,
but
I
think
the
key
bit
that
we
need
to
do
is
at
the
end
of
this.
Of
that
period
of
time
we
need
to
be
really
clear
to
people
is
what
it's
going
to
look
and
feel
like
for
them.
H
How
is
it
going
to
be
different,
because
quite
a
few
of
those
early
transition
states
might
not
affect
that.
Many
people
across
the
organization
will
certainly
have
a
big
effect
on
some,
but
not
everybody,
and
I
think
the
work
that
we're
doing
around
building
personas
is
enabling
them
to
talk
about.
You
know
we
can
create
people
as
these
personas
that
start
to
talk
about
what
it
feels
like
for
them
to
do
their
job
on
a
day-to-day
basis,
but
actually
also,
really,
importantly,
given
the
real
sense
of
connection
to
our
purpose.
H
Oh
yes,
that
was
right.
We
can
keep
those
journeys
being
updated
as
as
we
as
we
progress
through
those
transition
states.
A
K
All
of
the
work
has
focused
on
for
for
the
work
that
coaster
turns
up
zones:
let's
focus
on
two
things:
understanding
and
recognizing
people's
problems
today,
so
that
would
be
colleagues
it
would
be.
Providers
it'd,
be
people
who
use
services
so
understanding
the
problems
of
the
day
and
the
ambition
of
the
future.
The
north
star,
for
me
is
a
strategy
which,
which
sort
of
links
those
two
things.
So
what
what?
What
problems
are
we
trying
to
resolve
today?
A
Thanks
mark
saxton,
you
wanted
to
come
in.
Are
you
talking
about
this
or
are
you
you
moving
on
to
a
different
subject?
Because
if
you're
moving
on
I'll
just
ask
jorah
if
he
wants
to
come
back
but.
A
Okay,
perfect
jorah:
do
you
do
you
want
to
respond
to
any
of
ian
mark
or
or
kirsty
or
chris.
M
M
It
was
an
interesting
book
about
amazon
and
I
can
share
at
some
other
point
where
they
work
backwards
in
the
books
about
backwards
and
and
there's
a
chap
who
went
to
and
presented
to
bezos
and
and
so
he
he
done
his
mba
and
come
out
of
yale
or
harvard
or
whatever
it
was,
and
he
had
his
spreadsheets
and
competitive
analysis
and
swot
analysis
and
gap,
analysis
and
and
sort
of,
and
so
he
did
this
sort
of
hour
to
to
besos
and
sort
of
looked
at
him,
and
he
went
that's
really
good
in
the
chat
said.
M
I
don't
think
he
actually
meant
that,
but
then
he
said
where's
the
mock-up
and
there's
the
mock-up
that
he
really
wanted
to
see
because
the
this
person
was
responsible
for
amazon,
music
and
they
couldn't
take
on
napster
and
all
these
other
companies
had
come
in.
But
through
that
mock-up
and
insight
from
other
parts
of
amazon,
they
came
up
with
alexa
and
they
said
there's
something
that
we
have
to
differentiate.
So
I
think
what
what's
just
been
said
is
really
cool
because
it
allows
innovation
across
the
organization.
M
Not
not
just
you
know-
and
you
know
the
digital
folks
or
or
the
technologies
or
the
product
people,
but
everybody
should
be
innovating,
and
I
think
by
having
these
show-and-tells
and
mock-ups,
it
allows
you
know
us
to
get
insight
from
the
inspectors
who
are
sort
of
going
well.
How
will
this
help
me
and
with
those
personas
that
kirsty
talked
about
so
yeah?
It
was
just
a
really
really
good
answer
and
and
yeah.
That's
it
from
me.
Thank
you.
Laura.
L
So
mark
saxton
to
you
thanks,
you
know
I
enjoyed
that
debate
as
well.
That
was
good.
I
want
to
make
a
separate
point
to
kirsty
to
say
that
I
think
it's
great
that
you
bring
this
report
to
to
this
board.
L
What
to
me,
it
tells
me,
is
that
there's
actually
the
the
ability
to
do
business
as
usual
and
to
transform
but
you're
doing
it
around
the
model.
The
model
is
the
people
plan.
That's
what
we
invested
in.
I
think
you
know
you
can
really
see
the
outputs
coming
through
each
element
of
the
of
the
people
plan.
So
you
know
I
really
support
it.
I
think
it's
a
it's
a
great
part
of
the
the
reporting
process
that
you
do
so.
Thank
you.
A
Great
ian
sorry,
you
want
to
come
back
in.
B
It
might
be
an
extreme
weather
event.
It
might
be
climate
change,
it
might
be
whatever
it
is,
but
I
think
over
the
next
five
to
ten
years.
We
need
to
be
thinking
about
the
ability
to
do
business
as
usual,
but
the
business,
the
ability
to
change
our
scope
and
the
nature
of
our
business
really
on
the
fly,
which
adds
an
additional
level
of
complexity
to
the
whole
idea
of
what
business
as
usual,
really
means-
and
I
think
all
of
our
thinking
is-
is
starting
to
move
in
that
direction
as
well
now.
B
A
A
Okay,
perfect,
very
good,
in
which
case
let's,
let's
let's
move
on
and
chris,
I
think
it's
with
you
on
the
insight
report.
K
Yes,
this
is
the
the
eighth
insight
report
that
we've
done
through
the
kobe
crisis,
so
I
thought
just
to
take.
We've
done
some
evaluation
over
the
last
few
weeks.
I
just
thought
I'd
give
colleagues
just
a
sort
of
a
reminder
of
why
we
do
this
and
a
little
bit
about
the
feedback
we've
had
so
far.
So
during
the
time
of
code,
it
was
really
important
that
we,
we
could
be
clear
about
what
we
were
seeing
in
a
more
timely
way
than
some
of
our
thematic
reports
would
allow.
K
So
it
was
very
important
to
me
that
we
were.
We
were
able
to
do
this
in
in
real
time
to
provide
a
clear
picture
on
the
key
themes,
offering
clarity
against
some
of
the
assumptions
and
the
anecdotes
that
might
that
might
be
there
and
to
try
and
speak
on
behalf
of
the
whole
system,
not
just
health
or
social
care,
so
that
we
have
a
good
understanding
of
the
themes
both
internally.
Next,
only
ourselves,
but
also
we
can
support
that
wider
conversation.
K
Just
in
terms
of
some
of
the
feedback
we've
had,
we've
been
testing
this
with
them,
both
providers
and
other
stakeholders,
and,
first
of
all,
in
terms
of
awareness
and
really
strong
awareness
of
of
the
products
of
existence,
which
is
a
useful
way
to
make
sure
it's
going
to
be
used
about
84
in
out
of
social
care,
77
in
hospitals
and
about
55
percent
in
primary
medical
services.
Obviously,
there's
work
to
do
on
each
of
those,
but
it's
a
good,
a
good
start.
K
But,
crucially,
for
me,
the
ability
to
take
action
on
on
the
back
of
what
the
report
was
said,
particularly
from
national
stakeholders,
but
also
from
local
providers,
was
important
as
well.
It
prompted
conversations
at
local
level
between
providers
and
local
authorities,
health
and
wellbeing
boards,
and
it
also
gave
organizations
like
healthwatch
and
other
organizations
the
ability
to
to
ask
other
pertinent
questions.
K
So,
just
to
give
you
a
sense
of
how
the
fact
we'll
continue
this
evaluation
over
a
period
of
time
to
to
look
at
how
we
can
provide
the
information
in
a
more
in
a
more
useful
way
for
people,
and
particularly
the
the.
What
we
found
is
that
the
consistent
data
that
we've
provided
at
the
back
end
of
this
report
really
does
guide
people
who
might
want
to
use
the
data
so
not
just
academics,
but
also
local
system
partners
to
take
the
right
action
locally.
K
So
I
just
wanted
to
give
a
sort
of
a
sense
of
how
the
reports
are
being
used.
