►
From YouTube: CQC Board Meeting - July 2020
Description
No description was provided for this meeting.
If this is YOUR meeting, an easy way to fix this is to add a description to your video, wherever mtngs.io found it (probably YouTube).
A
Get
started,
let
me
welcome
everybody
to
the
public
board
meeting
of
the
cqc
on
the
15th
of
july.
We
have
no
apologies
for
absence.
Can
I
ask
if
there
are
any
declarations
of
interest
that
anybody
needs
to
raise
specifically
in
relation
to
this
meeting?
A
Excellent?
Thank
you
very
much.
Indeed.
Can
I
particularly
welcome
lizzie
dobres
who
dobre
sorry.
I
pronounced
that
wrong.
Having
promised
lizzie,
I
would
get
it
right.
I
got
it
wrong.
I
do
apologize
lizzy,
but
you're
very
welcome
at
the
meeting
anyway
and,
as
you
know,
please
do
feel
free
to
contribute
to
the
meeting
is
the
co-chair
of
our
gender
equality
network
and
it's
representing
the
network
organizations
today
at
the
at
the
meeting.
A
A
The
action
log
had
one
item
on
it
and
I
think
kirsten
you're
just
going
to
give
it
an
oral
update
on
that.
Please.
B
Yes,
sorry,
my
sister
was
crying
yes,
so
this
was
to
do
with
the
the
registration
record,
the
red,
how
we
record
representations
in
registration.
B
Basically,
if,
if
we
get
a
representation-
and
it's
upheld,
that's
actually
a
good
thing,
because
it
means
that
the
participant
the
the
register
person
who's
applying
to
be
further
registration,
has
actually
taken
on
board
our
recommendations
and
has
corrected
something.
So
that
that's
that's,
that's
why
it
reads
like
that
and
that's
so
that's
where
we'd
like
to
keep
it
like
that,
if
that's
okay,
hopefully
that
clarifies
the
point
from
last
last
board.
A
It
certainly
clarified
it,
for
me,
is
everybody
else
now
suitably
clarified?
Thank
you
kirsty
very
much.
I
know
you're
having
power
problems,
so
thank
you
for
for
being
able
to
join
us
right.
So
unless
there's
anything
else
arising,
that's
not
otherwise
on
the
agenda,
in
which
case
cnn
can
we
come
to
you
please,
for
the
executive
team
report.
C
Thanks
good
morning
peter
good
morning,
everybody,
this
is
a
slightly
longer
executive
team
report
than
than
I
would
usually
write,
because
I
thought
now
was
a
good
time
to
update
the
port,
the
board
and,
of
course,
the
public
on
our
plans
for
the
for
the
coming
months.
C
I
think
it's
fair
to
say
that
that
if
you
were
to
read
the
newspapers
and
and
actually
go
out
and
about
there's,
some
degree
of
normality
is
returning
to
society,
and
I
think
I
think
we
would
all.
We
would
all
welcome
that
and
see
that
as
a
positive.
C
But
I
do
think
the
kovit
19
is
still
present
in
a
number
of
the
providers
that
we
regulate
and
that
we
need
to
consider
any
action
that
we
take.
In
that
context,
I
think
I
think
we
we
also
need
to
recognize
that
there
is.
There
still
remains
a
fair
amount
of
regional
variation,
and
I
think
we'll
talk
about
this
later
on
the
insight
report,
which
is
further
on
on
the
agenda
that
demonstrates
regional
variation
in
terms
of
numbers
of
cases
and
and
and
and
sadly
death
rates
as
well.
C
So
I
think
I
think
first
things.
First,
it's
really
important
to
acknowledge
that
there's
been
some
really
great
work
from
from
providers
and
and
the
teams
the
teams
that
work
within
those
providers.
You
know
that
just
we
we've
heard
so
many
front
line
stories
from
from
social
care
and
and
and
in
health,
and
those
frontline
stories
have
been.
C
You
know
frankly,
inspirational
shirt
to
all
of
us
and
we've
had
a
huge
privilege,
I
think,
as
an
organization
of
being
able
to
to
range
across
social
care
and
health
and
see
what's
going
on
on
the
ground
and
see
and
listen
to
those
stories
firsthand
and
and
then
I'd.
You
know
in
adult
social
care
alone,
for
example,
we've
spoken
to
20
000
providers.
C
Over
the
last
over
the
last
few
months,
we've
had
lots
of
really
positive
stories,
alongside
understandable
caution
from
those
providers
about
the
next
steps
and
those
next
steps
out
of
covid
and
that's
the
environment.
We're
working
in.
I
think
that
sort
of
that
environment
of
of
optimism,
but
but
also
of
caution
as
well.
C
I
think,
need
to
reflect
that
that
optimism
in
past,
but
I
do
think
that
we
need
to
be
able
to
have
plans
which
enable
us
to
pause
and
take
a
step
back
if
we
need
to
either
at
a
national
level
if
we
feel
that
covet
is,
is,
is
rising
on
a
national
scale
or
or
have
or
be
able
to
flex
our
plans
locally
to
take
account
of
of
local
issues.
