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From YouTube: CQC board meeting – November 2017
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A
Right
good
morning,
everybody
and
welcome
to
the
November
board
meeting
of
the
CQC.
We
have
an
apology
from
our
chief
executive
Sir,
David
Ben,
who
is
in
New
Zealand,
otherwise,
I
think
we
are
all
here.
Are
there
any
declarations
of
interest
that
anybody
needs
to
make?
Okay
good?
We
have
the
minutes
of
the
meeting
of
the
18th
of
October
are.
They
are
true
and
accurate
record
of
everything
we
said.
A
Thank
you
on
the
action
log.
There
is
one
item
that
says
it's
completed
and
I
would
respectfully
suggest
it
should
remain
on
the
action
log,
because
it's
the
the
action
that
there's
been
agreed.
Is
it
provisionally
included
in
an
AR
GC
meeting
in
January,
but
I
think
until
that's
happened,
it
should
remain
on
the
action
log.
Otherwise,
if
it
doesn't
happen,
we
will
lose
sight
of
it.
So
that's
people
happy
well
just
amend
the
the
log
for
the
future,
so
anything
else
arising
that
anybody
wanted
to
raise
okay
good.
A
B
Yeah,
thank
you
very
much
and
really
I'm
delighted
to
present
to
you
the
first
annual
report
of
the
National
Guardians
office,
and
you
have
the
very
first
copies
of
the
hard
copy
here
for
the
board,
because
it's
published
today-
and
this
is
not
just
to
talk
about
the
work
that
my
office
has
been
doing,
but
really
to
highlight
the
work
that's
been
happening
across
England,
particularly
at
regional
and
also
at
trust
level
and
I.
Hope
that
the
report
reflects
that.
I.
B
Think
what
I've
been
really
pleased
by
is
how
the
freedom
to
speak
up
initiative
has
been
really
grasped
across
the
country,
not
only
in
the
provider
organizations
but
also
in
the
arms-length
bodies
as
well,
including
our
sponsoring
bodies.
So
I'm
particularly
pleased
that,
for
example,
in
CQC,
you
have
your
own
freedom
to
speak
up
Guardian,
because
I
feel
that
that
sends
the
role-modeling
to
the
rest
of
the
system
which,
which
is
which
is
so
excellent
it.
A
C
Well,
they
do,
firstly,
I'd
like
to
express
my
gratitude
to
Henrietta
for
the
way
in
which
she's
approached
her
tasks
over
the
last
year
and
the
tremendous
progress
she
and
her
staff
have
made.
Excuse
me
from
a
standing
start
to
a
situation
where
every
trust
of
the
country
has
Guardian
and
many
actually
have
more
than
one
and
a
network
of
them
and
through
the
national
guard,
is
office,
a
network
of
support
and
training
of
meetings
teams.
C
But
it's
now
I've
been
to
several
of
these
meetings
and
they
are
inspirational
to
see
the
commitment
put
in
by
people
from
all
walks
of
life
of
Europe
within
NHS
trusts
in
relation
to
the
freedom
to
speak
up,
it's
just
not
the
end
of
the
journey.
Obviously
it
is
a
start,
but
the
fact
that
this
commitment
is
evidence
throughout
the
country
will
go
in
itself,
a
long
way
to
making
star
feel
safe
to
speak
out.
A
D
What
I
said?
Congratulations
Henrietta
and
your
team
I
think
reporters.
It
shows
impressive
work
over
the
first
year
and
my
sense
going
around
talking
to
hospitals
and
staff
at
hospitals
is.
This
is
already
having
an
effect
out
there.
There's
a
freedom.
Speak
of
Guardians
are
often
brought
up
as
an
issue
talk
to
chief
executives.
They
highlight
their
role.
It's
I
mean
less,
that's
impressionistic.
E
B
That's
impact
already
we're
also
publishing
data
on
a
classified
trust
basis,
about
how
many
staff
are
coming
forward
to
speak
up,
and
although
that
isn't
the
answer,
it
does
raise
some
interesting
questions
about
the
numbers
and
whether
staff
coming
forward
anonymously
or
not,
and
also
on
the
theme
so
up
until
the
end
of
June
of
4,000
people
had
spoken
up
and
a
quarter
of
that
was
about
patient
safety
issues.
But
40%
was
on
bullying
at
harassment
and
in
fact
the
Guardians
have
said
to
us.
B
Could
we
please
change
that
that
that
definition
to
unacceptable
conduct
and
I
think
that
that
gives
us
an
idea
of
what's
happening
on
the
ground?
So
if
we
start
seeing
people
feeling
confident
to
come
forward
and
talk
about
unacceptable
conduct
and
patient
safety
issues,
and
then
the
right
actions
are
taken
as
a
result,
it's
in
the
feedback
that
the
individuals
give
on
their
quality
of
service
that
they've
received
is,
in
my
view,
as
the
impact,
so
I
hope
that
I've
made
sense
with
that.
B
So
we
say
to
the
Guardians
when
you've
completed
a
case,
go
back
to
the
individual
and
ask
them
whether
they'd
speak
up
again.
87%
of
the
people
who
were
are
said
that
they
would,
and
two
percent
said
that
they
wouldn't
now
obviously
delighted
by
the
87
percent,
because
that
does
run
counter
to
the
previous
narrative.
That
speaking
up
is
a
career
limiting
activity,
but
we're
more
interested
in
the
two
percent
who
said
that
they
wouldn't
and
whether
people
feel
that
they've
had
that
Pimentel
or
other
negative
experience.
B
And
you
can
see
from
the
graphs
on
the
right-hand
side
of
page
17
that
there's
a
really
marked
difference
between
the
trusts,
with
an
outstanding
CQC
inspection
report
and
those
with
inadequate,
and
so
from
my
perspective,
there's
something
about
whether
speaking
up
is
a
proxy
for
leadership
in
some
way
and
when
I've
talked
to,
for
example,
other
bodies
like
GMC.
They
say
that
their
junior
doctors
survey
and
their
trainers
survey
almost
exactly
mirrors.
The
findings
that
we've
had
as
well.
So
I
do
think.
F
Adult
social
care,
and
the
issue
for
me
is
that
very
often
speaking
up
in
adult
social
care
environments
is
even
more
difficult
than
it
is
speaking
up
in
large
organizations
like
NHS
trusts,
because
if
you're
working
in
a
care
home
and
very
often
you
will
be
working
alongside
and
living
alongside
the
people
that
you
might
actually
want
to
be
raising
concerns
about,
and
that
may
make
it
even
more
difficult
for
you
to
feel
confident
about
doing
that.
So
it's
something
that
you
and
I
have
spoken
about
and
butchers.
F
Give
you
the
opportunity
to
speak
about
it
here
and
what
prospect
do
you
think
there
is
others
looking
to
extend
the
good
work
that
you're
doing
into
and
the
broader
adult
social
care
sector
and
particularly
to
and
have
enable
the
principles
that
you've
identified
here
about
what
works
in
terms
of
speaking
of
and
help
us
from
adult
social
care,
inspection
and
regulation?
Point
of
view
to
encourage
that
and
in
this
sector.
Well,.
B
Absolutely
I
agree:
I
mean
I,
we're
talking
about
secondary
care
in
England
here
in
the
report,
but
we've
actually
been
doing
a
lot
of
engagement
with
the
independent
sector
providers
who
provide
care
across
a
whole
range
of
different
settings,
even
including
into
schools,
into
prison,
health
care,
etc.
So
I'm
really
interested
to
see
how
they're
going
to
pick
this
up,
because
if
there's
a
standard,
NHS
contract,
for
example,
for
continuing
care,
then
that
essentially
means
that
this
is
part
of
that
contract.
B
There's
been
a
really
interesting
group
of
people,
who've
been
coming
to
that
and
I
think
it's
a
real
mark
of
the
people
who
are
running
the
regional
networks
that
they're
really
to
people
from
primary
care,
from
independent
sector,
from
hospices
and
from
other
providers
coming
to
their
regions,
because
their
feeling
is
that
if
their
patients
require
hospice
care,
they
want
to
make
sure
that
once
they're
discharged
from
the
provider
they're
still
able
to
be
in
an
environment
where
the
staff
can
speak
up
and
I.
Think
that
tells
you
about
the
values
now.
B
What
I
would
say
is
there's
also
something
about
the
appetite.
So
this
came
in
under
the
standard
NHS
contract.
It's
now
see
part
of
the
well-led
inspection
framework.
So
there's
something
about
the
push
factors
and
the
pull
factors.
I
mean
we
welcome
any
provider,
any
type
of
provider
to
come
and
ask
us
about
things:
we're
working
with
with
Institute
sport
with
g4s
with
spire
with
Mary
Stopes.
So
so
we're
really
open
to
that,
and
also
with
our
pan
sector
network.
B
Looking
at
how
other
sectors
of
the
economy
are
addressing
this,
whether
that's
in
the
military
I
was
at
Sandhurst
last
week,
we've
got
the
institute
of
business
ethics
really
interested
in
what
we're
doing
and
I
do
think
that
other
sectors
of
the
economy
are
looking
at.
Freedom
speak
up
Guardians
as
that
human
interface,
rather
than
just
a
call
centre
and
seeing
the
impact
that
it
can
have
so
it's
very
early
days,
but
we're
really
open
to
inquiries
from
a
wide
range
of
different
organisations.
Thank
you
very
much.
A
B
D
Thank
you
and
not
work,
just
to
say
I
mean
you
mentioned
a
case
review
report.
This
I
think
is
out
today
that
you
make
a
recommendation
there,
the
CQC,
and
we
will
take
that
forward
in
our
in
our
new
guidance
coming
out
of
the
consultation
feedback
that
we've
producing
in
a
few
months
time.
So
thank
you
very
much
for
that.
We'll
take
it
on
board
now.
B
Thank
you
very
much
and
you
know
I
think
it's
you
know
when
our
role
is
independent,
we
do
need
to
be
able
to
look
for
how
other
organizations
can
support
to
set
the
culture,
and
so
it's
it's.
It
might
seem
in
some
ways
that
we're
you
know
looking
at
things
in
a
way
that
hasn't
been
looked
at
before,
but
what
I
would
say
is
that
we
have
to
do
things
in
looking
towards
the
future.