This
report
to
report
a
takes
a
closer
look
at
how
urgent
and
emotive
care
services
in
secondary
care
and
community
care
have
been
affected
by
the
pandemic
during
during
the
winter.
It
highlights
the
action
taken
by
ckc
to
support
organizations
that
are
under
pressure.
K
The
challenges
in
emergency
services,
arising
from
an
increase
in
demand,
is
not
new.
In
fact,
even
before,
at
the
very
start
of
the
pandemic.
In
april
2020,
we
were
working
with
frontline
clinicians
from
emergency
departments.
To
look
at
how,
particularly
in
in
secondary
care,
could
support
mitigate
risk
and
what
they
could
do
to
to
manage
service
services
better
in
their
area.
K
This
led
to
the
publication
of
a
thing
called
patient
first,
which
was
a
a
document
that
said,
we
wrote
alongside
the
clinicians
to
give
a
real
sense
of
how
secondary
care
can
support
better
the
better
management
of
patients
through
the
secondary
care
pathway.
It
looked
at
a
number
of
issues
around
flow
around
infection
control
around
reducing
patients
need
to
be
in
emergency
departments,
staffing
across
the
across
ed
and
also
the
treatments
within
emergency
departments.
K
What
the
data
in
this
report
has
shown
is
that
there
are
still
some
challenges
that
that
some
organizations
are
facing
in
managing
the
flow
of
people,
and
particularly
those
admitted
in
to
hospital
in
the
timely
way,
and
it
demonstrates
some
of
the
variation
that
we
found
when
we
first
produced
the
the
patient
first
principles.
K
K
This
report
also
shows
some
of
the
variation
in
different
parts
of
the
country.
Urgent
emergency
care
is
not
just
about
acute,
a
and
e
departments.
It
also
covers
primary
care,
community-based
care
and
all
services
contribute
to
how
people
receive
an
emergency
response,
as,
as
rosie
said
earlier,
we're
shortly
going
to
publish
our
urgent
dementia
care
provided
clarity
review,
which
shows
some
of
some
of
the
of
the
the
interesting
insights
about
how
different
parts
of
the
country
have
managed
during
the
covic
crisis.
K
What's
clear
to
me
and
probably
cleared
to
others
is
where
there
are
good
pre-existing
relationships.
The
kovid
pandemic
acted
as
a
catalyst
for
collaboration
between
primary
and
secondary
care
and
it,
and
it
often
relied
upon
those
those
partnerships
and
that
understanding,
but
where
that
was
in
place,
then
governance
and
funding
and
the
setting
of
common
goals
was
much
easier
and
agreeing
how
we
can
how
we
can
support
this
moving
forward.
As
we
move
out
of
that
pandemic,
I
think
will
be
would
be
key.
K
Peter
pappy
takes
some
questions
or
comments
on
the
on
the
report
and
any
any
other
data
in
it.
Great.
A
E
Yes,
I
just
second
that
peter.
I
think
this.
This
is
excellent
and
a
big
thank
you
to
the
team
that
put
this
report
together.
I
I
think
it
produces
it's.
The
best
insights
I've
seen
into
what's
going
on
in
urgency,
emergency
care
over
this
winter,
and
it
is
a
very
interesting
picture.
I've
heard
people
saying
that
they
they
were
taken
aback
by
the
impact
of
capital.
E
Urgent
emergency
care
during
the
winter,
which
I
think
is
is
is
strange
because
in
truth,
we've
been
warning
about
this,
since,
as
chris
said
april,
and
the
college
of
emergency
medicine
has
been
worried
about
it
as
well,
it's
clear
that
kobe
d
is
going
to
have
an
impact,
but
actually
this
this
analysis.
That,
in
the
insight
report,
I
think,
is
a
very
interesting
a
reflection
on
the
impact
that
this
has
and
it
is
very
mixed.
E
E
These
issues
need
to
be
addressed
if
we're
not
going
to
have
more
difficult
winters
coming
in
the
years
ahead.
Thank
you,
ted
robert.
F
Thank
you,
a
really
great
report
and
please
keep
them
coming
they're
really
good.
My
question
is
about
capacity
and
the
comment
you
did
make,
which
chris,
which
is
actually
normal
figures,
thought
hey.
He
had
not
gone
up
and
I
understand
it
and
I'm
happy
to
be
corrected
for
this
wrong.
There
hasn't
been
a
spike
in
relation
to
flu.
F
In
fact,
flu,
which
has
always
been
the
previous
winter
problem,
is,
in
effect,
non-existent
and
hey
I'd,
be
fascinated
to
know
why
that
might
be
the
case,
but
secondly,
is
there
something
to
be
learned,
then
about
keeping
putting
it
bluntly.
Flue
cases
make
sure
they're
treated
in
some
different
way
other
than
a
e,
or
is
it
just
that
people
aren't
all
three
cases
are
now
thought
being
diagnosed
as
coveted,
there's
something
clearly
very
fundamental
here
that
it
strikes
me
that
the
system
actually
needs.
K
To
learn
from
I'm
trying
to
put
my
phd
hat
on
so
I've
been
talking
to
colleagues
in
phd
about
about
this.
I'm
sure
others
have
as
well
so
phe
know
they
do
regular
testing
of
the
population
around
flu.
So
it's
not
just
about
people
being
misdiagnosed
as
copied
or
flu,
but
you're.
Absolutely
right.
There's
been
a
a
tremendous
drop-off
in
in
in
flu
cases,
psg
believe
it's
a
result
of
the
of
the
the
social
distancing
and
the
world
of
masks
and
the
washing
hands
measures
that
that
came
with
them
with
kovid.
K
So
in
a
sense,
a
knock
on
impact
of
of
the
of
the
rules.
If
you
like,
around
covert,
has
meant
that
flu,
as
almost
I
think
the
last
case
was
sometime
in
december,
there's
literally
been
one
or
two
cases
over
that
time.
So
there's
very,
very
few
outbreaks
of
what
might
be
described
as
normal
flu
there's
also
been
an
increase
in
the
update
to
the
flu
vaccine,
which
may
also
may
also
have
supported
it,
but
you're
you're,
absolutely
right.
But
your
wider
point
then
about
what's
where
you
don't
see
those
other
those
indicators.
K
The
fact
that
the
hospitals
are
still
struggling
is
an
important
one
and
the
relationship
between,
as
we've
said
and
ted
said
on
many
occasions,
the
relationship
between
a
hospital
and
other
elements
of
its
local
network
are
really
important.
If
you're
going
to
manage
flow
effectively,
it
is
not
just
about
what
happens
inside
the
walls
of
the
hospital,
and
you
know
we've
already
paid
tribute
to
them
to
the
people
who
work
in
those
in
those
settings
under
tremendous
pressure,
but
the
relationship
between
those
and
other
parts
of
the
system
in
an
area.
A
Good
jorah.
M
Just
a
quick
question
because
I
was
looking
you
know
a
great
report.
I
was
looking
at
page
13.
Does
the
definition
of
flow
and
the
relationships
in
a
in
in
the
network,
as
you
just
described
just
the
definition
of
well-led,
then
change
because
currently
I
guess
well-led
is
inside
of
your
own
network
or
inside
your
own,
but
does
our
definition
then
change
if
you're
looking
at
it
more.
K
Holistically,
I
mean
ted
may
want
to
come
in
here
as
well,
but
we've
been
looking
at
what
well-led
means
in
all
in
all
settings
and
all
sectors,
but
certainly
we
think
over
the
last,
probably
the
last
three
years
since
we
began
the
early
work
on
on
looking
at
systems
as
a
whole.
The
the
importance
of
leaders
not
just
managing
within
their
own
environment
but
being
a
part,
a
partner
to
a
local
system,
is
a
key
feature
of
how
well
led
should
be
devised.
K
So
there
are
already
key
lines
of
inquiry
around
this
area,
but
I
think
it's
this.