C
And,
of
course,
we
saw
in
the
last
few
weeks
the
the
issues
in
in
leicester
and,
again
from
our
point
of
view,
we
need
to
have
plans
in
place
that
enable
us
to
to
perhaps
take
a
step
back
or
indeed,
a
step,
a
step
forward.
If
we
need
to
in
certain
in
certain
time,
at
certain
times
to
to
do
our
work.
So
flexibility
has
got
to
be
our
watchword
in
in
any
of
the
plans
that
we
talk
about.
C
So
so,
as
I'll
talk
in
a
moment
about
about
ambitions
and
and
the
dates
for
those
ambitions,
I
think
all
of
the
dates
that
I
talk
about
have
got
to
be
seen
as
as
being
flexible,
depending
on
on
where
we
are
as
a
nation,
either
as
a
whole
nation
or
as
regions
within
within
that
nation.
So
I
think
it
feels
like
it's.
The
conversation
is
going
to
be
a
live
one
and
and
a
fairly
dynamic
one.
C
I
I
think,
speaking
to
partners
and
providers
I've
over
the
last
few
weeks.
I
think
we've
all
been
struck
by
the
real
sense
that
that
the
last
few
months
have
been
challenging
and
that
they
have
fostered
innovation
and-
and
I
think
that
challenge
has
inevitably
brought
out
that
innovation
in
a
number
of
different
ways.
C
So
our
plans
have
to
do
a
number
of
things
that
they
have
to
help
build,
that
momentum,
around
innovation
and
support
providers
who
are
ambitious
for
those
who's
who
use
their
services.
I
think
you
know:
we've.
We've
certainly
felt
that
we
want
to
to
make
sure
that
we
we
are.
We
encourage
and
support
providers
who
are
ambitious
getting
out
of
their
way
if
we
need
to
providing
support
and
and
advice
and
so
forth
to
make
sure
that
they
can
realize
those
ambitions.
C
C
We
will
step
in
and
and
deal
with
that,
but
but
that
balance
between
between
between
keeping
up
the
momentum
on
innovation
and
keeping
the
public
safe
is
really
important,
because
at
the
end
of
the
day
our
purpose
is
to
is
to
give
the
public
assurance
around
safety
and
quality
of
service
and
to
promote
wider
improvements,
and
we
want
to
make
sure
that
those
two
things
are
never
in
conflict
and-
and
I
I
think,
we've
managed
to
do
that
so
far
and
I'd
like
to
continue
to
keep
doing
that
in
in
in
promoting
improvement.
C
I
I
think
we
wanted
to
try
and
be
practical,
because
you
know
I'm
very
struck
by
the
fact
that
you
know
many
of
the
many
of
the
people
who
who
are
leaders
in
in
health
and
social
care
will
not
have
been
able
to
so.
I've
got
to
get
out
and
about
in
the
way
they
traditionally
would
have
done.
They
haven't
been
able
to
go
and
see
neighbors
in
in
similar
services.
They
haven't
been
able
to
benchmark
themselves
around
what's
going
on
in
the
wider
in
in
their
wider
community.
C
So
we've
captured
lots
of
examples
of
good
practice
on
our
website
and
we've.
That's
a
part
celebration
part
contribution
to
to
the
improvement,
improvement
story
of
health
and
social
care,
and
the
reason
we've
done
that
in
that
format
is
because
it's
a
very
practical
way
for
people
just
to
go
onto
our
website.
Look
at
things
and
think.
Yes,
I'm
going
to
copy
that.
You
know
it's
almost
a
plagiarized
with
pride
approach,
I
suppose,
and
that
that's
a
simple
online
resource.
C
C
We've
also
internally
completed
some.
Some
really
important
upgrades
to
our
technology-
and
I
know
mark,
will
talk
about
this
in
a
moment,
and
that
has
enabled
us
to
do
things
quite
differently.
It's
enabled
us
to
to
to
work
in
quite
different
ways
of
working
in
in
working
different
ways.
It's
enabled
us
to
move
out
at
a
pace
that
was
just
inconceivable
even
a
few
months
ago,
and
it's
also
enabled
us
to
begin
to
use
data
and
intelligence
more
effectively.
C
I
think
we
are
probably
at
the
foothills
of
that
journey,
but
I
think
I
think
the
opportunities
that
we
have
the
infrastructure
we've
created
and,
more
importantly,
the
relationships
we've
built
with
people
like
mhs
digital
and
our
colleagues
in
the
department
and
others
has
given
us
an
opportunity
to
do
some
really
exciting
things
around
around
how
we
use
data
and
and
and
also
has
has
given
us
some
some
options
around.
The
degree
to
which
we
do,
or
indeed
don't
go
on
site.
I
think
you
know
to
be
really
clear
about
it.
C
C
So
I
I
see
the
future
the
future
the
future
year
really
is
being
in
in
broadly
three
phases,
and
I
loosely
call
them
now.