B
A
A
Good
Martin
can
I
just
go
back
and
correct
myself,
because
I
forgot
to
say
that
Paul
Corrigan
is
also
an
apology
for
this
meeting
he's
been
called
away,
he'll
be
back
later
today,
but
probably
not
before
the
end
of
the
meeting.
So
he
has
apologized
and
I
apologize
for
forgetting
to
say
that
Andrea,
the
chief
exec
is
report.
Okay,.
F
First,
one
is
the
next
phase
for
adult
social
care
and
primary
medical
services,
and
it's
just
a
report
to
the
board
that
we
published
the
response
to
the
second
consultation
on
the
20th
of
October,
and
so
we
have
moved
forward
with
that.
We're
starting
the
work
on
the
different
way
of
registering
services
and
taking
that
forward
with
our
registration
transformation
program.
F
We
introduced
the
new
adult
social
care
assessment
framework
on
the
1st
of
November
and
that's
the
that's
kind
of
has
aligned
with
the
healthcare
framework
in
a
much
better
way,
has
taken
out
duplication
and
simplified
some
of
the
questions
and
which
I
think
hopefully
will
be
helpful
and
from
a
primary
medical
services.
Point
of
view.
There's
a
phase
approach
starting
there
and
using
the
new
health
assessment
framework
as
well.
So
that's
just
to
kind
of
give
the
board
that
update,
although
you've
obviously
seen
the
detail
previously
in
terms
of
the
specifics
of
the
next
phase.
F
Ok,
good
move
on
I,
certainly
well,
so
this
is
the
oops
I
just.
H
F
So
this
is
to
move
on
to
our
first
team
effort
and
we
have
Pete
in
the
room
who
can
answer
any
specific
questions
in
October.
You
approve
the
direction
for
the
digital
enhancement
and
intelligence
work
program
and
asked
to
have
the
benefits,
timelines
and
deliverability
to
come
back
to
you,
and
that
will
happen
in
December
and
just
to
report
that
the
first
agile
project
and
the
new
way
that
we're
doing
these
things,
which
good
for
me
is
sitting
in
the
provider.
Information
collection
for
adult
social
care
has
now
passed.
F
Certainly,
from
a
registration
point
of
view
has
some
very
good
initial
meetings
and
particularly
to
connect
with
providers
who
will
be
using
that
system
to
make
sure
that
we're
engaging
with
them
appropriately
and
to
make
sure
that
the
digital
function
has
got
the
right
capabilities.
The
first
phase
of
the
restructure
has
been
initiated
and
with
thanks
to
the
colleagues
from
the
people
Directorate
who
obviously
supporting
Pete
and
his
team
and
taken
that
forward.
So
as
I
say,
any
difficult
questions
for
Pete.
So.
A
I
So
I
guess
in
addition
to
that,
so
that
the
share
your
experience,
which
is
the
public
facing
ability
for
individuals
to
express
anything
they've,
have
experienced.
That's
also
passed
the
Alpha.
It
was
going
into
alpha
when
that
was
written.
It's
gone
through
that
now
as
well,
so
that
was
built
on
the
back
of
the
provider.
Information
carry
on
social
returns,
so
that
meant
we
can
move
from
one
project
to
the
next
one
very
quickly
because
of
the
architecture
we're
putting
in
place.
So
that's
been
very
helpful
and
but
fundamentally
we're
doing
three
things
in
parallel.
I
At
the
moment,
the
first
one
is
de
clarity
on
the
benefits
and
exactly
why
we're
doing
the
things
and
what
order
they
be
happening
in.
So
we
all
have
the
common
understanding
of
that.
The
second
one
is
making
sure
that
we
have
the
right
internal
staff
capabilities
to
deliver
against
those
over
the
next
year
and
it
cetera,
and
the
third
one
is
to
make
sure
we
have
the
right
external
capabilities
to
augment
that
why
we
go
through
the
process,
both
in
terms
of
short
term
and
long
term
extra
work.
I
A
F
You
so,
as
the
board
will
know
at
the
start
of
October,
the
government
announced
that
an
independent
review
of
the
Mental
Health
Act
will
take
place
throughout
2018.
Expecting
a
final
report
with
recommendations
by
next
autumn.
We
will
be
a
part
of
the
working
group,
that's
developing
that
as
an
expert
member
and
as
the
independent
monitoring
body
for
the
Mental
Health
Act.
K
You
and
just
to
say
that
HealthWatch
stands
ready
to
help
as
ever,
and
we
decided
in
our
last
committee
meeting
that
we
can
have
a
major
focus
on
mental
health.
It's
it's
come
out
top
top
priority
for
our
local
HealthWatch
across
the
country,
so
we
just
set
up
an
advisory
group
ourselves,
so
we
are
pulling
together
collecting
all
the
information
we
can
to
give
you
any
evidence
that
would
be
of
help.
K
E
Well,
one
of
the
slight
disadvantage
of
having
a
public
board
on
a
private
board.
Is
that,
because
of
the
report
that
we've
got
coming
out,
we've
obviously
talked
a
little
bit
about
the
Mental
Health
Act
reform
process,
as
well
already,
but
so
board.
Members
would
mind
it
just
important
that
we
don't
at
the
public
board,
give
the
impression
that
we
haven't
had
a
detailed
discussion
about
this
issue.
There's
a
couple
of
points
that
came
out
of
our
early
discussion.
E
A
Okay
and
so
just
just
to
be
clear,
I
mean
appropriate
times
the
CQC
people
led
by
Paul
Elia
to
doing
this
will
be
at
the
board
talking
from
CGC
perspective,
I
think
some
of
what
you
were
saying
was
from
a
helpfully
about
what
you
think
the
CQC
role
will
be.
Some
of
it
was
more
from
your
personal
involvement,
but
the
CQC
team
will
be
here
when
we're
here
to
report
I
think
young
Ted's
nodding
good.
Thank
you
put
those
anything
else
on
it.
A
F
So
there's
an
awful
lot
of
activity
going
on
there.
It's
really
important
for
ISM.
You
know
protecting
and
supporting
the
health
and
well-being
of
our
staff
that
we
really
focus
on
this
and
it's
important
for
the
board
and
to
see
it
but
sits
within
the
customer
and
corporate
services
and
Kate
will
answer
any
questions.
If
people
have
them
so.
B
Thanks
Peter
I
think
there's
two
areas:
there's
the
driving
safety
at
work
and
as
a
workstation
safety,
and
whilst
you
shouldn't
use
the
term
in
the
health
and
safety
arena,
we
do
use
a
carrot
and
stick
for
both.
So
the
carrot
for
both
is
to
improve
comms,
to
engage
people
and
just
the
attendance
at
the
health
and
safety
meeting.
The
attendance
from
the
directors
is
vastly
improves
that
you've
had
the
new
health
and
safety
team
in
place.
B
So
the
carrot
is
working
well
on
both
the
stick
for
the
driving
safely
at
work
is
that
through
finance,
we
have
actually
said
that
anybody
claiming
mileage
cannot
do
so
without
having
undertaken
the
driving
safely
at
work,
mandatory
training,
so
the
23%
of
people
who
haven't
completed
it
probably
haven't
driven
for
work
yet
issue.
So
I
think
that's
that's
the
way
to
do
that.
The
stick
for
the
work
station
is
safety
which
has
to
be
completed.
Every
two
years
relies
on
good
information
coming
out
of
the
system.
B
B
A
I
know
from
from
previous
experience,
it's
really
difficult
to
get
up-to-the-minute
data
because
you
have
people
joining
who
ain't
done
a
course
yet,
but
will
do
so
in
the
suppose
so,
but
if
we
can
find
a
way
of
satisfying
our
souls
that
in
a
reasonable
time
frame,
everybody
who
should
be
doing
mandatory
training
is
doing
it.
I
personally
would
feel
very
much
happier
it's
a
challenge.
I
know
Robert
is,
did
you
listening?
Yes,.
B
Okay,
so
on
the
first
point,
what
do
we
do
for
our
staff
and
I
think
a
particular
dot?
Social
care
have
been
very
engaged
in
working
groups
to
actually
look
at
risk
assessments
to
consider
all
the
different
risks
that
are
in
play
when
they're
out
inspecting
and
that's
now
being
rolled
out
to
PMS
and
Hospital
as
us
so
got
the
new
health
and
safety
team.
So
we
are
really
engaging
people
in
understanding
what
their
risks
are
and
how
we
address
them
and
all
of
the
policies,
working
practices
etc
being
pulled
together.
F
Under
sorry,
if
I
could
add
on
the
engagement
directly
with
staffers
kate,
says,
sue
Howard,
who
leads
on
these
issues
for
me
and
adult
social
care
is
done.
Is
tremendous
bank
to
work
with
individuals,
and
one
of
the
things
that
we're
looking
at
is
making
sure
that,
when
we're
doing
the
inspection
planning,
a
key
part
of
that
inspection
planning
is
to
consider
the
risks
that
might
present
themselves
and
and
then
to
ensure
that
staff
are
able
and
supported
to
have
conversations
with
their
managers
about
what
they
need
to
do
to
mitigate
that
risk.
F
And
therefore,
if
there
are
things
that
are
not
immediately
available,
we
can
escalate
on
that
basis
to
make
sure
that
people
are
supported.
And
the
other
thing
to
say
is
that
the
health
and
safety
and
well-being
committee
has
staff
representatives
on
it.
And
these
are
conversations
that
also
happen
with
the
joint
em
staff
groups
and
from
the
trade
union
point
of
view,
as
well
as
the
staff
forum.
So
the
variety
of
different
mechanisms
that
we
would
be
doing
that
in.
A
F
You
moving
on
to
the
information
security,
internal
update
report
and
board
members
will
recall
that
we
felt
had
an
independent
external
review
of
the
incident
where
we
lost
MDBs
certificates
and
that
review
made
a
number
of
recommendations,
and
so
we
are
publishing
today
a
report
which
sets
out
a
review
of
how
well
we've
done
with
those
recommendations
and
the
review
notes
that
there's
been.
You
know
a
very
significant
program
of
work
and
to
make
progress
in
implementing
those
recommendations
from
the
2016
external
review.
F
The
review
is
concluded
that,
for
the
recommendations
have
been
fully
met
and
require
no
further
work.
One
recommendation
on
information
risk
management
in
projects
was
fully
met,
but
we've
changed
working
arrangements
since
then,
so
we'll
need
to
do
some
more
work
to
make
sure
that
those
changes
are
appropriate
for
the
new
way
of
working.