This
crisis
has
shown
that,
where
you
have
those
relationships
and
where
leaders
can
act
together
well
where
they
can
share
resources,
have
a
common
vision
and
have
common
metrics.
For
what
good
looks
like
you
will
get.
A
people
who
use
services
will
get
a
better
outcome.
So
certainly
it's
an
important
feature
of
of
well-led,
and
I
think
one
that
we
are
increasingly
going
to
focus
on
in
our
work
going
ahead
and
ted
wants
to
come
in
as
well.
E
E
Well,
just
to
second
that
really
I
I
mean,
I
think
we
we
need
to
understand
leadership
in
terms
of
system
leadership
when
it
comes
to
urgency,
emergency
care.
It
cannot
just
be
done
within
one
part
of
the
system.
You
can
have
excellent
leadership
with
the
emergency
department,
but
if
the
hospital
leadership
doesn't
support
them
and
the
system
doesn't
support
the
hospital,
then
they
can
still
run
into
capacity
problems,
and
I
think
the
capacity
mismatch
we
see
within
emergency
care
is
sometimes
physical
capacity.
E
Sometimes
it's
its
ability
for
patients
to
flow
through
the
system.
The
fact
we
see
that
mismatch
is
a
reflection
of
the
fact
that
system
leadership
has
not
really
grasped
the
issues
and
I
think,
there's
a
real
challenge
going
forward
that
we
should
look
at
well-led
from
a
system
perspective
wherever
we
can.
G
Just
to
add
to
that
as
well,
because
as
people
know,
most
of
them,
urgent
emergency
care
actually
happens
outside
of
the
hospital
and-
and
it's
so
important
that
the
system,
all
parts
of
the
system
are
involved
in
what
is
often
quite
a
complicated
kind
of
set
of
pathways.
G
Primary
care,
community
pharmacies,
dentists,
adult
social
care.
All
of
those
parts
of
the
system
need
to
be
taking
ownership
of
this
and
working
together,
and
I
think
we've
got
a
real
opportunity
as
we
work
with
our
system-wide
approaches.
We're
learning
through
the
provided
collaboration,
reviews
and
the
previous
work
we've
done
on
the
local
system
reviews
as
we
start
to
look
at
what
the
ics
developments
will
bring
with
the
white
paper.
G
I
think
there's
a
real
opportunity
for
us
to
test
this
because,
as
ted
said,
that
leadership
at
every
every
part
of
the
system
is
really
important
at
a
very
kind
of
small
primary
care
network
level
right
the
way
up
to
the
ics
level,
and
we
need
to
make
sure
that
all
parts
of
the
community
are
very
involved
in
those
discussions.
I
Thanks
everybody,
I
am,
I
agree
about
the
the
points
around
our
well-led
domain
and
the
importance
of
system
leadership.
I'm
just
wondering
whether
what's
happened
with
covid
is
actually
a
fundamental
shift
in
the
way
that
people
use
healthcare
and
it's
more
about
public
behavior.
So
lots
of
people
are.
I
You
know:
we've
been
trying
for
years
across
health
to
try
and
reduce
the
number
of
a
e
attendancies
and,
as
he
said,
spread
the
care,
the
emergent
and
urgent
and
emergency
care
around
the
system,
so
that
people
are
treated
in
the
right
place
when
they
need
it,
and
it
might
be
that
you
know
in
the
same
way
that
apparently
lots
of
hand
washing,
has
reduced
the
incidence
of
flu
and
also
bacterial
infections.
I
If
people,
if
the
public
continue
to
behave
in
a
more
health
conscious
way
in
terms
of
infection
prevention,
but
they
also
change
their
behavior.
They
don't
go
to
the
gp
as
often
they're
happy
with
remote
and
phone
conversations.
They
don't
go
to
a
e
as
often
because
they
seek
help
elsewhere.
Then
that
requires
us.
I
Doesn't
it
a
cqc
to
regulate
in
a
different
way,
but
also
to
make
sure
that
we're
still
encouraging
the
public
to
come
forward
for
treatment
when
they
need
it,
because
some
of
these
excess
deaths
that
we
have
seen
are
about
people
being
afraid
of
covert
and
not
coming
forward
for
a
different
reason.
So
I
think
there's
a
really
interesting
piece
of
work
and
something
we
could
tap
into
around
public
behavior
as
well
as
the
way
that
we
look
at
leadership
of
the
system.
K
Absolutely
really
sally
we've
been
doing
some
work
with
nhs,
england
and
public
health,
england
and
and
sort
of
the
nudge
unit,
leading
this
piece
of
work
on
what?
What
out
of
this
crisis
do
we
want
to
promote
in
terms
of
a
a
different
way
to
offer
public
health
and,
in
our
context,
I
think
it's
important
people
can
still
feel
they
can
access
the
services
that
will
help
them,
but
they
don't
have
to
access
the
services
that
they
used
to
do
so.
K
People
used
to
there
was
a
lot
of
work
and
a
while
ago
to
say
why
do
people
go
to
a
e?
Well,
it's
a
branded
service
that
people
understand
and
people
know
about,
and
they
think
that
they
think
they
will
get
better,
but
actually
what
the
crisis
has
shown
is.
K
How
do
we
make
sure
that
that
access
to
care
is
managed
well
in
different
areas
that
responds
to
the
to
the
local
health
needs
of
our
population?
I
think
the
challenge
for
us
as
an
organization
is
how
do
we
support
that
work?
How
do
we
show
what's
working
well
in
different
areas
and
how
do
we
add
our
weight
to
the
changes
that
we
want
to
see
that
happen
that
happen
at
that
regional
level?.
G
G
What's
you
know
on
where
they
go
for
their
treatment
or
whether
they
can
self-manage,
and
I
think,
a
lot
of
probably
a
lot
of
the
people
who
haven't
attended
general
practice
or
a
e
departments
actually
have
had
self-limiting
conditions
that
have
got
better
by
themselves.
However,
I
think
we
just.
G
I
would
really
like
to
just
reiterate
that
message
that
it's
really
important
for
the
public,
if,
if
you
have
symptoms,
you're
worried
about
to
go
and
seek
help,
I
I
think
we're
all
concerned
about
the
number
of
people
that
haven't
got
the
help
that
they
need
either
felt
worried
about
going
in
and
accessing
that
help
or
not
being
able
to
access
the
care
and
treatment
they
need.
G
So
so
I
think
we
just
need
to
reiterate
that
message
that
if
people
are
worried
about
their
symptoms
to
to
go
and
get
get
the
help
they
need,
but
I
think
the
other
thing
our
role
is
absolutely
making
sure
that
people,
if
they
do,
need
help
they
are
able
to
access
the
care
that
they
need.
As
chris
has
said,.
E
A
E
Just
just
to
reiterate
what
rosie
was
saying
there,
services
will
work
very
hard
to
keep
other
urgent
emergency
care
available
for
people.
Who've
got
non-covered
conditions,
and
so
people
should,
if
they've
got
symptoms
that
are
concerned
about
that,
they
think
a
serious
illness.
They
should
be
seeking
help,
and
I
think
there
is
a
worry
that
some
people
may
not
have
been
seeking
to
help
they
should
have
been
over
the
past.
E
I
I
think
the
fundamental
issue
is
here
is
that
that
we
need
emergency
emergency
care
to
be
designed
around
the
way
people
need
it
to
be
provided
for
them.
The
reason
why
people
go
to
a
e
are
mixed,
but
a
lot
of
it
is
just
because
it's
open
24
hours
a
day
and
it's
a
walk-in
service
and
it's
easy
to
get
to
so
we
need.
N
Hi,
so
just
an
agreement
with
ted
about
the
way
people
use
services.
I
think
this
point
is
important
for
healthcare
workers,
but
then
just
any
kind
of
worker
in
the
uk,
and
it's
just
about
education
and
like
sickness
policies.
So
you
know
people
are
afraid
to
miss
work
because
of
having
the
common
cold.