Next
and
and
future
now
is
about
continuing
to
regulate
again.
I
think
I
think
we've
talked
as
a
board
before
that
we
have
never
not
stopped
regular.
We've
never
stopped
regulating.
We
have
continued
to
regulate
during
this
time
period.
I
think
that's
a
really
important
public
message.
C
We
may
have
stopped
our
routine
inspections,
but
but
but
we
didn't
ever
leave
the
pitch
and
we've
done
that
in
a
series
in
a
range
of
different
ways.
Initially
we
were,
we
were
contacting
providers
and
understanding
what
their
needs
were
and
understanding
what
was
working
well
and
what
wasn't.
C
And
then
we
structured
that
into
what
we
call
the
emergency
support
framework
and
the
emergency
support
framework
is
a
series
of
rapid
and
structured
conversations
with
providers
that
examine
things
like
staffing
levels,
ppe
levels
and
other
things
that
are
getting
in
the
way
of
their
ability
to
to
cope
and
deliver
deliver
basic
services.
C
We've
continued
to
respond
to
information
from
the
public
and
whistleblowers
that
has
still
that
has
continued
to
come
in
in
in
in
volume,
and
we
are
continuing
to
promote
our
gift
feedback
on
care
service,
and
this
week
we
launched
a
a
a
promotion
income
in
in
conjunction
with
our
colleagues
at
healthwatch,
england,
the
because
we
all
care
program,
and
that
has
enabled
that
that
was
there
to
to
to
remind
people
that
there
is
a
channel
for
them
to
feedback
on
their
care
to
us.
C
Our
on-site
work
has
continued,
albeit
at
much
lower
volumes
than
we
have
traditionally
done,
and
what
that's?
What
that's
done
in?
In
practical
terms,
it's
enabled
us
to
look
at
those
very
high-risk
services.
Look
at
where
we've
heard
information,
that's
of
particular
concern.
We've
gone
in
and
looked
what's
gone
on,
and
then
we
brought
in
others
to
support,
and
that
might
be
national
support
in
this
in
the
form
of
support
from
nhs
improvement.
C
C
We've
also
started
this
week.
Our
provider,
collaboration
review
and
and
rosie
and
colleagues
will
talk
in
more
detail
about
that
later
on
in
the
agenda,
but
but
the
pcrs
are
again
about
about
just
continuing
this
journey
around
capturing
the
knowledge.
That's
going
on
looking
at
keeping
up
that
momentum
around
innovation,
which
is
which
is
so
very
important
in
this
in
this
at
this
time.
C
The
next
phase
of
what
we'll
be
doing
is
is
really
characterized
by
the
design
of
a
transitional
methodology,
and
we
hope
that
by
september
we'll
have
this
methodology
in
place.
C
It
will
continue,
it
will
use
our
new
technology
platform,
it
will
be
you,
it
will
use
the
technology,
lessons
and
and
the
technology
act
that
and
and
the
the
access
to
data
that
the
technology
platform
gives
us
to
start
to
do
a
more
sophisticated
understanding
and
a
more
sophisticated
assessment
of
what's
going
on
on
the
ground
that
that
work,
we
expect
to
link
back
to
our
five
key
questions.
We
think
those
five
key
questions
represent
a
a
useful
touchstone.
C
We
have
plenty
of
experience
as
a
regulator
using
those
five
key
questions,
but,
more
importantly,
I
think
providers
and
the
public
would
also
would
also
recognize
what
they
stand
for.
So
that
will
be
a
shorter
version
of
what
we
would
normally
do.
It
will
be
a
a
it
will.
C
It
will
refer
back
to
our
key
lines
of
inquiry
and
it
will
evolve
so
it
will
evolve
as
it
goes,
but
that
will
run,
I
hope,
until
the
early
part
of
2021,
and
we
want
to
we
want
to
as
part
of
this
design
in
a
reduced
data
collection
burden.
I
mean
providers,
often
talk
about
about
multiple
regulators,
asking
for
essentially
the
same
information
in
a
slightly
different
format
and
sometimes
it's
direct
duplication
other
times
it's
similar,
but
but
not
the
same.
C
We
want
to
try
and
design
in
the
ability
to
reuse
data
from
from
others,
wherever
wherever
we
can,
and
we
want
to
also
focus
on
things
that
really
matter
to
people
who
use
services.
I
think
again
and
again-
and
we've
mentioned
this
in
in
our
state
of
care,
but
we
want
to
explore
the
patient
experience
that
patient
journey
as
they
as
they
transit
from
one
provider
to
another.
That's
often
the
thing
which
actually
really
matters
to
people:
it's
not
the
actual
performance,
the
the
the
standalone
performance
of
an
individual
provider.
C
It's
how
those
providers
work
collaboratively,
that's
really
important
to
people.
So
we
want
to
explore
that
as
well,
and
then
we
look
ahead
into
the
future
into
the
into
early
2021.
What
we're
trying?