The
final
recommendation
was
about
cultural
change,
which
I'm
sure
you
can
imagine
is
is
a
much
more
challenging
thing
to
do,
and
that
was
recognized.
F
The
review
recognizes
that
progress
has
been
made
and
that
there
is,
but
there
is
more
work
to
be
done,
and
so
the
review
makes
for
new
recommendations
to
relate
to
the
ongoing
work
on
the
culture
change.
One
relates
to
the
change
arrangements
for
the
project,
management
and,
and
one
relates
to
overall
program
governments
to
make
sure
that
we're
pulling
all
of
this
together
and
so
there.
F
Those
are
now
part
of
CQC's
information,
governance
and
security,
improvement
and
change
plan
and
work
is
underway
to
progress
those
recommendations
and
we're
proposing
and
had
a
brief
conversation
with
Paul
as
chair
that
the
board's
accountability
and
corporate
governance
committee
will
continue
to
oversee
the
progress
in
that
work.
But
the
recommendation
around
Cult
change
does
actually
reflect.
What
does
the
board
do
around
this,
and
so
our?
What
we
plan
on
is
to
bring
a
paper
back
to
the
board
and
once
those
discussions
have
taken
place
to
discuss
with
you,
how
we
take
that
forward.
A
A
The
report
it
was,
it
was
a.
It
was
very
complimentary
about
the
way
that
that
you
Andrea
and
the
executive
team
had
dealt
with
the
issue.
So
I
mean
it
was
more
than
the
sort
of
neutral
factual
report.
It
was
quite
quite
glowing
in
its
compliment
for
the
progress
that's
been
made
as
well
worth.
Just
noting
anybody
want
to
raise
anything
in
that
regard
and.
F
F
Sleeping
so
we've
set
out
here
just
really
to
report
to
the
board
that,
on
the
first
of
November,
the
government
made
an
announcement
that
it
was
ending
its
three-month
suspension
of
the
HMRC
enforcement
actions
relating
to
the
minimum
wage
for
sleeping
provision.
And
there
is
now
a
new
scheme
run
by
the
HMRC.
The
Social
Care
compliance
scheme
and
organizations
have
12
months
in
which
to
conduct
a
self
review
of
that
liability
and
for
sleep
ins.
F
Work
does
continue
and
to
explore
the
case
for
government
financial
support
for
affected
providers
and
that
that
is
that
is
continuing
and
conversations
are
happening
and
was
was
set
out
in
the
government
announcement
and
just
to
reassure
the
board
that
this
is
something
that
our
market
oversight
team
is
keeping
a
close
eye
on.
Of
course,
because
the
market
oversight
scheme
only
looks
at
the
larger,
more
difficult
to
replace
providers.
We're
not
looking
at
the
whole
picture,
but
it
does
give
us
some
insight
into
what
the
issues
are
and
we
continue
to
work
with.
F
A
F
L
E
F
There
are
various
estimates
and
that
are
around
the
voluntary
organizations,
disability
group
and
care
England
and
various
other
groups,
and
did
some
work
and
came
out.
I.
Think
with
the
figure
of
about
400
million
was
a
potential
past
liability,
and
but
this
is
part
of
the
work
that
the
government
is
doing
in
terms
of
really
understanding
what
that
is
both
in
terms
of
the
backlog
that
there
might
be,
but
also
in
terms
of
the
ongoing
impact
and-
and
that's
been
part
of
the
discussion
that
they're
having
around
what
support
needs
to
be
had.
F
A
I
think
Lewis.
First
of
all,
there
isn't
a
lot
of
accurate
data
at
the
moment
because
there's
some
some
lack
of
clarity
even
now
about
exactly
what
this
will
mean,
but
to
take
Andrews
point.
There
are
two
dimensions
to
this:
there
is
the
impact
on
the
past,
and
certainly
some
some
of
the
big
providers
have
been
very
public
in
saying
yeah
at
best
it
wipes
out
our
our
years
and
years
of
accumulated
reserves,
but
it
doesn't
bankrupt
us,
but
I
mean
that
Buster's
huge
damage,
but
then
going
forward.
A
E
That's
helpful,
I
mean
I.
Suppose
it's
getting
the
information
to
sort
of
fill
in
the
gaps
in
that
or
that'll
be
really
helpful.
It
I
don't
have
the
400
million.
Was
it
translates
into
cost
to
a
local
authority,
for
example?
So
it
would
be
helpful
to
understand
this,
because
I
wouldn't
like
to
our
discussion
to
stop
with
provider,
concern
I.
Suppose
that's
what
I'm
saying
I
think
there
is
there's
a
soft
bottom
line
to
this,
which
we
need
to
understand,
but.
F
Because
if
there
is
a
restriction
on
Fancy's
being
available,
then
will
we
see
people
move
to
the
sorts
of
services
that
we
that
might
be
economically
more
advantageous,
but
actually
are
not
consistent
with
a
good
practice
that
we
know
as
important
in
terms
of
the
models
of
care
for
people
with
learning
disabilities?
So
I
think
we.
We
have
to
be
very,
very
vigilant
about
the
potential
impact
on
the
quality
and
the
model
of
care.
F
F
Don't
know
how
many
of
you
have
read
it
in
detail,
but
I
think
I
thought
it
was
an
absolutely
excellent
report
and
you
really
highlighted
some
very
significant
problems
which
other
commentators
have
picked
up
as
well,
but
will
feed
into
and
the
ongoing
work
that
we're
doing
and
again,
colleagues
from
across
hospitals,
PMS
integrated
care
and
policy
and
strategy,
and
can
answer
any
specific
comments
on
that.
But
just
to
commend
people
to
read
it.
D
Anybody
want
to
add
anything
to
it.
I
think
it's
a
very
important
report
and
the
the
final
report,
I
think,
will
be
very
important
because
you'll
be
moving
towards.
What
can
we
do
about
this?
I
mean
this
is
a
very
long-standing
problem.
It
has
been
a
problem
for
many
years,
it's
exacerbated
by
the
increase
in
demand,
and
it's
it's
between
the
providers
who
we
regulate
and
the
commissioners
who
we
don't
and
I
think
that
is
the
in.
So
many
of
these
things,
it's
a
system
issue
as
much
as
individual
provider
issue
I.
E
Sorry,
this
just
very
briefly,
I
think
it
was
very
good
reporter
there's
a
kind
of
momentum
building
about
this
issue,
and
our
report
is
part
of
it
and
I.
Think
Ted
is
right
about
what
is
then
going
to
happen
and
in
fact,
of
course,
the
children's
mental
health
is
quite
a
broad
area
and
in
fact
we
are
only
concerned
with
some
of
the
providers,
we're
concerned
without
the
primarily
the
health
providers.
E
But
of
course,
the
the
issues
run
across
a
number
of
agencies
and
in
the
end,
that
will
be
one
of
the
tasks
to
translate
what
we
find
into
something
which
reflects
the
broad
nature
of
the
problem.
But
it's
a
very
important
report
and
and
something
we
mustn't,
let
drop
it.
You
know
we
do
produce
quite
a
lot
of
reports
and
they're
often
I,
think
very
good,
but
it's
not
absolutely
clear
how
they
what
their
impact
is
on
the
system,
and
this
is
one
that
we
must
make
sure
as
a
proper
impact.
Robert.
K
A
A
M
You
Peter,
so
you
have
a
font
of
view.
The
performance
report
for
the
last
two
quarters,
the
first
six
months
of
2017
18
I'll,
just
do
a
short
summary
and
then
invite
my
chief
inspector
colleagues
to
say
a
few
words
about
each
of
their
areas.
Over
the
last
six
months,
we've
undertaken
9,000
inspections
on
7,000
or
so
of
those
we
have
published
our
reports.
The
other
reports
are
yet
to
come
within
that
we've
issued
about
1,100
enforcement
actions.
An
increasing
number
of
those
are
criminal
and
civil
actions
as
well,
particularly
in
this
in
this
quarter.
M
We've
included
the
annual
awareness
survey
of
the
public
of
CQC,
which
shows
positive
results
in
terms
of
the
generals.
They
call
the
awareness
of
CQC
and
the
public
and
a
rising
trend
from
past
years,
which
is
as
we'd
wanted
to
to
be.
We
also
see
within
that
that
those
groups
that
are
more
likely
to
be
thinking
about
and
choosing
their
care
are
more
likely
to
make
use
of
CQC
resources
and
be
aware
of
it.
M
We're
broadly
on
plan
in
terms
of
our
inspection
schedule
and
where
we'd
want
to
be,
but
we're
realizing
that
there
are
some
areas
where
the
complexity
of
the
work
that
we're
taking,
such
as
enforcement
means
that
that
can
become
more
difficult
to
meet.
And
is
also
visible
and
some
of
the
productivity
figures
that
you
see
in
the
performance
report
as
a
as
a
result,
stepping
back
from
the
operational
activity
and
looking
at
our
commitments
against
our
business
plan,
three-quarters
of
our
business
plan
milestones
are
rated
on
progress.
M
Green,
which
is
very
positive
about
a
quarter
of
them,
are
in
a
space
where
we
probably
would
like
to
have
somewhat
more
pace
on
the
delivery,
but
none
of
them
are
rated
with
a
significant
risk
of
non
delivery,
I
rated
red
where
they
are
reported
to
have
an
impact
on
delivery
where
we'd
want
to
be.
It
is
often
because
of
the
complexity
of
the
work
that
we're
undertaking,
such
as
some
of
the
digital
changes
at
the
border.
M
We've
discussed
a
few
times
in
the
past
and
then
finally,
looking
at
our
budget,
we
continue
to
under
spend
this
year
against
a
budget
at
the
moment.
I
understand,
forecast
dents
at
7.8
million,
but
some
of
the
challenges
that
we're
facing,
particularly
with
recruitment
over
the
rest
of
the
year,
might
mean
that
the
underspent
increases
further
for
the
rest
of
the
year.
That's
all
I
wanted
to
say
in
terms
of
the
summary
Andrea.
Do
you
want
to
start
with
a
few
words
on
thank.
F
You
and
thank
you
very
much
muttering
to
where
and
to
your
team
as
well
for
the
presentation
of
the
report,
which
gets
ever
more
interesting
and
on
the
registration
side
of
things,
as
the
board
knows,
have
the
overarching
responsibility
for
registration
for
all
three
sectors
and
just
to
pick
up
a
couple
of
points
on
there.