That
could
then
extend
to
something
else
and
part
of
our
look
at
health.
N
Inequalities
should
be
sickness
policies
and
how
that
affects
people,
you
know
being
afraid
to
miss
a
day
of
work
and
missing
an
important
chunk
of
their
like
earnings
for
the
month,
because
you
know
they
have
a
cold
and
they
just
can't
do
that
and
then,
like
gp
appointments,
are
unavailable
after
seven
or
three
week
unsociable
hours,
it
can
be
really
difficult
to
access
kind
of
healthcare
services
that
you
need,
and
so
there's
been
a
mentality
before
craved
of
just
powering
through
and
coming
to
work
with
the
cold
and
then
obviously
causing
other
people
to
get
sick
as
well.
N
So
we
just,
I
think,
it's
important
to
note
that
people
earning
under
a
certain
amount
of
money
as
an
annual
income
won't
have
the
luxury
of
always
thinking
about,
maybe
like
their
health
in
in
a
daily
sense,
but
they're
more
rushed
to
a
knee
when
they
physically
and
emotionally
like,
cannot
breathe
or
something
like
that,
and
you
know
kind
of
visibly
need
the
help
that
only
any.
I
guess
in
that
situation
can
provide.
A
Thanks
latoya
good,
really
good
points.
Thank
you.
Stephen
has
just
joined
us.
So
stephen
welcome
to
the
meeting
any
other
points
from
anybody.
A
So
what
I'm
going
to
suggest
is
because
we're
running
just
miraculously
a
few
minutes
ahead
of
time
and
we've
got
various
colleagues
joining
us
for
the
next
two
items
so
sally.
Could
we
could
we
just
take
the
acgc
report
to
give
the
other
colleagues
a
chance
to
get
to
us.
I
Of
course,
thank
you
thank
you.
So
there
was
an
agc
meeting
on
the
3rd
of
february.
It
had
a
whole
new
cast
of
characters,
including
me.
As
the
new
chair
and
a
number
of
my
non-exec
colleagues,
we
have
produced
a
summary
report
in
a
minute.
It's
important
just
to
note
a
couple
of
things.
The
point
I
made
before
about
the
laying
of
our
annual
reporting
accounts
isn't
and
hasn't
been
a
cqc
issue.
I
It
is
around
the
local
government
pension
scheme,
but
I'm
very
pleased
that
we
have
been
able
to
lay
that
report
and
I'd
like
to
say
thank
you
to
all
of
the
people
in
cqc
who've
contributed.
I
know
chris
sasha
is
here
on
the
call
today
and
we
did
say
thanks
in
the
acgc
meeting,
but
I
think
I'd
like
that
recording
because
it
was
a
huge
effort
to
put
that
together.
I
It
does
have
an
implication
for
the
same
timetable
this
year,
because
the
national
audit
office
have
alerted
us
to
the
fact
that
the
same
same
timetable
and
the
same
delays
are
likely
and
we,
along
with
other
organizations
that
I've
been
involved
with,
have
challenged
them
on
the
timetable.
It's
ordered
to
seeking
reassurance
from
auditors
from
auditors,
particularly
when
most
of
those
pension
schemes
are
funded,
but
we
will
report
back
on
the
timetable.
I
think
just
expect
more
of
the
same
this
year.
I
I
I
Mark
saxton
and
jorah,
and
myself
are
going
to
operate
that
on
a
rolling
chair
basis
to
see
who's
relevant
in
terms
of
inputting
their
expertise
and
who's
relevant
to
chair.
But
I'd
like
to
say
thanks
to
mark
for
chairing
a
really
good
subcommittee
meeting
that
we
had
a
week
or
two
ago,
so
more
of
the
same
I'd
like
to
think
we're
being
dynamic
and
we're
supporting
both
the
new
strategy
and
the
whole
portfolio
of
change
programmes
that
we
have
and
look
forward
to
seeing
people
in
the
meeting
at
the
end
of
march.
A
Thank
you
sally
any
questions
for
sally,
so
can
I
just
say
I
mean
I.
I
wholeheartedly
agree
that
the
idea
that
it
becomes
routine
that
our
financial
statements
are
published
in
11
months
after
the
year
end,
it's
really
completely
unacceptable,
so
outside
our
control,
but
anything
we
and
other
organizations
can
do
to
put
some
pressure
on.
They
should
do
because,
certainly
that
the
hold
ups
are
not
at
our
end
at
all
great
good.
A
So
everybody
is
now
here,
I'm
not
sure
they
weren't
here
before,
but
anyway,
they're
all
here
now,
so
we'll
get
get
back
to
the
the
order
of
the
agenda.
So
the
next
item
is
the
action
for
race,
equality,
group
and
kirsty.
I
I
don't
know
whether
you're
gonna
just
introduce
this
sue
howard.
I
know
he's
with
us
and
you're
you're
extremely
welcome
sue.
Thank
you.
A
O
O
O
Everybody
I'm
going
to
introduce
talfik
to
you
who
is
going
to
he's
a
chair
of
the
race
equality
network,
but
he's
also
a
keen
member
of
the
action
for
race
equality
group
and
he's
going
to
present
this
paper
to
you
so
over
to
taothek.
Thank
you
and.
A
Tafik,
you
were
on
our
you
attended
our
board
not
long
ago.
So
most
of
us
very
know
you
very
well
anyway,
over
to
you.
D
Thank
you
very
much,
a
very
good
afternoon
to
you
all,
I'm
weirdly,
supported
today
by
a
colleague
of
mine,
omar
phillips
oma.
Do
you
want
to
introduce
yourself
please
thank
you.
D
I'm
sorry,
oh
I'm
so
sorry,
so
let
me
just
go
back
again
so
very
good
afternoon
my
name
is
tafik
balagun,
I'm
co-chair
member
of
the
u.s
equality
network
and
member
of
the
action
forest
equality
network.
D
D
We
are
pleased
to
tell
you
that
a
dedicated
project
manager
has
now
been
recruited
to
support
the
action
forex
equality
group.
With
this
work.
We
would
also
like
you
to
support
our
next
steps,
which
list
below
for
the
development
and
implementation
of
the
ar
eg
engagement
plan.
The
u.s
action
plan
will
be
a
life
plan
which
will
be
added
to
amended
and
expedited
as
required.
D
A
B
Thanks
peter,
I
just
wanted
to
search,
extend
my
thanks
to
tafik
and
and
sue,
and
a
number
of
other
colleagues
who've
worked
very
hard
on
this.
I
think
that
the
really
important
point
here
is
those
three
aim.
Statements
are
designed
to
be
three
big
statements
of
of
of
principle.
They
are
there's
a
tangibility
to
them,
which
is
which,
which
is
good,
but
it
they
are
supported
very
much
by
the
by
the
the
race
quality
scheme,
which
has
a
series
of
of
smaller
actions
and
smaller
targets
within
it.
B
B
It's
not
a
challenge
that
we
as
cqc
alone
can
can
solve,
but
I
think
I
think
we
are
definitely
making
strides
in
the
in
the
right
direction
and
I
think
there's
also,
I
think,
a
a
sense
within
the
organization
that,
in
having
this
conversation
in
this
in
this
open
and
straightforward
way
that
we,
we
have
been
doing
that
we're
actually
able
to
influence
providers
and
making
sure
that
our
inspectors,
if
they
as
they
go
out
and
do
their
jobs,
are
able
to
influence
well
beyond,
like
the
walls
of
cqc.
B
So
a
big
thank
you
to
for
the
work
that's
gone
on,
but
also
recognizing
this.
This
is
a.
This
is
a
this
is
not
a
short-term
thing,
but
but
it's
something
that
I
think
everybody
is
incredibly
committed
to,
and
I've
been
really
pleased
at
the
the
level
of
the
groundswell
of
opinion
from
everyone
in
cqc
for
for
this
agenda
and
every
time
I
have
taufik
another
colleague
on
on
my
weekly
calls
and
so
forth.