What
we
want
to
try
and
bring
together
there
is
is
our
new
strategy
that
we,
as
a
border,
are
working
on
the
moment
ready
for
early
2021,
bring
together
a
future
regulatory
platform,
and
that
will
look
quite
different
to
our
traditional
methodology.
C
I
I
don't
think
that
we
will
be
writing
the
the
conventional
reports
that
people
might
be
familiar
with
anymore,
we're
looking
for
ways
to
publish
material
online,
we're
looking
for
for
ways
to
to
do
things
in
a
much
more
digital,
lighter
weight
way
and
making
sure
that
the
the
product
we
are
producing
are
useful
to
providers
in
terms
of
driving
their
improvement
journey,
but
also
useful
to
the
public
as
well
trying
to
take
the
things
that
are
a
real
value
out
of
what
we've.
What
we've
traditionally
done.
This
is
not
a.
C
This
is
not
designed
to
throw
everything
away
that
we've
ever
done
before,
but
it
is
about
building
on
what
we've
got
and
and
drawing
out
the
the
key.
The
key
facets
of
our
previous
work
we'll
continue
to
look
for
ways
to
reduce
the
data
burden
on
providers
and
we'll
look
to
sha,
and
I
want
to
look
back
look
for
ways
to
share
back
the
data
that
we
have
and
the
and
the
and
the
perspective
that
we
bring.
We
have
that
privilege
of
perspective.
C
I
think,
as
a
regulator
where
we
can
see
what
everybody
is
doing
and
I
think
the
ability
to
present
that
back
to
providers
in
the
form
of
benchmarking
can
be
a
very
powerful
way
of
of
people
comparing
themselves
and
improving
what
they
do
and
delivering
on
their
ambitions
for
the
people
that
use
their
services,
and
I
think
the
the
future
regulatory
platform
is
the
practical
means
by
which
we
are
going
to
deliver
the
ambitions
that
we're
going
to
set
out
in
our
strategy
in
2021,
and
I
think
you
know
if,
when
we
take
that
even
further,
I
think
the
new
technology
platform
and
that's
this
new
way
of
thinking-
gives
us
opportunities
to
use
tools
like
artificial
intelligence
in
our
in
our
assessment
of
risk.
C
So
we
could
be
predictive
in
terms
of
risk
rather
than
rather
than
reactive
along
you,
you,
you
merge
that
alongside
digital
regulation
tools,
apps
and
so
forth,
it
will
enable
our
teams
to
focus
on
building
relationships
with
providers
and
building
relationships
with
people
who
use
services.
So
we
can
blend
the
best
of
what
digital
can
offer
with
the
best
of
what
of
what
person-to-person
interaction
can
offer.
C
There
are,
of
course,
I
think,
questions
about
frequency,
about
ratings
and
so
on
and
we've
not
yet
answered
those
questions,
and
I
think
we
want
to
work
through
those
with
providers
and
the
public
during
the
course
of
the
autumn.
You
know,
I
know
people
value
ratings,
I
think
both
providers
and
the
public
value
ratings,
and
I
think
they
will
have
a
place
in
our
future.
But
the
question
is
how
and
and
how
will
we
arrive
at
those
ratings?
C
So
I
think
overall
I'd
say
this
is
where
it's
a
point
now,
where
we
are
starting
to
accelerate
the
work.
C
We
had
been
expecting
to
do
over
the
next
couple
of
years
and
I
hope
that
public
and
providers,
and
indeed
our
own
teams,
will
see
the
benefit
of
this
of
this
work
and
the
approach
that
we're
taking
that
now
next
and
future
approach-
and
I
hope
you
know
the
end
to
the
end
point
I
think-
is
that
it
will
enable
us
to
be
seen
as
an
even
more
effective
as
a
regulator
providing
assurance
to
the
public
and
an
effective
partner
to
provide
us
in
terms
of
their
improvement
journey.
C
So
I'm
going
to
pause
there,
peter
I
know
I
know.
Colleagues,
especially
chief
inspector
colleagues,
would
like
to
just
talk
briefly
about
some
of
the
work
they're
doing
in
their
areas
to
support
that
that
overall,
ambition,
so
can
I
hand
over
to
kate
in
the
first
instance.
D
Thanks
ian,
so
if
I
just
talk
a
bit
about
what
we've
done
now
and
what
we
anticipate
doing
it
in
the
kind
of
coming
weeks
and
months,
so
as
ian
says,
we've
spoken
to
over
20
000
providers
in
adult
social
care
and
of
our
providers.
45
of
them
have
now
had
their
emergency
support
framework
conversations.
So
we
are
having
regular
conversations
with
providers
where
they
are
facing
challenges
and
we
are
we're
making
good
progress
on
contact
with
with
all
of
our
providers.
D
It
might
be
of
interest
to
the
board
that
we
had
a
session
with
a
thousand
providers
on
monday
to
talk
about
our
strategy,
and
in
that
I
was
opportunistic
and
ask
providers
to
give
me
some
feedback
about
their
experiences
of
the
emergency
support
framework,
and
I
was
pleasantly
surprised
with
the
flood
of
positive
comments
that
came
back
from
providers
about
their
perception
of
it
being
partly
been
working
in
partnership
with
their
inspector
with
it
leading
to
action
and
it
being
supportive.