The
first
is
the
we've,
given
you
I
think
for
the
first
time
at
the
board,
the
information
on
the
unregistered
providers.
F
This
is
a
significant
element
of
our
work
in
registration,
where
people
refer
to
tours
and
services
that
may
be
operating
without
having
registered
with
us
to
deliver
a
regulated
activity,
and
that
is
obviously
not
what
we
want
to
have
happen
and
you,
the
kind
of
consequence
of
that
is
sometimes
people
didn't
realize
and
they
need
to
be
reminded
and
we
go
through
the
process
with
them
and
they
do
get
registered.
In
other
circumstances,
they
stop
providing
the
service
and
in
other
circumstances,
we
have
to
take
enforcement
action
and
to
make
that
happen.
F
So
it
is
a
significant
element
of
work
and
we've
not
reported
on
it
previously,
and
the
level
of
activity
that
we're
seeing
at
the
moment
the
forecast
for
the
full
year
would
represent
a
20
percent
increase
in
activity
compared
to
last
year.
So
again,
it's
a
significant
chunk
of
work
and
obviously
takes
up
quite
a
lot
of
time
on
behalf
of
the
people
who
are
having
to
deal
with
that.
F
The
second
thing
I
just
wanted
to
say
was
that
coming
off
the
back
of
the
improvement
from
the
because
McCole
center
around
and
processing
the
applications
for
registrations
which
is
improved
over
the
year
and
following
the
reorganization
of
the
team.
Earlier
in
the
year,
we
are
seeing
a
relatively
stable
performance.
F
If
you
kind
of
took
the
four
pink
line
on
slide
10,
which
is
this
year's
activity,
it
will
probably
be
coming
out
roughly
at
about
84
percent
across
the
board,
which
is
an
improvement
on
last
year,
doesn't
take
us
quite
to
where
we
want
to
be,
which
is
to
get
us
up
to
making
sure
that
we're
making
decisions.
What
90
percent
of
the
time
within
50
working
days.
Some
of
the
aspects
that's
been
impacting
on
is
we
have
new.
F
It
is
an
improvement
in
performance,
it
still
not
where
we
want
to
be,
but
we
have
had
a
significant
level
of
sickness
and
within
the
team
and
some
very
complex
and
registration
decisions
that
we've
had
to
have
to
make
there.
So
that
has
impacted
on
that,
but
we
are
through
the
registration
transformation
program
and
also
the
continuous
improvement
work
that
Joyce
Frederick
and
her
team
are
leading
on
with
others.
We
are
hoping
to
see
that
in
performance
improve
as
we
go
forward
and
did
want
to
mention
the
point
about.
F
At
the
moment
we
have
been
looking
at
that
in
terms
of
how
we
can
recover
that
position
with
use
of
bank
staff
and
other
other
ways
of
managing
the
activity,
but
we
have
had
some
turnover.
We
have
had
sickness
in
those
services
as
well
and
and
what
that
creates
for
us,
unfortunately,
is
we
never
reduce
the
number
of
locations
that
we've
got
to
monitor.
So
the
monitoring
of
the
notifications,
the
inquiries
of
the
safeguarding
the
whistleblowing
that
comes
in
then,
has
to
get
spread
amongst
a
smaller
number
of
people.
F
So
that
increases
the
time
that
people
individually
spend
on
that
which
obviously
decreases
the
amount
of
time
that
they
can
spend
on
inspections.
So
we
are
rescheduling
inspections
to
make
sure
that
we're
managing
risk
going
back
to
inadequate
and
requires
improvement,
but
that
is
causing
a
bit
of
a
drift
on
some
of
those
services
that
we
previously
rated
as
good
and
as
I
say,
we're
working
very
hard
to
try
and
address
that.
But
it
is
a
difficult
situation
for
us
to
manage
at
the
moment
and
blast.
F
But
not
least,
we
are
continuing
to
improve
the
performance
on
report
writing
and
whilst
there
was
a
full
dip
in
September,
which
I
think
is
a
consequence
of
the
holiday
season
in
august
and
september,
because
those
people
who
don't
have
kids
a
school-aged
go
away
in
September
and
those
who
I
have
kids
of
school
age
go
away
in
August.
And
that
means
that
time
is
taken
out
in
the
short
period
of
time
that
people
have
got
to
turn
reports
around
and
that
dropped
us
by
a
percentage
point
in
September.
A
A
huge
amount
of
very
positive
news
in
this
and
I
think
particular
congratulations
to
the
registration
team
and
a
lot
of
lot
of
really
good
stuff
being
done,
but
there's
also
a
weight.
A
way
to
go
is
now
innocent.
I
mustn't
lose
sight
of
those
things
long
program,
but
not
quite
there
are
the
specific
points
anybody
would
like
to
raise.
A
L
H
The
detail
in
the
report
like
Andrea,
we
continue
to
focus
on
what
is
reported
in
the
report
is
a
breach
of
four
quarters
for
those
that
have
been
inspected.
In
fact,
the
numbers
have
gone
down.
We
have
a
narrative
on
every
single
one
of
the
cases.
The
numbers
are
small
in
the
report.
It
also
talks
about
our
work
on
defense,
medical
services,
which
were
very
pleased
with
that
is
funded
by
the
defence
services,
not
by
the
NHS
or
by
the
providers.
H
D
Ted,
sorry,
thank
you.
As
the
board
knows,
we
launched
our
next
phase
of
hospital
inspections
in
August
and
so
we're
now
three
months
into
that
and
I
think
it
has
been
going
well.
So
far
we
haven't
used
the
first
reports
on
to
the
next
phase
and
I
think
that
is
the
next
milestone
and
we
split
that
to
occur
in
the
next
few
weeks,
probably
early
December.
So
so
we
making
good
progress
on
that
that
the
what
we
have
done
over
the
last
few
months
is
introduced
a
detailed
dashboard
for
all
our
frontline
inspectors.
D
So
they
come
on
to
their
own
performance
and
that
feeds
up
to
the
Directorate
dashboard.
So
we
review
that
on
a
regular
basis,
so
we
are
making
for
progress
in
lots
of
performance
areas,
but
there
is
more
to
do
two
areas
I'd
like
to
highlight
yeah
because
they
come
out
in
the
report
is
a
Productivity.
Now
we
had
because
next
phase
was
delayed
because
of
election
perder
we're
a
bit
behind
where
we
wanted
to
be
when
we
originally
planned
this
financial
year.
D
But
having
said
that,
we
are
launching
15
next
NHS
trusts,
next
phase
inspections
a
month,
which
is
exactly
the
number
we
anticipated
in
this
in
this
part
of
the
year.
So
we
believe
we're
on
track
when
we
get
up
to
full
speed,
it'd
be
about
20
a
month.
We
have
already
planned
to
do
that
during
next
next
year.
D
The
next
calendar
year
so
I'll
be
starting
that
early
after
the
new
year
and
I
think
if
we
can
achieve
that,
I
think
I
mean
a
considerable
achievement,
because
these
enables
us
to
get
towards
the
annual
cycle
of
energy
stress
inspections
which
we're
aiming
to
achieve,
which
was
a
bold
ambition
and
as
yet
we're
still
on
track
to
achieve
that.
The
the
the
the
grass
you
see
here
reflects
if
you'd
like
activity,
although
I
think
there
is
some
issue
about
the
way
that
the
inspection
activity
is
captured.
D
D
21,
it
hasn't
fed
through
into
the
September
kpi's.
Yet,
having
said
that,
we
are
making
progress,
we
still
republishing
a
few
reports
from
the
old,
comprehensive
energy
inspection,
so
those
are
the
reports
that
causes
most
difficulty
and
I
have
to
say
they
have
been
delayed
and
the
graph
reflects
that.
But
we
haven't
very
few
of
those
left
to
publish.
We
are
continuing
to
publish
independent
health
reports
under
the
first
phase,
we've
made
great
progress
in
terms
of
reducing
the
the
target,
the
delays
and
publishing
those
we've
halved.
D
The
median
time
of
publications
since
March
we're
now
down
to.
If
you
look
at
the
October
figure
in
the
media,
the
time
to
publication
was
48
days,
which
is
a
substantial
achievement
for
the
Directorate
over
the
last
few
months.
As
we
go
into
next
phase.
As
I
said,
we
are
plan
to
to
publish
next
phase
reports
over
the
next
few
weeks.
We
are
mounting
that
very
closely
and
as
yet,
we
are
on
target
to
publish
those
within
our
KPI
and
remember.
D
We
have
changed
in
report
format,
we've
changed
the
whole
process
of
Quality
Assurance
and
that's
to
tackle
this
issue
of
delays.
In
report
publications
so
at
the
moment
we're
on
track
to
deliver
the
next
phase
report
in
a
timely
way.
We
haven't
yet
done
so
when
we're
monitoring
that
very
carefully,
but
we're
very
closely
focused
on
it
going
forward.
C
You
I'm
just
thinking
up
Bob
Steven,
says
about
the
staff
and
the
encouragement
about
them
that
level
of
self
sickness.
Could
someone
help
me
as
to
what
we
benchmark
that
against
I
mean
I?
Don't
know
whether
just
under
four
percent
is
group
sad
or
and
different
compared
with
other
organizations
and
the
other
curiosity
and
I
don't
know
if
it
is
one
is
that
the
line
is
always
flat,
in
other
words,
there's
no
change
in
sickness
absence
rate
table
over
the
year
and
as
a
layman,
I
would
have
thought.
C
B
I
think
that
we
set
in
the
five
percent
targets
based
on
other
similar
businesses.
I.
Think,
if
you
look
into
the
health
service
in
certain
areas,
it
would
be
may
be
able
to
at
eight
percent
would
be
normal
if
you're
looking
into
commercial
businesses
is
much
lower,
so
sits
with
similar
organizations.
And,
yes
it
should.
You
know
it
does
increase
during
the
winter
months.
Oh.
F
Yeah
not
much
yeah,
and
one
of
the
things
to
say
is
that
there
is
variation
amongst
the
directorates
across
the
five
directorates
and
probably
the
adult
social
care
and
registration
directors.