There's
a
real
positivity
around
this
agenda,
which
I
think
is
is
is,
is
a
really
it's
really
good.
B
L
Thank
you
peter,
and
many
apologies
for
for
joining
so
late,
but
I'm
very
pleased
that
I
have
joined
just
in
time
to
very
much
welcome
this
this
paper
and
all
of
the
great
work
it
it
clearly
represents,
and
and
as
a
new
board
member.
This
is
very
much
me
kind
of
not
understanding
quite
yet
sort
of
the
the
culture
of
the
organization
and
how
you
will
work.
L
But
I
was,
I
was
struck
by
the
the
third
of
the
key
priorities:
zero
tolerance
of
discrimination
with
a
year-on-year
reduction
in
the
proportion
of
bame
colleagues
reporting
they've
personally
experienced
discrimination.
L
I
I've
had
lots
of
discussions
in
lots
of
organizations
over
the
years
around.
That's
great,
that's
fine!
It
does
rather
depend
on
the
degree
of
confidence
that
those
working
in
the
organization
have
in
the
reporting
systems
and
for
some
organizations
there's
kind
of
a
prior
issue
that
colleagues
may
feel.
L
L
So
I'm
interested
in
sort
of
where
you
feel
cqc
is,
in
that
sense
of
sort
of
general
internal
confidence
amongst
colleagues
that
I
can
report,
I
should
report
it
will
be
taken
seriously.
Someone
will
follow
it
up,
in
which
case,
if
everyone's
already
there,
you
could
expect
to
see
over
time
a
decline
in
reporting.
L
O
Yeah
I
can,
I
can
certainly
respond
to
that.
I
mean
you're,
absolutely
right,
stephen
in
that,
to
be
honest
in
the
first
instance,
we're
hoping
to
see
an
increase
in
that
if
we
get
this
right.
The
whole
point
of
this
group
is
that
it
is
a
very
much
a
collective
collaborative
group
from
right
across
cqc.
O
That
includes
organizational
development
includes
race,
equality,
network
colleagues,
but
we
also
are
tapping
into
every
opportunity
to
encourage
people
to
speak
up
so
we're
also
working,
for
example,
with
our
speak
up
guardians
and
tapping
into
to
the
facility
to
the
opportunities
that
we
have
there.
One
of
the
key
things
we're
going
to
be
doing
is
putting
together
an
engagement
strategy
for
this
group
and
we're
going
to
make
sure
that
the
work
that
we're
doing
is
really
becomes
everyday
language
becomes.
O
The
business
of
everybody
becomes
something
that
people
talk
about
as
the
most
normal
thing
in
the
world
and,
to
be
honest,
we're
going
to
be
a
little
bit
in
people's
faces.
With
this,
we're
going
to
be
regularly
in
ian's
calls
we're
gonna
we're
gonna,
have
an
intranet
page,
we're
going
to
make
sure
that
we're
really
getting
the
message
across
loud
and
clear
that
this
is
a
cultural
shift.
We
expect
to
see
people
being
encouraged
and
promote.
O
You
know
to
speak
up
and
to
be
honest
about
the
experiences
that
they're
having
and
one
of
the
great
things
is
that
we
want
to
really
build
the
relationships
with
colleagues
from
a
black
and
minority
ethnic
background,
so
that
they
really
start
to
trust
us.
They
start.
They
really
know
that
they
can
come
forward,
that
they
that
they're
protected
that
they're
safe,
that
this
is
a
safe
environment.
O
A
Lots
of
hands
have
gone
up,
but
jill
do
you
want
to
come
in
jill
nicholson,
just
probably
responding
on
that
last
point.
I
expect.
P
Thanks
peter
so
steven
nice
to
meet
you,
I
think
we've
got
our
introductory
chat
in
next
week
or
so
I
think
it's
a
really
important
point
you
make.
We
have
data
from
our
regular
people,
surveys
which
indicate
the
difference
between
a
perception
of
bullying
and
harassment
of
discrimination,
and
then
the
reporting
of
any
incident.
So
yes,
we've
got.
We've
got
clear
data
which
indicates
that
there
is
a
a
gap
that
we
would
need
to
continue
to
to
address.
P
I
think
the
wider
cultural
piece
is
really
interesting
and
I'm
happy
to
pick
that
up
sort
of
separately
when
we,
when
we
talk,
I
think
for
me-
and
others
will
have
heard
me
say
this
before
sort
of
this
is
this
goes
to
the
heart
of
relationships
in
organizations.
P
It
goes
to
the
heart
of
the
confidence
and
skill
and
capability
of
line
managers
to
be
able
to
listen,
effectively
and
and
be
alert
to
issues,
but
and
therefore,
then
there
is
a
clear
relationship
and
trust
that
that
somebody
will
be
supported,
but
also
that
actually
people
are
aware
of
microaggressions
and
call
people
out
on
behavior,
and
I
think
you
know
we've
got
a
lot
to
do
in
order
to
like
many
very
many
organizations.
This
is
not
unique
to
cqc
to
really
focus
on
that
that
key
relationship
of
line
management.
Q
Thank
you
and
it's
it's
another.
This
is
I'm
raising
another
sort
of
general
line
management
point
in
relation
to
this
I
mean
I
would
I
would
commend
this
report
and
I
commend
this.
This
action
plan.
It's
wonderful
to
see
this
level
of
commitment
and
to
see
the
huge
amount
of
of
effort
that
has
gone
into
producing
such
a
comprehensive
plan.
You
know
this
really
will
change
the
dial
if
we
can
deliver
this
and
we've
all
got
to
be
behind
this.
Q
This
plan,
the
one
area
where
there
was
only
one
point
which
I,
which,
which
I
wanted
to
call
out-
which
I
thought
was
perhaps
a
bit
narrowly
presented
in
in
the
plan-
and
it's
the
one
on
feedback
after
after
interviews
on
on
page
four
of
the
of
the
report
and
and
the
recommendation
that
positive
and
meaningful
feedback
is
given
to
all
candidates,
you
know
yes,
absolutely
interviews
are
a
really
important
milestone
and
an
opportunity
to
look
at
the
whole
person
and
a
great
opportunity
to
give
rounded
feedback
for
people,
but
you
know
way
too
many
times.
Q
I've
found
over
the
years
line.
Managers
are
just
too
polite
and
too
nice
and
hold
back
and
don't
give
the
difficult
feedback
that
is
essential
for
people
to
to
make
progression.
So
you
know
so.
Yes,
absolutely
people
should
be
given
honest,
constructive,
candid
and
above
all,
actionable
feedback
following
following
interviews,
and
they
should
be
given
the
support
to
follow
up
on
that.
But
I
think
we've
got
to
make
sure
that
that
is
ingrained
in
all
interactions.
Q
By
managers
with
managers
so
that
you
know
people
all
the
time
are
given
the
support
that
they
need
to
address
things
which
might
be
holding
them
back
in
in
in
their
advancement.
So
I
might
my
incredible
would
be
to
to
make
sure
that
this
is
drawn
more
widely
and
there
is
the
you
know:
the
active
support
for
managers
to
have
those
rounded
conversations
and
candid
conversations
on
a
day-to-day
on
a
day-to-day
basis.
But
I
would
you
know
thoroughly
endorse
this
plan.
I
think
it's
it's
great
to
see.
A
Thank
you
mark
good
point
ally
and
then
robert.
R
Ali,
thank
you
just
to
echo
what
colleagues
have
said
a
really
excellent
report
and
really
important
that
we
are
focusing
on.
What's
such
an
important
area,
I
wanted
to
specifically
highlight
and
and
applaud,
really
the
fact
that
you
have
clarified
three
key
ambitions
in
such
a
direct,
clear
manner,
and
I
think
that's
going
to
be
a
real
strength
in
making
sure
that
we
focus
on
outcomes
as
we
continue.
Thank
you.