D
So
a
really
good
framework
that
has
provided
some
supportive
monitoring
conversations
with
providers
during
this
time
and
with
that
vast
amount
of
contact
we've
had
with
social
care
providers,
I
can
share
with
the
board
that
the
the
majority
of
social
care
providers
have
done
an
absolutely
outstanding
job
in
these
unprecedented
times,
and
I'd
like
to
take
this
opportunity
to
take
my
off
to
those
social
care
workers
who
have
delivered
with
all
of
the
challenges
that
they
have
faced.
D
So
the
majority
of
social
care
providers
have
done
an
absolutely
brilliant
job
during
covered
and
all
the
challenges
it
has
presented.
D
However,
we
have
always
said
that
we
would
go
out
and
visit
a
service
in
person
if
we
couldn't
get
the
confidence
and
the
assurance
we
needed
through
these
monitoring
conversations.
So
since
the
start
of
us
stopping
our
routine
inspections
in
adult
social
care,
we've
we've
crossed
a
threshold.
We've
visited
73
providers
where
we
had
worries
and
50
of
those
those
visits
were
triggered
or
contributed
to
by
people
from
the
public
or
people
who
work
in
care,
informing
us
about
something.
They
were
worried
about.
D
So
ian's
comments
about
our
because
we
all
care
campaign
and
our
encouragement
for
members
of
the
public
and
family
members,
carers
and
people
who
work
in
the
sector
to
tell
us
we
want
to
know
we
want
to
know
the
good
stuff,
the
bad
stuff,
the
mixed
stuff,
because
all
of
that
helps
inform
our
daily
view
of
quality
of
care
and
risk.
So
a
big
thank
you
to
everyone
who
has
been
in
touch
with
us
as
an
organization,
and
please
keep
on
keep
on
talking
to
us
because
it
does
lead
to
actions.
D
So
50
of
our
physical
visits
were
contributed
to
as
a
result
of
feedback
from
from
the
public
when
we
undertook
those
73
inspections.
We
found
a
variety
of
things
and
the
themes
of
our
early
findings
are
in
our
insights,
a
report
that
we
will
talk
about
later
on
in
this
public
board.
Not
everything
that
we
found
was
covert
related,
so
we
found
a
number
of
things
would
have
been
evident
in
providers.
D
We
were
worried
about
prior
to
covid,
so
things
such
as
effective
management
of
falls,
nutrition,
hydration
pressure
care.
So
we
found
a
wealth
of
things.
Our
starting
point
is
always
how
we
can
support
the
provider
to
improve
the
quality
of
care
and
keep
people
safe.
But
in
some
rare
circumstances
we
have
taken
action
to
close
services
down
because
we
weren't
confident
and
that
would
have
been
in
partnership
with
the
local
authority
and
the
clinical
commissioning
group.
But
the
majority
of
providers
have
done
an
absolutely
exceptional
job
in
terms
of
what
next.
D
So
we
are
currently
planning
and
undertaking
a
series
of
targeted
and
responsive
inspections
in
the
coming
weeks
and
months
based
on
services
that
we
are
categorizing
as
high
risk.
So
we've
got
156
books
in
the
diary,
but
that
number
will
go
up
and
that's
through
the
rest
of
july
and
august
in
terms
of
what
constitutes
a
high
risk
service.
D
Myself,
ted
and
rosie
have
worked
closely
together
so
that
we
are
all
looking
for
the
same
lens
of
ingredients
such
as
whistleblowing
concerns,
safeguarding
alerts,
concerns
from
stakeholders,
feedback
from
members
of
the
public
and
concerns
about
whether
a
service
might
have
a
close
culture.
So
all
of
those
things
are
informing
our
inspectors
to
take
a
consistent
approach
in
making
decisions
about
where
we
want
to
go
out
and
see
a
service
in
person
and
every
time
we
cross
the
threshold.
D
We
are
having
a
specific
focus
on
infection
prevention
and
control,
so
we
will
have
that
focus
when
we
go
out
to
the
services
we're
worried
about
in
the
summer,
but
also
we've
committed
to
doing
a
set
of
inspections
on
providers
where
we
don't
have
any
particular
concerns
with
the
user
going
to
find
out
what
they're
doing
around
good
infection
prevention
and
control.
So
we're
really
keen
that,
as
well
as
addressing
concerns
when
we
see
them
from
the
unique
position
that
we
sit
and
being
able
to
describe
to
the
health
and
care
sector.
D
This
is
what
what
good
looks
like
when
it
comes
to
good
infection
prevention
control,
so
that
we
can
make
sure
that
everyone
is
as
well
equipped
as
they
can
be
for
a
potential
wave
too
or
a
tricky
winter.
That
might
be.
That
is
likely
to
be
on
the
horizon
in
terms
of
what
we've
learned
and
how
that's
changing
the
way
we
work.