We've
got
a
higher
level
of
sickness
and
which
is
partly
reflected
because
our
age
profile
is
different
and
we
have
an
older
cohort
of
staff
and
we
have
more
long-term
sickness.
Simple,
absolutely
you
know
legitimate
reasons.
F
People
have
cancer
and
you
they've
got
to
go
away
and
have
their
treatment
when
we
expect
them
to
come
back
and
all
those
good
things,
but
that
will
obviously
have
an
impact
so
so
that
there
are
variations.
But
the
important
thing
is
monitoring
it,
making
sure
that
we're
supporting
staff
and
when
that's
appropriate,
to
do
so
and
particularly
taking
into
consideration
what
we're
doing
to
support
people
may
have
mental
health
problems.
And
we've
done
an
awful
lot
of
work
over
the
last
year.
F
Around
mental
health
awareness
training
for
managers
to
enable
them
to
support
their
staff
in
the
most
appropriate
way.
And
this
has
been
you
know-
a
great
initiative
from
the
Academy,
but
also
with
staff
and
Ted's
director
in
in
mental
health,
who
have
been
leading
on
that
training
with
staff
which
has
been
incredibly
well
received.
And
we
are
now
looking
to
roll
out
some
of
the
materials
that
we've
used
for
managers
for
all
staff
as
well.
Steve.
H
Thanks
Justin,
we
do
all
take
this
very
very
seriously,
and
most
of
our
workers
are
home
workers
and
I
won.
We
all
feel
that
there's
an
under
reporting
of
sickness
by
home
workers
and
probably
the
they've,
got
really
committed
staff
who
work
very
hard
and
we're
very
conscious
of
the
isolation
that
they
might
feel
and
can
easily
get
into,
and
so
so
me
since
Ruth,
our
director
of
HR,
has
been
here.
Who
is
a
really
excellent
appointment?
H
We've
been
thinking
about
how
we
can
encourage
people
to
link
up
work
together
more,
even
though
they
work
as
home
workers
encouraging
more
meetings.
Telephone
calls
between
them
to
avoid
isolation
which
will
help
both
keep
them
going
physically
in
the
job
but
psychologically
as
well,
so
in
which
we
do
take
it
very
very
seriously.
C
Graduates
ask
a
follow-up,
which
is
the
NHS
staff
survey,
includes
a
question
which
tells
us
and
the,
in
my
view,
appalling
percentage
of
NHS
staff
who
say
they
gave
to
work
even
though
they
don't
feel
fit
to
do
so
now.
I
mean
one
can
argue
about
the
validity
of
the
figure,
but
it's
that's
what
the
vigor
is.
C
Do
we
have
any
similar
measure
in
the
which
I'll
appreciates
a
little
more
difficult
when
people
are
working
at
home,
but
I
just
wonder
whether
I
mean
we
value
our
staff
and
know
that
we
had
in
particular
their
commitment
to
the
job,
but
I
would
not
like
it
to
go
under
the
radar.
If
there
was
a
figure
like
the
NHS
has
in
our
staff,
which
I
very
much
hope
there
isn't
I.
F
Don't
think
the
staff
survey
includes
that
specific
figure
when
we
we
do
ask
a
question
about
morale.
But
we
don't
ask
that
specific
question
when
we
bring
the
staff
survey
back
to
the
board
in
the
new
year,
because
we've
just
completed
the
staff
survey
and
we're
just
kind
of
starting
to
get
the
results
now
to
the
executive
team.
Maybe
that's
something
that
we
can
consider
in
terms
of
what
we
might
want
to
do
for
the
future.
J
Just
looking
at
the
registration
process,
we
implemented
a
new
system
on
page
10.
We
implemented
a
new
system
for
the
NCS,
but
I'm
not
seeing
less
I'm
reading
ink
incorrectly
an
improvement
on
the
registration
process
and
we
still
seem
to
be
way
behind
the
KPIs,
maybe
reading
an
incorrectly.
But
it's
wondered
if
we're
seeing
the
benefits
of
this
new
system
or
or
not.
J
J
B
Just
OH
it
shall
be
on
page
10,
yeah,
okay,
so
basically
it
is
an
improvement
than
last
year
because
we've
got
to
say
the
Green
Line
is
the
2016
figure.
So
we
set
a
stretch
target
of
90%,
so
it
has
actually
improved
on
last
year
and
what
we
will
keep
that
under
reviews
to
whether
or
not
is
the
correct
target
in
terms
of
ncsc
processing,
which
is
actually
the
easy
part
of
the
registration
processing.
B
They
are
actually
doing
the
turnaround
of
registrations
registration
applications
within
their
five
days
and
they
are
achieving
at
the
done
hundred-percent.
The
the
chart
that
we've
got
here
is
about
whether
or
not
the
whole
process
is
completed
within
50
days,
and
there
can
be
some
quite
difficult
and
protracted
registrations
once
once
that
fairly
bit
has
being
done
so
ncsc
are
getting
the
benefits
out.
Whether
or
not
that
target
is
realistic.
Given
some
of
the
complicated
registration
we
get
in
what
remains
to
be
seen,
but
it
is
that
the
performance
has
improved
I.
B
G
J
F
F
E
I
ask
two
things
that
both
relate
to
items
which
aren't
usually
in
the
performance
report
so
that
they
stand
out.
For
that
reason,
and
the
first
is
the
the
issue
of
the
unregistered
providers
that
you
referred
to
Andrew
and
try
to
understand
what
that
what
this,
how
this
comes
about,
because
there
are
over
a
hundred
a
month
coming
to
our
attention.
E
Your
prediction,
for
you
therefore
is
about-
is
just
under
1,500
for
the
year
that
so
these
are
unregister
and
we
refer
to
them
in
the
performance
report
on
slide
10
as
being
its
superior
fitness
volume
of
inquiries,
which
I
suppose
raises
the
question
about
how
we
then
know
about
them,
but
but
more
broadly,
might
I.
Suppose
my
fear
would
be
that
these
are
providers.
E
I
may
be
wrong
about
this,
but
my
prejudices
tell
me
that
they
might
be
providing
a
model
of
care
that
we
might
not
have
registered
and
so
I'm
wondering
whether
we
have
any
further
information
about
the
breakdown
of
who
they
are.
Are
they,
for
example,
residential
settings
for
people
with
for
all
the
people
or
people
with
learning
disability?
E
Are
they
being
established
with
the
agreement
in
some
sense
of
local
Commission's
people,
local
authorities
and
CCGs,
who
might
be
paying
force
people
to
go
there
because
and
also
how
quickly
we
discover
and
given
that
they
are
unregistered?
How
do
we
know
about
them
and
how
quickly
seem
to
me
that
this
is
a
slightly
strange
phenomenon?
The
profit
I'll
pause
there
and
then
come
back
to
my
second
point:
they're
just
completely
different.
So.
F
It
may
well
be
a
good
idea
for
us
at
a
future
stage,
to
give
you
a
little
bit
more
information
about.
What's
behind
all
of
this,
because
this
is
across
all
three
sectors
and
there's
actually
quite
a
lot
in
the
in
the
sector
that
Steve
is
responsible
for
where
we
see
unregistered
providers,
people
setting
themselves
up
to
provide
certain
procedures
and
and
those
not
being
registered
with
us.
F
How
we
get
to
know
about
them
is
that
people
tell
us
about
them,
so
they
will,
and
sometimes
that
is
local
commissioners
who
pick
up
the
fact
that
there
are
services
that
have
been
provided
locally,
that
they
do
their
due
diligence
on
and
discover
that
they're
not
registered
with
us,
and
so
they
raise
it
with
us.
Very
often
it's
members
of
the
public-
or
it
may
be
other
healthcare
professionals
and
social
care
professionals
who
were
raising
it
with
us.
F
For
example,
we've
had
services
where
people
have
been
looking
after
people
in
their
own
homes
and
and
and
actually
is
that
a
care
home.
What
is
the
nature?
Is
there
a
regulated
activity?
That's
been
provided,
and
sometimes
these
inquiries
come
to
nothing
because
there
isn't
there
isn't
a
regulated
activity,
that's
been
delivered
and,
and
we
can
close
it
on
that
basis.
Sometimes
it
is
that
people
were
trying
to
do
something
below
the
radar
and
we
have
to
do
something
about
it.
F
So
that
kind
of
gives
you
a
bit
of
a
flavour,
but
what
we
can
do
perhaps
for
the
next
quarter
when
we're
doing
this
report
and
them
looking
at
Malta,
who
is
kindly
nodding
at
me
to
include
a
little
bit
more
in
terms
of
what
the
breakdown
is
and
we
gotta
a
helpful
blank
quadrant
on
that
page
and
so
I
think
that
what
we'll
do
is
to
provide
err.
Maybe
a
pie
chart
of
the
different
and
services
that
that
relates
to.
E
E
E
So
just
there's
some
discrepancy
in
the
figures,
I
think
have
less
they're
reporting
different
things,
and
but
anyway,
putting
that
aside,
the
it
is
actually
quite
interesting
reading
and
one
of
the
things
that
comes
across
is
first
of
all.
That
awareness
is
writing.
That
is
largely
prompted
awareness,
I
assume.
That
means
people
are
given
the
name
of
CQC
and
we
say
well,
do
you
know
what
they
do
or
something
like
that?
E
So
do
we
know,
for
example,
what
the
equivalent
figures
or
can
we
can?
We
know
what
the
coolympics
might
be
for
Ofsted
or
I,
don't
know
Ofcom
or
off
Jen.
Well,
if
Jen
I,
suppose
where
there's
a
broad
public
interest
in
what
they
they
might
do
so,
and
you
know
the
figures
on
the
face
of
it-
seem
good
when
people
are
directly
asked
about
us,
not
so
good
when
they're
just
spontaneously
asked
who
is
doing
this
kind
of
work,
but
is
that
what
we
might
expect
from
a
survey
of
a
national
body
like
this?
So.
A
M
May
have
a
bit
more
to
add,
so
thanks
Luis
suggests
on
the
statistical
question
and
graph
a
shows
you,
the
general
awareness
that
there
is
a
national,
regulate
and
half
of
social
care
graph
view
shows
to
the
awareness
that
there
is
a
Care,
Quality,
Commission
and
as
you'd
expect,
less
people
are
aware
of
what
we're
called
and
are
aware
that
there
is
a
regulator.
That's
what.