Thank
you.
Thanks.
F
And
then
robert,
thank
you.
My
praise,
along
with
everyone
else's
a
question
really
along
the
lines
of
stephen,
had
about
the
last
point
about
the
second
point
in
relation
to
recruitment,
career
development
and
so
on.
There's
a
stage
before
anyone
applies
for
a
job
or
a
post
or
training
or
whatever,
which
is
having
the
confidence
and
the
encouragement
to
do
that
and
some
people's
life
experience,
but
rather
as
it
does
in
the
harassment
space
suggests
to
them
wrongly.
F
And
I
wonder
what
is
intended
to
be
done
in
that
space
in
relation
to
in
the
responsibility
that
line
managers
have
to
encourage
people
to
think
of
themselves
differently.
In
terms
of
you
know,
they
can
do
things
and
put
themselves
forward
and
the
extent
to
which
the
culture
of
our
organization
is
one
which
just
expects
that
to
happen,
but
one
where
it
assumes
that
it
happens
so
jill.
P
I'm
happy
to
comment
on
that.
Thank
you
so
robert.
I
think
it's
a
really
good
point
that
you
make.
We
we're
doing
a
lot
of
stuff
that
should
guide
our
line
managers
to
have
the
right
kind
of
career
conversations
with
their
colleagues,
we're
just
about
we've
refreshed
and
just
about
to
launch
our
new
talent
strategy
so,
and
that
goes
throughout
the
organization,
so
encouraging
career
conversations.
P
So
actually
I'd
expect
by
managing
through
a
process
that
we
will
not
only
identify
those
who've
got
potential
to
progress
and
be
able
to
then
support
them
to
develop
and
deploy
them
and
mobilize
them
effectively
across
the
organization,
because
that's
a
key
part
of
development
for
me,
but
also
that
we
have
got
we've
got
an
opportunity,
then,
to
sort
of
spot
where
we
might
have
some
cold
spots,
so
really
have
some
data
that
helps
us
understand
where
the
right
quality
of
conversations
work
will
are
not
actually
happening
in
the
organization.
P
So
I
think
that
in
itself,
as
a
tool
will
help
us
and
the
work
that
we're
doing
through
the
people
plan,
online
management
capability
will
has
at
the
heart
of
it.
This
is
the
key
points
that
have
been
made
mark
made
them
really
chambers
made
them
around
around
feedback.
It
is,
it
is
vitally
important,
and
actually,
we've
got
anecdotal
and
clear,
also
qualitative
evidence
that
that
not
everybody
gets
feedback
in
sort
of
set
piece
recruitment
activity.
A
A
That
sorry,
robert
didn't
mean
to
cut
across
you
sally
and
and
then
I'm
going
to
go
back
to
traffic
and
then
we're
going
to
move
on
so
sally.
I
Yeah
just
a
quick
point
to
say
I
I
endorsed
a
report
and
applaud
the
aims
as
well.
I
think
the
proof
of
the
pudding
as
always,
is
in
the
eating.
Isn't
it
so?
I
We
have
a
fantastic
plan,
I
think,
as
a
board,
it's
up
to
us
and
through
the
race
quality
action
group,
to
monitor
improvements
in
the
statistics
we
have-
and
I
think
I'm
writing
saying
that
cqc
is
one
of
the
larger
health
arms
length
bodies
that
has
certainly
rares,
I'm
not
sure
about
disability,
monitored
on
a
number
of
actions
and
we
get
fed
back.
A
Thank
you
sally
tafik.
Do
you
want
to
say
anything
by
way
of.
D
Thanks
peter,
the
statistics
clearly
show
that
we
still
lagging
behind,
and
we
know
this
matters
will
take
time
to
clear
to
resolve
and
then
I
believe
we
on
the
right
track,
which
obviously
starts
with
the
acceptance
of
this
paper,
and
once
this
has
been
approved.
I
believe
there
is
nothing
further
in
doing
those
from
delivering
what
I
believe.
It's
a
societal
problem
which
I've
already
pasted
in
the
in
the
chat,
and
I
think
we
can
be
proud
of
us
going
forward.
A
Thank
you
very
much,
thank
you
and
thank
you
for
all
the
work
that
you
and
colleagues
are
doing
on
this.
I
I
think
I
can
safely
interpret
from
the
positive
comments
that
have
been
said
around
the
board
table
that
we
do
endorse
this
report
for
publication,
but
I
just
confirm
that
excellent.
So
we
formally
endorse
the
publication
and
we
will
obviously
be
watching
with
great
interest
how
how
successful
we
are
in
progressing
things.
A
So
let
us
move
on
as
to
the
next
item,
which
is
the
workforce,
disability,
equality,
standard
annual
report.
I
know
my
friend,
paul
kirby
has
joined
us,
I'm
not
sure
who's.
Introducing
this
mark
suddenly.
Are
you
in
anything
very.
J
Brief
introduction,
so,
as
you
said,
we've
got
paul
kirby
is
the
chair
of
our
disability,
equality,
network,
joining
us
and
also
kieran
prashar,
who
I
will
hand
over
to
shortly.
You
can
provide
some
more
detail
about
the
report,
but
in
brave
brief
summary.
This
is
the
this
is
the
first
time
that
we
are
we're
adopting
this
standard.
So
this
is
the
nhs
stand,
standard
called
the
workforce,
disability
equality
standard,
and
it's
really
important
that
help
to
help
us
understand
and
improve
the
experience
of
disabled
colleagues.
J
As
part
of
the
introduction
of
this
standard,
we've
measured
ourselves
against
those
empirical
metrics
that
are
required,
and
that's
really
helped
us
identify
the
areas
for
improvement
for
us
and
we're
starting
to
we're
standing
up
a
project
to
help
us
develop
those
programs
that
action
plan
over
a
period
of
time,
in
a
very
similar
way
that
we
that
we
talked
about
in
the
last.
The
last
item
so
I'll
just
hand
over
to
kieran,
then
for
a
little
bit
more
detail.
T
Thanks
very
much
mark
and
hello,
everybody,
and
so,
as
as
mark
said,
we've
got
the
this.
The
first
time
that
we
are
pulling
together.
We've
kind
of
submitted
our
data
for
the
workforce,
disability,
equality,
standard
and-
and
I
just
wanted
to
say
kind
of
upfront
really
that
this
action
plan
has
been
jointly
developed
with
our
colleagues
from
the
disability,
equality
network
and
and
it's
a
real
product
of
partnership
really
and
so
a
big.
T
Thank
you
to
paul
and
his
colleagues
from
the
disability
equality
network
for
working
with
us
on
that
and
and
as
marcus
said,
the
plan
will
be
kind
of
overseen
through
a
project
group
led
by
mark
and
and
all
of
the
activities
that
are
within
the
action
plan
are
aligned
to
our
diversity
and
inclusion
strategy.
T
So
we
can
see
the
thread
running
through
all
of
this,
and
so
some
highlights
really
from
the
action
plan
just
to
draw
out
and
as
there
is
lots
of
detail
in
there,
so
we're
looking
to
improve
representation
of
disabled
colleagues
across
the
organization,
but
particularly
at
senior
levels.
And
that
is
a
theme
that
runs
across
the
wes
and
the
wadez
and
we're
doing
that
through
our
recruitment
approaches
and
ensuring
that
they
are
as
inclusive
as
possible
and
where
we
can
kind
of
look
to
introduce
new
ways
of
doing
things
and
to
improve
that.
T
Another
key
action
for
us
is
reviewing
our
reasonable
adjustments
policy
and
process
and
to
really
understand
what
lies
behind
the
inconsistent
experiences
that
colleagues
are
reporting
around,
having
reasonable
adjustments
in
place
to
enable
them
to
do
their
job
well
and
looking
at
how
we
can
improve
that.
So
that's
a
really
key
part
of
the
action
plan.