D
So
it's
been
fascinating
to
see
our
inspectors
develop,
different
ways
of
gathering
information
and
intelligence
and
how
that
is
making
them
think
about
how
they
may
want
to
do
things
differently.
So
I
think
the
challenge
we
will
pose
to
ourselves
as
we
go
forward
is:
what
do
you
absolutely
need
to
see
in
person?
Are
you
crossing
the
threshold
and
what
can
you
do
remotely?
What
policies
and
procedures
can
you
review
remotely?
What
one-to-ones
can
you
have
for
staff
members
over
zoom
or
teams
calls
etc?
D
So,
and
this
is
particularly
irrelevant
in
the
home
care
sector.
So
when
we
go
out
to
a
home
care
provider,
we
often
go
sit
in
a
small
office
where
maybe
one
or
two
members
of
staff
are
there,
but
because
the
bulk
has
delivered
in
people's
homes,
we
don't
get
the
opportunity
through
that
way
of
meeting
people
face
to
face.
D
So
we
started
conversations
with
the
uk
association
about
whether
we
might
pilot
a
pro
an
approach
in
home
care
about
how
we
could
gain
that
assurance
about
the
quality
of
care
being
provided
without
going
to
visit
the
home
care
office,
but
actually
spending
more
of
that
time,
having
having
conversations
over
over
the
screen
with
people
who
receive
services
and
and
their
staff.
D
So
we
will
come
back
and
update
board
on
that,
as
we
go
forward
with
that,
hopefully
over
the
summer
and
then
just
finally,
everything
that
we're
doing
is
informing
our
thinking
that
we'll
go
into
the
strategy
for
2021
onwards,
but
the
focus
the
particular
focus
on
infection
prevention
control.
I
anticipate
will
be
something
that
we
will.
D
E
Thank
you
ian
so
in
hospitals
in
the
in
the
reports
in
the
papers
that
the
board
has
got
there's
some
details
about
the
current
inspection
activity
and
to
just
come
back
to
what
ian
and
kate
were
saying
is
we
have
not
stopped
inspecting
and
risk-based
targeted
inspections
are
continuing
as
necessary
and
as
determined
by
the
intelligence
we
get
from
monitoring
and
we
use
the
the
the
the
factors
that
kate
has
already
outlined.
Look
at
clinical
outcomes.
E
We
look
at
serious
incidents,
whistleblowing,
we're
good
good,
giving
give
feedback
on
care
information
which
is
becoming
increasingly
important,
safeguards
and
also
information.
We
receive
from
other
stakeholders
as
well,
and
that
is
all
very
important
in
determining
where
our
risk-based
inspections
are
taking
place.
E
We
are
minimizing
the
on-site
activity
wherever
we
can,
but
we
are
making
sure
that
the
inspections
can
determine
whether
services
are
safe
and
we
are
taking
enforcement
action
where
necessary,
and
we
continue
to
publish
reports
on
those
inspections
as
we
progress,
so
that
work
is
going
on
in
terms
of
the
monitoring
work
which,
during
the
code
epidemic,
has
been
increasingly
important.
We've
developed
new
tools
for
that.
E
One
of
the
tools
we're
using
is
the
emergency
support
framework
which
you've
heard
described,
which
has
been
used
so
so
widely
in
adult
social
care,
we're
using
it
in
selected
sectors
within
the
hospital
services
and
we're
finding
it
very
valuable.
In
those
terms,
we've
issued
guidance
to
our
inspectors
to
focus
in
their
monitoring
calls
on
safety,
particularly
infection
from
prevention
and
control,
but
also
on
how
well
trusts
are
re-establishing
services
for
patients.
E
Who've
had
their
treatment
delay
because
of
the
coveted
epidemic
and,
of
course,
that
is
now
becoming
increasingly
important
going
forward
and
we're
doing
work
jointly
with
nhs
england,
nhs
improvement
to
understand
the
processes
there
and
to
be
able
to
interact
with
trucks
in
a
way
that
it
is
supportive
and
helps
them
share
good
practice.
So
that's
a
very
important
part
of
our
monitoring
going
forward
at
the
moment.
E
We're
rolling
out
a
development
of
the
emergency
support
framework,
which
is
a
tool
we're
using
to
assess
compliance
with
national
guidance,
around
infection
prevention
and
control
that
is
being
rolled
out
across
all
nhs
trusts
at
the
moment
and
we'll
be
reporting
on
the
outcome
of
that
at
the
next
board.
Meeting
having
said
that,
the
early
evidence
is,
there
is
very
high
levels
of
compliance
in
the
majority
of
trusts
in
those
trusts
where
they're,
where
they
find
they.
They
cannot
meet
the
standards
at
the
moment.
E
Justifying
that
a
supportive
way
forward,
we're
also
working
very
closely
with
nhsi
to
monitor
trust
that
are
in
special
measures,
and
there
are
only
eight
trusts
in
quality.