E
M
On
your
point,
around
the
awareness
of
reports
you're
quite
right
and
I.
Our
purposes
is
that
where
people
have
a
choice
of
service
or
more
deliberating
about
where
they
receive
care,
they're
more
likely
to
be
aware
and
look
at
it.
That's
also
coming
out
in
the
age
groups
and,
as
you
said,
people
who
are
choosing
choosing
a
care
home
interesting,
it
doesn't
come
out
everywhere.
So
maternity
is
an
example.
We
think
there
is
more
deliberation
and
choice,
and
you
know
you
don't
have.
M
The
same
effect
is
on
care
and
care
homes,
but
I
think
it
is
important
input
and
evidence
for
the
work
that
we're
now
doing
on
understanding
how
we
actually
share
information
with
the
public
in
particular,
and
how
we're
reviewing,
how
we
publish
inspection
reports
and
bring
those
information
out,
not
just
through
the
reports,
but
generally
our
website
as
well,
and
hopefully
that
will
help
us
with
that.
Wider
awareness
on
your
question.
How
comparable
it
is
I'd
suggest
would
bring
some
something
back.
M
A
N
Thank
you
Peter.
This
is
for
I
think,
probably
for
a
molten
cake
together,
because
I
was
just
interested
in
the
under
spend
on
pay
basically
and
the
come
the
multi
made
about
recruitment
because,
as
I
recall
a
couple
of
years
back,
we
were
struggling
to
recruit
inspectors
as
fast
as
we
needed
to
in
order
to
complete
our
inspection
programs.
It
up
to
the
time.
David
Lipman
said
that
we
had
set
ourselves
in
which
we
have
to
be
located
to
the
public
and
to
D
H
and
I.
B
Okay,
so
the
understand
is
related
to
the
fact
that
we
have.
We
haven't
been
able
to
recruit
in
certain
areas
and
in
some
cases,
and
also
on
the
pay
underspend,
it's
related
to
spy
usage
as
well,
that
we
haven't
been
undertaken.
The
same
number
of
inspections
as
well
as
we
originally
thought
we
would
when
we
set
the
budget
and
profiled
it.
So
we
are
expecting.
B
B
We've
also
had
discussions
separately
about
where
we
need
to
recruit
to
and
Ruth
has
got
a
very
clear
target
and
she's
also
done
a
very
good
plan
of
what
she
can
realistically
and
to
take
and
who
she
can
get
through
the
door
and
I'm
we're
proactively
with
reaching
people,
rather
than
waiting
for
vacancies
to
occur.
So
I,
don't
think
we're
going
to
get
back
into
that
situation,
but
we
always
still
don't
you
understand
this.
M
It's
also
worth
saying
that
we're
traditional
recruitment
is
difficult.
We're
considering
alternatives
on
how
we
can
deal
with
that.
So,
in
particular
case
in
hand
is
for
my
team
of
analysts,
where
we
want
to
automate
quite
a
lot
of
the
current
processes,
and
actually
we
can
do
that
by
investing
in
work
that
we
do
over
the
next
3
4
5
months,
rather
than
recruit
additional
people
into
our
team
and
to
deal
with
it.
D
There
well
at
the
moment
we're
predicting
we're
going
to
hit
our
targets
within
hospitals.
Recruitment
is
much
much
better
than
it
was
and
we
are
close
to
to
where
we
want
to
be
I.
Think
the
main
our
main
concern
is
the
turnover
and
you'll
see
the
turnover
11%
or
so,
and
that
we've
got
as
Kate
mentioned.
We've
got
to
be
proactive
about
recruiting,
not
waiting
for
a
vacancy
and
then
filling
it
and
having
a
gap,
but
actually
having
a
constant
stream
of
people
come
again
exciting
with
the
10%
turnover.
D
D
Some
of
the
risks
that
we
we
know
we
face
in
some
of
the
sectors:
independent
health,
for
instance,
where
we've
identified
new
risks,
we
we
need
to
just
review
the
number
of
inspectors.
We
need
to
do
that
and
we
are
doing
that
going
forward,
but
I
think,
as
Kate
mentioned,
Ruth
is
taken
forward
to
a
criminal
strategy
and
I'm
pretty
comfortable.
Have
sufficient
new
recruits
to
actually
deliver
what
we
need
to
the
next
year
as
well.
A
D
F
That
is
shifting
the
the
inspection
profile
in
terms
of
the
inspections
that
we
need
to
do
so
I'm
worried
about
that.
Clearly,
our
vacancy
levels
have
had
some
impact
on
that.
The
levels
of
sickness
and
absence
have
also
had
some
impact
on
that
and,
as
I
explained
earlier,
once
you
take
those
factors
into
account
and
you
factor
in
the
notifications,
inquiries,
whistleblowing,
safeguarding
inquiries
that
we've
got
to
monitor
and
ensure.
F
That
of
being
picked
up
and
that
were
close,
spread
amongst
a
smaller
number
of
people,
has
an
impact
in
terms
of
the
amount
of
time
that
they've
got
to
do
inspections,
so
we're
very,
very
conscious
of
all
of
those
factors.
Looking
at
how
exactly
as
Ted
has
said,
what
can
we
do
to
proactively
recruit
into
vacancies
and
to
also
predict
those
people
and
folk
have
been
fantastic
actually
in
terms
of
saying?
Well,
you
know
I
can
retire
and
I'm
planning
to
retire
at.
F
Why
and-
and
that
is
enabling
us
to
and
to
plan
for
that
in
a
way
that
we
haven't
done
previously
and
also
to
look
at
our
skill
mix
and
to
think
about
how
do
we
look
at
the
things
that
we're
asking
inspectors
to
do?
Are
there
things
that
we're
asking
inspectors
to
do
that?
Somebody
else
could
do
so
that
we
free
up
their
time
to
actually
get
out
there
and
do
inspections.
A
K
K
K
First
up
and
looking
back
over
here,
I
am
very
proud
to
present
I
think
you
will
have
had
copies
of
our
annual
report,
and
this
represents
hundreds
of
thousands
of
people's
voices
and
through
local
HealthWatch
and
up
through
national
HealthWatch
and
I
just
like
to
make
perhaps
two
points
around
that
leading
on
from
what
I
hoped
I
was
going
to
do
when
I
became
chair
first
is
about
tome
and
the
second
one
is
about
intelligence,
and
the
one
about
tone
is
how
to
make
sure
that
all
this
evidence,
all
this
customer
feedback,
some
of
which
is
complimentary,
some
of
which
is
critical,
some
of
which
is
actually
full
of
rich,
seems
of
good
ideas.
K
How
to
make
sure
that
people
providers
actually
do
listen
to
it,
and
we've
worked
our
socks
off
trying
to
make
sure
that
our
toners
b1
of
helpfulness
development,
we're
here
to
help
and
I.
Think
you
get
a
sense,
I.
Think
from
our
on
your
report
that
more
and
more
people
are
taking
up
the
evidence.
In
fact,
providers
are
now
asking
us
for
more
evidence.
I
think
that's
that's
a
really
a
great
thing
and
there's
a
role
for
HealthWatch
in
in
helping
with
that
communication.
K
I
was
at
a
meeting
in
Hammersmith
the
other
night
and
the
chair,
the
local
campaign,
the
hospital
said,
thank
goodness.
You're
here,
wouldn't
have
a
conversations
all
in
plain
English.
We
can
understand
what
you're
talking
about.
So
we
are
very
keen
to
make
sure
that
people
have
their
say
doesn't
mean
that
we
don't
also
hold
their
feet
to
the
fire
when
we
need
to.
We
had
a
one
local
soldier
recently
that
was
having
problems
in
its
attitude
to
commissioning,
and
we
were
absolutely
straight
down
line
said
this.
This
will
not
do
and
they
came
back.
K
They
said,
okay,
yes,
we
agree.
The
other
point
was
about
intelligence.
When
I
came
on
as
chair,
I
really
I
think
I'd
I
want
I
said:
I
want
to
have
a
cobra.
It
was
a
Judi
Dench
moment
and
we
have
indeed
got
an
intelligence
system
now
which
I'm,
proud
of
and
got
a
little
team
across
there
who
are
constantly
combing
and
looking
over
what
local
HealthWatch
are
doing
what's
happening
elsewhere
and
making
sure
that
our
offer
to
local
HealthWatch
our
CRM
system
is
as
good
as
it
possibly
can
be
it's
getting
there.
K
But
the
other
thing
I
found
just
talking
to
some
local
HealthWatch
is
that
they've
got
a
lot
more
information.
That's
not
actually
necessary.
Reaching
us
I,
don't
know
why,
whether
whether
it
was
and
actually
when
I
started
talking
to
my
fam
there's
a
bit
there
about
trust
and
you
I'm
here
in
the
Midlands,
why
would
I
pass
it
to
you
folk
in
London
type
of
thing?
K
So
I
spent
a
lot
of
time
over
the
last
12
months,
going
out
to
local
HealthWatch
talking,
hopefully
gaining
trust
with
amela
with
the
team
and
the
and
there's
some
really
good
quality
people
out
there.
The
research
teams
out
there
so
I
think
we're
really
starting
to
us
or
get
a
grip
on
on
on
the
intelligence.
K
We
absolutely
when
you
probably
saw
in
a
CPC
state
of
care
report.
Our
evidence
absolutely
supports
what
you're
saying
I
think
our
unique
contribution
is
to
provide
that's
the
practical
level
of
do
tail
that
enables
people
in
the
service
to
go
art.
That's
what
the
problem
is.
So
recently
we
looked
at
delayed.
K
Oh
no,
we
looked
at
emergency
readmissions
and
everyone
you
see
is
a
bit
of
an
issue,
but
what
we
found
when
we
really
really
looked
at
it
was
that
it's
in
the
first
48
hours
and
then,
if
you
say,
pass
that
back
to
people
I
get
all
right.
Okay,
let's
hold
look
see
what's
happening.
What
what
are
you?
What
are
the
issues
so
I
think
that's
where
we
make
our
biggest
contribution
and.
K
Looking
forward
well
I
one
other
thing:
I'm
busy
recruiting
at
the
moment
for
new
members
of
the
committee,
so
application
under
applications
have
closed
and
we
have
400
applications.
I
was
I
was
delighted
as
a
great
reflection
on
the
HealthWatch
Network
that
so
many
people
work
working
to
come
and
help
looking
forward.