T
Another
one
is
working
really
closely
with
paul
and
colleagues
in
the
disability,
equality
network,
on
understanding
the
issues
that
are
lying
behind.
Colleagues,
reporting
higher
instances
of
experiences
of
bullying
harassment
and
discrimination,
whether
that
be
from
the
public
or
whether
that
be
internally
and
again,
there's
a
link
here
across
and
between
the
res
and
the
modest
around
using
a
respect
campaign
to
really
start
to
promote
the
behaviors
that
we
expect
within
the
organization
and
zero
tolerance
around
those
behaviors
that
we
don't
want
to
see.
T
And
finally-
and
there
is
also
a
continued
focus
on
improving
our
data
and
increasing
the
self-reporting
rates
and
for
disability,
which
we
know
kind
of
vary
across
different
parts
of
the
organization
and
doing
that
through
regular
campaigns
is
another
really
important.
Part
of
the
plan,
and
so
you'll
see
that
there
are
some
links
across
as
obviously
both
the
res
and
the
verdes
are
strongly
linked
to
our
diversity
and
inclusion
plan.
So
hopefully
you
can
see
how
all
of
these
activities
all
do
align
and
but
I'm
happy
to
take
any
comments
or
questions.
A
Q
Thanks
thanks
very
much
for
this,
and
and
yet
again
it's
you
know
it's.
I
don't
care
what
I
said
on
the
previous
item,
it's
great
to
see
the
focus
on
this
and
it's
great
to
see
a
spirited
approach
to
it
actually
being
translated
through
to
a
concrete
action
plan.
I
mean
that
you
know
things
are
not
going
to
happen
without
a
plan
and
that's
that's
great
to
see.
Q
I
had
a
question
in
relation
to
because
it's
the
first
year
that
we've
we've
submitted
this,
so
I'm
hoping
that
we're
going
to
get
some
some
some
benchmarking
information
in
response
to
this,
and
it
would
be
interesting
to
to
see
that
at
some
stage
I
mean
again,
you
know
context
of
that.
Benchmarking,
I
think,
would
be
useful
in
some
areas
where
we
probably
don't
know
what
level
we
should
be
at
so
things
like
self
barriers
to
self
reporting
and
disability
status.
Q
We're
probably
gonna
never
get
to
zero,
and
it
would
be
good
to
understand
where
we
think
we
should
be,
but
but
on
all
the
other
metrics.
Even
though
our
goal
doesn't
change,
our
goal
is
absolute
performance.
Relative
performance
is
quite
helpful.
In
terms
of
understanding,
relative
performance
is
helpful
in
terms
of
prioritization
and
it's
helpful
to
understand
where
you're
you're,
behind
your
peers
and
you
can
seek
out
best
practices
or
where
you
are
ahead,
and
you
should
be
encouraging.
Q
You
should
be
encouraging
others.
So
I'm
right,
I
think
that
that
we're
going
to
see
some
benchmarking
information
and
how
are
you
intending
to
use
that
to
hear
that.
A
Jill,
can
you
hang
on
to
that
because
I
know
stephen
and
then
sally
want
to
come
in
and
then
maybe
they'll
all
ask
questions
that
you
need
to
answer,
but
stephen,
first
of
all,.
L
Great,
thank
you
peter
and
again,
thank
you
ever
so
much
colleagues
for
a
really
important
piece
of
work
here.
The
the
area
I
just
wanted
to
to
understand
a
bit
better
is
is
how
you
see
this
relating
to
what
I
guess
is
a
is
a
wider
program
relating
to
mental
health,
because
we're
all
seeing
in
all
of
our
organizations.
I
guess
I
mean
significant
and
really
quite
worrying
trends
in
relation
to
mental
health.
L
How
does
how
does
that
sit
in
relation
to
a
sort
of
formal
policy
around
disability
in
in
the
workplace?
L
I
Yeah,
thank
you.
I
I
applaud
the
report
again.
I
wanted
to
say
I
think
there
are
some
fairly
quick
wins
such
as
you
know.
Only
around
half
of
people
think
that
we
make
relevant
adjustments
to
them
in
the
workplace
and
I
think
there
are
some
harder
wins
around
declaration,
for
example,
or
helping
people
understand
more
what
might
be
a
hidden
disability,
and
I
don't
know
whether
you
have
any
senior
people
in
the
organisation
who
who
are
happy
to
talk
about
something
they
have.
I
think,
have
just
enhanced
your
board
disability.
I
I
have
a
hidden
condition,
I'm
very
happy
to
talk
about
it.
I
never
used
to
regard
myself
as
disabled
in
any
way
shape
or
form,
and
I
still
don't
it
doesn't
affect
my
ability
to
do
my
job,
but
I
think
the
declaration
and
the
support
that
we
offer
to
people
is
quite
important
and
on
that
I
think
one
of
the
performance
reports
we
had
earlier
showed
that
we
have.
I
I
think
it's
around
12
in
the
relevant
population
who
declare
as
disabled
cqc's
is
around
seven,
but
there's
a
there's,
an
undeclared
gap
of
around
seven
and
there's
a
big
question.
Isn't
there
over
whether
we're
actually
representative
of
the
normal
population
and
that's
fine?
We
should
still
proceed
with
our
plan,
but
whether
we're
actually
not
because
of
the
undeclared
bit.
So
I
think
there
are
some
easy
things
to
do
and
some
harder
things
to
do.
A
Going
to
keep
putting
you
on
hold
because
there's
lots
of
things
for
you
to
come
back
on,
but
paul
paul
kirby.
You
have
your
hand
up.
I
think.
U
Yes,
I
did,
and
I'm
trying
to
put
my
hands
down
to
make
sure
it's
not
an
old
hand
that
I
keep
getting
just
to
reintegrate.
Some
of
the
comments
good
afternoon
border
remember
some
of
the
faces
I've
not
met
before
so
it's
good
to
see
some
new
faces.
I
just
wanted
to
reintegrate
in
the
the
den
group
we
have
so
many
I've
decided
to
have
so
many
subgroups.
Let
me
talk
about
stevens
you're,
about
mental
health.
U
We've
got
a
mental
health
subgroup
and
if
you
appreciate
the
disability,
it's
quite
a
range
from
somebody
mentioned,
like
the
hidden
disability
right
up
to
visual
and
hearing
impairment,
so
on
so
we've
got
eight
subgroups
in
the
den
that
have
specifically
targeted.
Certainly,
for
example,
we've
got
the
dragon
users
groups
that
focus
on
the
technology
issues
and
before
I
was
actually
filtered
all
those
issues
I
couldn't
deal
with.
So
that's
why
we
have
the
subject:
mental
health,
physical
and
we've
got
century,
and
so
on.
U
So
anything
the
commission
said
that,
can
you
look
at
this
policy
or
look
at
the
the
changes
or
even
just
moving
officer,
stratford,
any
barriers
and
everything
else?
I
can
allocate
those
to
certain
subgroups,
but
this
report
is
the
benchmark
of
the
start
of
that
step,
so
hopefully,
where
the
next
journey
will
be
is
hopefully
spread
out
with
other
areas,
and
I
appreciate
the
mental
health
is
a
big
vast
area
that
it's
more
now
than
ever
than
during
cobied
and
they're,
self-isolating
and
so
on.
U
So
this
is
the
a
good
start,
the
bench
sort
of
a
springboard
of
the
doing
that
report,
and
hopefully,
from
the
work
onwards,
working
with
the
od
team
that
we
are
have
more
focus,
but
what
really
would
help
with?
Hopefully,
the
next
pulse
survey,
with
a
lot
of
dna
strategy
in
there
that
will
benchmark
closely
what
we've
been
doing
and
what
changes.
So
it's
hopeful
and
it's
and
it's
it's
nice
to
be
involved
in
the
positive
changes.
P
Been
responded
to
respond
respond
to
a
couple
of
those
things,
so
I
I
actually
was
going
to
bring
paul
in
and
to
answer
your
particular
question,
stephen,
because
I
know
that
he
has
got
his
subgroups,
including
mental
health.