Symmetrical
measures
now,
which
is
the
lowest
there
has
ever
been,
and
I
think
one
of
the
things
that
we
need
to
not
forget
is
many
trusts
have
made
enormous
progress
over
the
last
few
years
and
our
reports
published
during
the
pandemic
have
demonstrated
that
progress
has
continued,
and
so
it's
important
to
to
recognize
the
progress
that
is
going.
F
E
Equally,
we
need
to
monitor
the
trust
where
we
have
concerns
those
trusts
and
special
measures
and,
of
course
we
need
to
return
to
those
trusts.
To
make
sure
they've
made
improvements
and,
as
part
of
what
we're
doing
at
the
moment
is
we
are
assessing
them
as
part
of
the
risk-based
inspections.
We
have
been
back
to
some
trust
in
special
measures
undertaking
risk-based
inspections.
E
We
are
monitoring
their
progress
if
necessary,
we're
taking
more
enforcement
action
and
if
they
are
not
making
satisfactory
progress,
where
we
are
escalating
that,
but
equally
we're
looking
forward
to
the
interim
methodology
that
ian
has
mentioned,
and
our
interim
methodology
needs
to
be
streamlined.
It
needs
to
be
flexible
to
respond
to
the
coverage
pandemic,
but
it
also
needs
to
give
us
the
information
we
need
to
make
decisions
on
trust
such
as
those
in
special
measures
that
need
decisions
about
their
way
forward.
E
And
so
we
need
to
make
sure
we
have
a
very
flexible
methodology
to
take
that
forward
over
the
next
few
months
and
that's
something
we're
going
to
be
focusing
on
as
we
develop.
The
new
methodology.
We've
already
learned
a
lot
from
using
the
current
methodology
in
novel
ways
during
the
risk-based
inspections,
doing
more
inspections
without
without
going
on
site
nearly
as
much,
and
I
think
we
have
already
moved
forward
in
that
and
we'll
be
developing-
that
in
the
interim
methodology
going
forward
as
we
go
forward
and
I
think
building
on
that
entry
methodology.
E
G
Thank
you
so
just
to
talk
about
a
little
bit.
What
we're
doing
now,
as
kate
and
ted
have
both
explained,
we've
been
working
very
hard
and
our
teams
have
been
working
hard
behind
the
scenes
over
the
last
few
months
to
look
at
risk.
G
There's
been
a
massive
transformation,
as
people
are
aware
in
primary
care
in
all
of
the
different
sectors,
whether
it's
been
general
practice
one-on-one
out
of
our
services,
dentists,
there's
been
a
huge
amount
of
work,
leading
to
a
rapid
use
of
digital
technology,
changing
models,
and
I
think,
as
kate
said,
I
think
we
ought
to
be
congratulating
our
providers
who,
by
the
most
most
of
the
providers,
have
stepped
up,
have
done
brilliant
work
to
actually
introduce
innovation
and
have
have
managed
to
do
that
in
very
challenging
times
and
certainly
in
primary
care.
G
At
the
moment,
colleagues
tell
me
that
demand
is
increasing
significantly
at
the
moment
and
they're
having
to
manage
new
challenges
and
are
no
way
out
of
the
woods
at
the
moment.
If
anything,
there's
different
challenges
than
there
were
back
in
march,
but
but
it
it
remains
a
difficult
time,
and
I
fully
think
we
need
to
consider
that
as
we
go
forward.
However,
we
have
had
some
areas
of
of
concerns
and
risks
flagged
to
us.
We've
undertaken
six
inspections
since
march,
two
of
which
were
raised
by
whistleblowing
concerns.
G
The
others
were
raised
by
other
information
of
concern.
The
types
of
themes
we've
been
seeing
are
things
like
people
not
making
to
equate
referrals
when
they
needed
to
lack
of
monitoring
of
high-risk
drugs,
lack
of
oversight
of
controlled
drugs,
sadly
leading
to
a
death
of
a
patient
reports
being
falsified
and
and
retrospectively
amended,
and
people
not
picking
up
on
some
of
the
recommendations
from
hospital
consultants,
for
example
a
patient
having
a
stroke
because
they
weren't
anticoagulated
on
the
recommendation
of
a
consultant.
G
So
so
those
are
the
type
of
concerns
that
that
we've
seen
over
our
inspections
and
we
have
taken
appropriate
action
in
with
in
partnership
with
the
local
ccgs
and
the
other
things
we're
working
on
at
the
moment,
are
around
infection
prevention
control
and
we're
working
to
support
the
insight
work
around
that
and
we're
also
thinking
ahead
about
flu
season.
G
So
from
an
operational
point
of
view,
we
know
that
that
there
is
going
to
be
a
very
kind
of
significant
national
priority
to
make
sure
that
people
are
immunized,
which
is
really
important
and
we're
looking
at
making
sure
that
all
the
procedures
around
that
are
are
carefully
thought
through,
so
that
that
that
goes
as
smoothly
as
possible
in
terms
of
next
steps.