Oh,
we
are
preparing
our
strategy
for
the
next
four
or
five
years
and
going
out
to
people
and
saying
well
what
do
you
think?
K
How
would
you
see
the
future
and
I
is
interesting
because
talking
earlier
about
the
pressures
on
the
system,
actually
people
are
very
keen
to
take
control
of
their
own
health,
whereas
about
four
or
five
years
ago,
when
we
were
asking
people
they
saw
well,
they
are
uriah,
heep
type
levels
of
humility
and
gratitude
to
the
NHS
and
wouldn't
dare
question
it
now.
There
are
much
better
place,
it's
it.
It
seems
when
they
want
to
take
control,
they
want
to
be
involved
they're
up
for
it.
K
They
recognise
all
the
pressures
on
the
NH,
as
it
don't
add
to
them.
They
really
want
information
that
will
help
them
stay
healthy,
but
when
things
go
wrong,
they
want
quick
access
to
to
a
health
care.
So
we're
talking
and
we're
going
to
take
forward
our
strategy
and
we
bring
something
back,
hopefully
is
here
in
a
very
early
in
2018.
So
that's
the
story
from
HealthWatch
great.
A
K
There
is
a
lot
of
churn
out
there.
There
are
challenges
with
funding,
but
we're
just
about
to
write
to
the
Secretary
of
State's.
We
have
our
hours
to
do
each
year
with
a
picture
of
what
is
happening
out
there.
Overall,
the
system
is
in
good
is
in
good
health.
The
challenge
for
us,
though,
is
to
make
sure
that
the
quality
of
the
best
is
the
quality
of
all
I,
probably.
A
K
Yes
and.
K
K
Manchester
has
a
grant
of
our
85,000
pounds,
while
funding
85,000
has
the
whole
of
Manchester
looking
at
the
city,
and
yet
they
are
the
sort
of
David
and
Goliath
like
ability
to
really
get
a
grip
on
what's
happening,
a
local
system
so
I
haven't
comfortable
I
know
there
will
be
in
the
normal
distribution
of
outstanding
doing
all
right
and
that
there
will
be
some
and
we
have
a
team
of
regional
people
who
are
out
there
all
the
time,
making
sure
that
that
they
are
as
good
as
there
can
be,
but
it
we
really
rely
and
work
very
closely
with
local
authority
commissioners
who,
after
will
have
a
final
responsibility
on
getting
that
to
a
quality
service,
and
they
seem
to
be
very
keen
and
very
happy
with
her.
D
K
Question
well
going
back
to
my
I
think
it
was
South
Yorkshire
where
they
got
a
big,
accountable
care
system
coming
in
there
and
I
went
to
talk
up,
went
to
talk
to
some
110
local
trust
governors
the
other
day,
and
they
were
all
very,
very
aware
of
their
local
HealthWatch
and
elsewhere.
West
your
al-faisal
Yorkshire
focus
member
West
Yorkshire.
Likewise
there
that
they
were
HealthWatch
where
one
one
local
HealthWatch
is
tackling
this
bit
and
one
is
yeah,
they've
got
themselves
into
a
team
Manchester.
K
There
was
here,
probably
this
time
last
year,
if
you'd
ask
me,
I've
been
signing
bit
more
pathetic,
because
people
were
there's
a
sense
which
local
HealthWatch
we're
trying
to
work
out,
how
to
knock
on
the
door
and
make
their
voices
heard,
but
I'm
hearing
much
less
of
that
now
and
I
do
think
that
they
are
getting
much
more
of
a
getting
their
voices
heard.
More,
it
was
marvellous,
for
is
that
on
the
list
of
priorities
you
know
they
put
engagement.
K
First
of
all,
and
we've
been
working
on
that
ever
since
one
local
HealthWatch
I,
think
it's
down
in
Dorset
Martin
was
saying
that
he
couldn't
get
himself,
so
he
decided
to
publish
you
a
list
of
ten
negative,
five
or
ten
principles,
a
good
engagement
and
say
across
the
media.
I'm
going
to
judge
you
guys
by
how
you
do
this.
He
said:
I
had
phone
calls
from
all
the
local
providers
in
the
next
week,
so
there
are
ways
and
means
of
doing
this.
I
come
back
to
my
David
and
Goliath
analogy.
L
A
F
A
Apologize
that
those
here
are
faint,
any
change.
I
have
a
great
job
in
your
absence,
if
you
were,
if
you
weren't
listening
Louis
looks
if
he
wants
to
ask
a
question
and
then
I'll
give
you
a
chance
to
do
that.
Now
that
you
know
what
change
said,
so
it's
bitter
hard
to
say
to
you
is
there
anything
I
want
to
add,
because
you
don't
know
actually,
but
if
ability,
but
if
you
want
to
say
well,
you
know
jokes,
the
moment:
do
this
I'm.
A
F
Don't
know
the
exact
figure
and
I
can
I
can
certainly
send
it
through
to
you,
because,
but
but
a
number
of
local
healthwatch
do
look
at
the
types
of
services
that
there
are
and
people's
experience
of
it.
I
can't
tell
you
off
the
top
of
my
admit,
my
head,
how
many
of
the
hundred
and
fifty
to
do,
but
I
can
dig
that
out
for
you
I.
E
Suppose
I
was
thinking
you
had
mentioned
that
next
year
mental
health
will
be
a
theme.
Obviously,
alcohol
and
drugs
are
not
just
about
mental
health,
but
that's
an
important
issue
for
mental
health
and
a
lot
of
concern
at
the
moment
about
the
way
in
which
alcohol
and
drug
sir
drug
services
have
been
rather
separated
from
in
the
way
that
they're
commissioned
from
from
mental
health
generally,
and
it
just
would
be
a
very
useful
and
source
of
information.
I
think.
F
At
the
we're
still
scoping
the
piece
of
work
that
we
want
to
do
on
mental
health,
and
perhaps
we
could
have
a
conversation
with
you
in
those
early
scoping
days,
because
there's
so
much
I
think
there
were
36.
Priorities
were
thrown
up
from
the
local
healthwatches
experience
and
so
we've
got.
We've
got
to
really
decide
at
what
angle
we
come
at
it
from,
but
perhaps
you
wouldn't
mind
a
bit
of
your
time,
because
I
think
that
that's
an
important
issue.
C
But
it's
really
encouraging
that
so
many
people
contact
you
and
in
one
way
or
another,
and
you
get
the
information
from
them.
Is
there
any
rather
following
on
prozis
question,
looking
at
the
numbers
in
relation
to
up
the
hospital
care
section
on
the
Mental
Health
Services
section,
and
so
on,
you,
there
state
specific
numbers,
who've
informed
your
report
in
that
section.
C
Those.
What
surprised
me
slightly
was
that
you
actually
have
think
I'm
right
in
thinking
more
people
thought
through
about
primary
care
than
hospital
care
and
I
just
wanted
to
have
how
how
it
breaks
down
between
the
various
sectors.
That's
the
first
question
and
just
developing
Louis's
point
how
you
reach
out
to
vulnerable
groups
generally
including
mental
health
and
people
who
may
indeed
have
would
not
be
the
people
who
were
forwarding
coming
come,
who
either
come
forward
with
their
concerns.
F
It
is,
it
is
quite
interesting:
the
public
tend
to
volunteer
a
lot
of
information
about
primary
care
and,
and-
and
some
of
that
is
about
access
to
care,
access
to
primary
care
services.
That's
tends
to
it.
They
are
also
quite
satisfied
once
they
get
those
services,
but
they
tend
to
talk
about
it
more
than
other
Caroline
surveys,
because
it
just
makes
sense.
It
touches
more
of
the
population
than
those
who
use
hospital
care.
F
A
number
of
HealthWatch
I
think
have
traditionally
found
it
easier
to
engage
with
hospitals
because
their
buildings
and
their
their
their
and
and
and
so
a
lot
of
the
relationships
have
been
built
up
there
and
they've
made
a
concerted
effort
to
build
relationships
across
primary
care
as
well.
I.
Think
personally,
when
we
talk
about
more
vulnerable
groups,
are
hard
to
reach
groups.
I
think
it's
one
of
healthwatch
greatest
strengths.
F
Camden
HealthWatch
has
done
some
brilliant
work
with
Bangladesh
community
and
built
advocates
within
that
community,
so
that
they
can
help
things
around
breastfeeding
and
accessing
services.
Those
sorts
of
stuff
but
I
actually
think
it's
one
of
the
unique
bits
that
we
should
be
pulling
out
more
and
talking
about
more.
A
F
One
thing-
and
this
is
this-
is
something
I'm
very
proud
of.
My
first
meeting
here
I
was
asked:
are
you
doing
anything
on
Social
Care
and
we're
doing
a
lot
on
Social,
Care
and
I
wanted
to
highlight
that,
and
just
in
the
last
few
months,
we've
produced
two
reports
on
Social
Care,
one
about
people's
experience
of
living
in
care
homes
and
another
report
on
people's
experience
of
domiciliary
care
and
when
we
move
on
to
mental
health
and
the
social
care
aspect
of
that
will
be
a
big
plank
of
work.
That
will
do.
A
Yeah,
you
made
somebody
happy
today,
yeah
great
Jane
and
Imelda.
Thank
you
very
much
and
thanks
to
your
colleagues
both
at
health
watching
down
and
around
the
country,
since
this
is
very
good.
Thank
you.
So
it's
a
terrible
cliche
to
say
that
staff
are
are
our
greatest
asset,
but
but
actually
in
the
case
of
CQC,
they
really
are.
A
We
could
not
do
any
of
the
things
that
we
do
without
the
incredibly
good
staff
that
we
have
I,
but
I
wanted
today
to
just
take
a
moment
of
the
board's
time
to
introduce
Paula
Mansell,
who
has
got
the
recognition
of
outstanding
contribution
award
this
year,
the
ROC
award
and
it
just
fabulous.
What
you've
been
doing.
A
The
Paula's
role
is
to
lead
on
all
kinds
of
sector
integration
work
and
on
developing
our
own
understanding
as
an
organisation
about
how
services
are
integrating
and
how
we
will
then
respond
to
all
of
that
regulating
new
models
of
care.
Whole
pile
of
things
which
are
are
really
really
important
to
us,
but
that
isn't
why
she
got
the
rock
award.