I
would
just
add
to
that
that
we
are
as
an
organization
offering
a
huge
amount
of
support
and
to
people
who
might
be
struggling
at
the
moment
because
of
the
ongoing
pandemic,
or
simply
because
they
are
having
a
particularly
difficult
time
anyway.
P
So
so
I
think
I
think
we
obviously
have
still
got
to
pay
really
close
attention
to
this,
but
I'm
I'm
confident
that
paul's
sub
group
are
alerting
any
issues
that
we
might
have
in
the
organization
and
bringing
them
to
me
and
the
od
team
to
to
to
share
we.
They
work
really
closely
with
our
well-being
reps
as
well.
So
that's
what
I
hope
covers
off
your.
So
your
important
question
on
mark's
point
about
benchmarking.
Yes,
absolutely
can't
wait
to
get
our
hands
on
the
data.
P
I
think,
as
you
articulated
and
in
as
well
in
in
terms
of
the
res
data
which
is
more
established
and
we've
been
publishing
against
for
longer
and
getting
access
to
sort
of
that
that
benchmarking
across
wider
organizations,
there
are
some
things
that
we
will
be
stronger
at
and
some
things
where
we'll
be
wanting
to
learn
from
those
who
are
in
a
better
place
than
us
and
have
learnt
some
lessons
already.
So
I
think
that
applies
to
both
to
the
race,
equality,
work
and
also
the
disability
equality
work.
P
So
I'm
really
keen
to
continue
to
look
at
that
benchmarking
and
sally
you're.
Absolutely
right.
Some
of
this
is
is
potentially
harder
to
shift
and
then
than
it
is,
and
I
think
on
the
reasonable
adjustments
and
the
data
that
we've
got
there.
I
mean
we
paul-
and
I
and
and
our
wider
teams
have
had
lots
of
conversations
about
this
previously
in
with
mark
sutton
as
the
sponsor.
P
I
I
I
think
it
does
bear,
although
you
describe
it
as
a
quick
win.
I
think
it
does
bear
some
further
work
and
understanding,
because
I
think
what
sits
behind
that
is
is
probably
some
local
interventions
and
activities
that
may
be
lacking
that
we're
not
actually
yet
aware
of.
P
So
I
think
there
is
a
probably
a
sense
that
paul,
through
his
net,
his
network
and
of
colleagues,
can
help
us
get
to
understand
more
what
it
is
that
is
impacting
the
the
the
percentage
of
people
who
are
saying
they're
not
getting
the
adjustments
that
they
need,
because
I
don't
necessarily
think
that
is
entirely
technical
or
equipment,
adjustments
or
contractual
changes
that
we
would
manage
centrally
so
there's
more
to
understand,
but
I
think
we
should
get
to
a
point
sooner
rather
than
later,
where
we
can
address
that
particularly
meaningfully
and
then
your
second
point
about
hidden
disabilities,
but
also
the
influence
and
and
and
of
senior
role
models
in
this
is
really
really
important.
P
I
was
having
a
conversation
a
few
months
ago
with
some
senior
colleagues
and
at
one
of
whom
said
I
have
a
long-term
health
condition.
I'd
never
considered
it.
A
disability,
I
don't
take
a
disability
box,
but
I'm
really
happy
to
share
my
story
and
I
think
the
power
of
storytelling
is
really
important.
It
encourages
people
to
feel
as
if
they
are
able
to
share
something
personal.
P
A
Thank
you
jill,
and
I
and
I
think
from
the
conversation
that
we've
just
had
I'm
pretty
confident
that
the
board's
happy
to
endorse
the
publication
of
the
of
the
report
everybody's
nodding
so
again,
thank
you
very
much
everybody
for
for
bringing
it
and
paul.
Thank
you
for
all
the
work
that
you're
doing
with
your
colleagues
much
appreciated.
A
Good,
no,
no
other,
no
other
business
from
the
board.
We
do
have
two
two
questions
from
a
member
of
the
public
robin
pike.
The
first
is
how
does
cqc
monitor
referrals
from
gps
to
hospital
trusts?
There's
some
examples
given,
but
I
went
I
went
to
read
those
out
but
ted.
That's
probably
one
for
you
to
answer.
Please.
E
Thank
you
peter.
So
as
part
of
our
inspections
of
hospital
trusts,
we
do
assess
how
they
manage
referrals
and
waiting
lists,
and
we
look
at
that
under
the
responsive,
key
questions.
So
the
responsive,
key
question
focuses
very
much
on
this,
and
this
is
particularly
a
feature
when
we're
looking
at
elective
services
and
outpatient
services,
and
I
think
robin
is
right
to
raise
this,
because
this
is
an
area
we've
found
problems
in
the
past
and
we
have
found
poor
practice
in
the
past
about
managing
referrals
and
waiting
lists.
E
But
we've
reported
on
this
quite
extensively
and
taken
enforcement
action
where
necessary-
and
I
think
practice
has
improved
considerably
over
the
last
few
years.
But
this
is
an
area
we
will
continue
to
keep
focus
on
going
forward
and,
of
course,
this
is
going
to
be
really
important
in
the
provider.
Management
of
the
backlog
of
care,
as
I
talked
about
earlier
on,
their
effective
management
of
waiting
lists
and
referrals,
is
going
to
be
absolutely
central
to
make
sure
that
people
do
get
the
right,
prioritization
and
the
right
care
at
the
right
time.
E
Robin
mentioned
ccgs
in
their
role.
Of
course,
we
don't
regulate.
Ccgs,
but
his
reference
to
them
is:
it
is
an
important
reminder
of
the
importance
of
how
patients
experience
care
within
systems
and
how
it's
really
important.
The
system
builds
care
around
the
needs
of
individual
patients,
and
that
is
very
much
a
feature
of
our
strategy
going
forward.
A
K
Yeah,
so
robin
quite
rightly
mentions
that
having
a
good
website
that
can
engage,
people
providers
and
other
groups
is
really
really
important.
It
is
our
biggest
channel
for
for
engaging
all
groups.
What
robbie
refers
to
is
paid
for
advertising,
where
pay
for
advertisers
have
a
have
an
ability
to
jump
rankings
I've
just
as
we've
been
talking,
I've
just
just
looked
at
a
number
of
searches.
So
this,
if
you
search
for
cqc,
you
will
see
one
today.
K
One
paper
advert
above
us
but
you'll
see
on
the
right
hand,
side
our
name,
our
organization
and
who
we
are
as
well
as
obviously
details
of
others.
If
you
search
care
rating,
we're
top
if
you
search
hospital
rating
with
top,
if
you
search
gp
rating
we're
top,
so
it
really
does
some
people
do
choose
to
buy
advertising.
I
think
it's
important.
We
have
a
a
good
website
with
good
html
content
that
will
naturally
form
part
of
the
of
the
come
to
the
top
without
the
need
for
advertising.
So
we
are
the
first.
K
We
are
the
first
service
that
appears
after
advertise
after
advertising.
I
don't
think
it's.
I
think
it's
more
important
to
have
a
good
website
with
good
engaging
content
and
good
links
that
will
that
will
push
push
us
to
the
top
of
those
google
ratings,
rather
than
continually
pay
for
advertising.
So
it
would
say
today
it's
one,
but
you
can
still
see
even
on
the
cqc,
where,
where
there
is
one
organization
there,
you
can
still
see
us
in
detail
on
the
right
hand,
side
great
thank.
A
You
very
much
chris.
I
hope
that
answers
your
questions
robin
and
with
that
we
can
end
our
public
board
meeting.
Thank
you
all
very
much
indeed,
and
we
are,
we
are
supposed
to
be
back
at
2
15,
but
we
are
running
behind
because
we
we
didn't
manage
to
do
the
change
portfolio
update.
So
I
wonder,
is
half
an
hour
long
enough
for
lunch
and
start.