But
it's
a
really
important
thing
to
be
doing.
A
The
rock
award
came
because
of
the
work
that
you
did
on
the
the
Cornwall
care
in
a
place
which
we
talked
about
elsewhere
in
the
board,
and
that
was
a
a
pioneering
in
a
sense
piece
of
work
for
for
CQC.
That
then
flows
into
a
lot
of
the
other
local
area
work
that
we
have
been
doing
and
I
just
think
it's
it's
fantastic
that
you
took
that
on
developed
it
and
did
everything
else
so
I
wanted
to
congratulate
you.
I
would
have
liked
to
have
been
handing
you
an
award,
but
you've
already
had
it.
A
A
Said
before
we
I
said
before
we
started,
I
would
embarrass
you
if
you
want
to
say
anything
you're
welcome
to
if
you
want
to
just
sit
there
and
bask
in
the
glory
of
the
applause
of
the
board.
That's
that's!
Absolutely
fine.
If
you
are
going
to
speak,
you
need
just
go
and
grab
a
microphone,
though
so
the
whole
world
can
hear
you
not
just
the
people
in
the
in
the
room.
Thank.
G
You
very
much
chair
all
I
would
really
like
to
say
is
that
it's
part
of
a
much
wider
piece
of
work,
looking
at
how
we
look
at
evolving
in
different
new
models
of
care,
and
then
it
was
very
much
a
piece
of
teamwork,
part
of
the
integration
team
and
the
work
they're
doing,
but
also
the
hospital's
team,
the
PMS
team
and
the
adult
social
care
team.
The
enthusiasm
and
commitment
to
take
on
this
new
and
very
different
piece
of
work
was
was
amazing
and
it
was.
It
was
great
to
work
part
of
that
team.
L
A
Thank
you.
Thank
you
very
much
again
stay
with
us,
please
so
for
the
board.
Is
that
any
other
business
anybody
wants
to
raise,
if
not
we'll
end
the
part
of
the
meeting,
but
that
leaves
us
with
not
a
lot
of
time,
I'm
afraid,
but
some
time
anyway
for
questions
and
and
so
on
from
members
the
public
and
I'm
going
to
take
them
in
the
order
in
which
they
reached
me
and
brain.
You
were
first
out
of
the
trap.
So
would
you
like
to
go
and
take
a
place?
O
In
July,
26
Steen
had
a
meeting
with
the
minister
there
after
ad
meetings,
Varys
chief
execs
in
terms
of
David
p.m.
I,
think
his
approach
was
on
very
relaxed
about
this
brand
and
Chris
Diaz
got
it
as
me,
and
therefore
thank
you
and
we'll
go
on
really
on
the
Tuesday,
the
7th
of
November
2017.
We
delivered
that
national
pilot
dine
to
a
committee
as
a
series
of
community
organizations
at
the
in
terms
of
voluntary
criminal
organizations.
There
are
about
100.
The
discussions
covered.
O
Eight
different
sites
in
Gloucester
Imelda
was
very
really
welcomed
and
Warner
pleased
to
be
absolutely
involved
in
that
in
terms
of
representation
from
Care
Quality
Commission
Paul,
Paul
Corrigan
was
there,
as
was
Chris
day
and
a
member
of
Chris
team
and
I
like
to
offer
through
bolt,
read
our
thanks
to
Chris
for
the
absolutely
dedication
commitment
and,
most
importantly,
representation
of
the
provision
of
CQC.
Really
what
is
very
clear
about
the
stars:
I,
don't
want
any
money,
our
only
project,
planner,
Dewani
structures
and
systems.
O
O
Secondly,
really:
what
is
their
offer
when
they
come
down
and
have
that
conversation,
for
example?
And
thirdly,
really
which
again
came
out
very
very
clearly
on
the
set
for
November,
which
in
fact
we
held
the
events
at
the
police
headquarters?
We
have
the
Chief
Constable
open
it.
So
often
that
tends
to
happen.
O
You
have
there,
the
chief
counsel
office
of
the
clinical
Commission
group
or
the
lead
for
the
Carrington,
whatever
my
decision
actually
really
that
we
need
to
go
wider
with
our
conversation
involve
greater
partners
really
so
the
Chief
Constable
rod,
Hansen
opened
it
and
whatever
Duncan
Selby
as
I've
agreed,
is
taking
the
national
lead
for
me
on
this
really
very,
very
clear
about
that
and
Duncan
actually
closed
it
with.
Is
those
three
comments
really
so
I
just
fall
into
in
the
community?
O
That's
nothing
more,
nothing
less
or
whatever,
but
what
I
can
say
really
is
again
when
we
provide
platforms
and
the
environment
and
the
supportive
aspect
to
this,
you
know
we
can
do
it
and
that
will
be
clearly
identified
and
discussed
with
the
ministers
with
Peter
with
the
National
bodies
and,
more
importantly,
with
those
60
community
organisations
were
actually
part
of
that
initial
conversation,
not
always
usual
whatever.
Really,
but
again.
Let's
take
this
a
very,
very,
very,
very
proud
moment.
A
P
P
P
The
question
Chairman
relates
to
the
digital
and
intelligent
strategy,
which
was
discussed
at
the
October
meeting
and
I'm
asking
whether
CQC
as
a
government
agency
might
benefit
from
collaboration
with
other
government
agencies.
That
already
have
a
lot
of
experience
in
this
field,
particularly
with
intelligence
gathering,
I
should
say,
I
come
from
Cheltenham
and
I
grew
up
about
a
mile
from
a
government
agency
that
has
a
lot
of
experience
in
his
field
and
then
in
particular
again
following
the
October
board
meeting
professor
Baker
mentioned
the
report
on
UCLH,
which
is
available
published
on
CQC
website.
P
M
The
longer
answer
will
come
from
Walter
Thank,
You
Robin,
so
on
the
first
part
of
your
question,
how
we're
working
with
other
government
agencies
and
the
first
thing
to
say.
Of
course,
peat
Sinden
is
a
joint
appointment
between
us
and
Energy's
improvement,
so
we're
already
working
very
closely
with
the
other
health
and
where
relevant
care,
sector
organisations,
including
Energy's,
digital
NHS,
England
and,
of
course,
alongside
that,
also
also
much
more
widely
with
the
government
digital
service,
which
oversees
a
lot
of
all
of
the
digital
development
across
the
public
sector
bodies.
M
I
can't
give
the
answer
of
what
it
will
look
like,
because,
right
now
we
are
in
the
process
of
doing
the
user,
research
and
understanding
of
what
the
different
audiences
of
the
organisation
are
looking
for,
particularly
from
our
website.
You
highlight
at
the
point
about
the
search
function
within
it.
M
Looking
for
information
about
a
particular
care
service,
or
indeed
the
wider
public,
so
we're
beginning
to
have
that
inside
in
those
findings
now
to
begin
to
design
the
website.
So
it'll
address
the
points
that
you
mentioned,
but
I
couldn't
tell
you
now
what
it
will
look
like,
but
we're
definitely
in
the
course
of
doing
something
about
it.
If.
A
I
could
just
add
that
you
know
intelligence
for
us,
isn't
just
the
sort
of
secret
intelligence
that
spooks
and
others
will
have
so
the
private
sector.
The
commercial
sector
does
an
awful
lot
of
gathering
of
information
which
is
intelligence
but
of
a
different
sort,
and
that
intelligence
and
understanding
how
they
gather
it
I
think
is
going
to
be
equally
important
to
us
as
anything
that
is
done
by
other
government
agencies
so
as
mortar.
A
Q
M
O
Q
Q
But
by
relatives
plus
with
the
agreement
of
the
home,
so
that
the
relative
not
so
much
a
spy
camera
as
that
the
relative
can
collaborate
with
the
staff
in
their
care,
and
it
is
also
a
good
thing,
because
people
in
the
government
have
been
saying
that
it
would
be
good
if
relatives
played
a
little
more
part
in
the
care
of
their
older
people,
and
this
does
give
an
opportunity
to
relatives
to
do
this.
So
what
I'm
hoping
is
that,
when
this
guidance
comes
out,
there
will
be
there?
F
You
very
much
and
thank
you
David,
for
the
advance
notice
of
the
question.
So,
as
you
know,
we
published
and
February
2015
information
for
the
public
and
we
have
previously
published
information
for
providers
around
the
use
of
surveillance
and
we're
coming
to
the
three-year
anniversary
of
that.
It
can
strikes
me
that
time
is
passing
very
quickly
because
it
doesn't
feel
like
three
years
as
we
did
that,
and
so
we
are
committed
to
updating
and
that
information,
both
the
providers
and
for
the
public.
F
Absolutely
right,
there's
a
variety
of
different
mechanisms
and
in
fact,
we
I
know
of
some
very
good
services
that
are
using
auditory
monitoring,
which
is
actually
having
a
real
positive
impact
on
the
quality
of
care
and
the
quality
of
experience
of
people
who
are
living
in
their
services
through
the
reduction
of
Falls,
for
example,
in
different
ways
that
they
had
not
necessarily
anticipated,
but
has
been
a
real
positive
impact
of
them.
So
we're
going
to
look
at
it
in
a
much
broader
sense
so
that
we
can
take
those
things
on
board.
F
We've
been
slightly
delayed
because,
as
some
I
think
Ted
mentioned
earlier,
some
of
our
plans
for
this
year
were
not
a
little
asunder
by
the
timing
of
the
general
election
and
that
kind
of
knocking
on
impact
in
terms
of
when
we
started
our
next
phase
of
regulation
and
the
work
that
we
needed
to
do
for
that.
But
we
are
starting
that
process
and,
in
fact
we're
having
an
initial
conversation
with
the
adult
social
care
external
co-production
group
tomorrow
on
Thursday.
So
we
are
starting
that
process.
F
A
David,
you
are
100%
right,
there's
a
lot
of
really
exciting
technology
out
there
and
it's
understanding
it
and
understanding
how
it
can
be
best
used.
So
thank
you
for
raising
that
and
I
afraid
I
wasn't
paying
proper
attention
to
the
clocks.
I
should
actually
have
said
we
had
to
stop
before
you
had
your
question
David,
so
you,
but
we
are
out
of
time
so
I
apologize
to
anybody
else
who
wanted
to
raise
a
question,
but
that
is
it
for
today.
Thank
you
all
very
much
for
coming.
Thank
you.