G
So
we're
working
very
closely
with
our
stakeholders,
particularly
in
general
practice,
to
look
at
how
we
can
think
through
our
regulatory
transitional
approach,
we're
supporting
nhs
england
with
their
bureaucracy
review
and
as
as
has
been
mentioned
earlier.
I
think
there
is
an
opportunity
for
us
to
continue
the
work
on
looking
at
how
we
work
with
the
other
regulators
to
make
sure
there
isn't
duplication
and
we're
certainly
working
with
the
other
regulators
around
that
we're.
G
Also
we've
rolled
out
we've
been
looking
at
a
pilot,
and
we've
actually
had
our
first
experience
of
being
able
to
access
gp
records
remotely
so
which
I
think
has
been
very
successful.
G
It's
meant
that
we've
been
able
to
look
through
patient
records
with
the
correct
controls
in
place
and
the
correct
all
of
the
correct
governance
arrangements
to
make
sure
that
it's
it's
done
in
a
correct
way,
which
has
enabled
us
to
explore
safety
in
areas
that
we've
got
immediate
risks
and
immediate
concerns
without
actually
being
on
site,
and
that's
something
we're
working
on
to
look
at
how
we
can
take
that
forward
as
part
of
our
assessment
process
in
our
in
the
future.
I
think
there's,
there's
still.
G
G
We
need
to
be
looking
at
how
we
can
make
sure
those
practices
get
the
support
they
need
to
improve
and
we
need
to
continue
to
work,
particularly
with
those
areas
of
concern,
to
look
at
actually.
How
do
we
make
it
care
as
safe
as
possible
and
I'm
having
those
discussions
with
with
other
stakeholders
at
the
moment?
We'll
talk
about
provided
collaboration,
reviews
in
the
future.
I
think
I
think
that
there's
something
that
they're
a
really
exciting
opportunity
and
we'll
with
they're
on
the
agenda
later
and
finally,
on
a
different
point.
G
I
just
wanted
to
flag
in
the
executive
team
report,
the
defense
medical
services
report
that's
mentioned,
and
I
just
want
to
take
this
opportunity
to
say
thank
you
to
the
defense
medical
services.
Team
they've
done
some
fantastic
work
during
the
last
three
years
that
they've
been
running
this
program.
They
work
very
much
in
partnership
with
the
defense,
medical
services,
regulator,
great
relationship
with
them
and
actually
what
the
report
demonstrates.
G
It's
a
it's
an
excellently
written
report
and
it
demonstrates
the
improvement
that
has
happened
for
people
who
for
armed
forces,
personnel
and
their
families
who
use
services
over
the
last
three
three
years
since
we've
been
involved
in
in
that
programme.
So
thank
you
to
all
the
team
involved
with
that.
H
Thanks
ian
so
just
to
talk
a
bit
more
about
some
of
our
digital
work.
We've
had
a
significant
investment
in
technology
to
support
the
organization
over
the
last
year,
and
that's
really
now
starting
to
bear
through
and
deliver
what
is
an
increasing
digital
capability
across
cqc.
H
Our
digital
foundations
program
is
nearing
it
successful
completion.
Now.
Last
year
we
completed
a
lot
of
work
to
introduce
modern
productivity
tools
such
as
microsoft
teams
and
sharepoint,
and
that's
really
supported
us
in
this
time.
Now,
where
the
organization
is,
as
everyone
is
working
from
home
and
last
month
we
saw
the
successful
implementation
of
a
new
capability
to
support
our
staff
for
a
new
customer
focused
modern
service
desk
and
also
through
greater
security
through
a
new
and
transparent
security
operations
center
and
probably
the
biggest
digital
foundations.
H
That's
really
helped
us
build
the
capability
to
enable
us
to
deliver
support
for
the
testing
work
that
we've
done
for
the
home
care
surveys
and
and
underpins
that
emergency
support
framework
that
we've
been
talking
about
and
and
enabled
us
to
do
that
in
a
an
incredibly
short
period
of
time,
and
this,
this
dynamics
platform
is
what
will
underpin
our
ongoing
regulatory
activities.
H
It
will
underpin
that
interim
methodology.
That
ted
was
just
talking
about
and
it
will
create
a
new
technology
solution
for
all
of
our
regulatory
needs,
a
regulatory
platform
and
that
will
bring
together
all
of
our
data
to
allow
more
advanced
analytics,
enable
us
to
innovate,
faster
experiment
and
and
deliver
change
in
in
an
agile
way.
H
C
Thanks
ian
thanks
mark
so
peter
I
I
thought
we
just
would
just
take
that
opportunity
just
to
describe
that
now.
Next
future
thinking
over
the
next
year
and
I'm
open
to
we're
up
to
questions
from
from
colleagues
thanks
peter.
A
I
Yeah,
I
I
mean,
I
think
you
agree
with
your
comments,
peter
it's
amazing.
What's
already
been
achieved
and
quite
excited
about
where
we're
where
we're
headed.
My
question
was
then
towards
ian,
and
maybe
chris
you
know
if
you're,
a
member
of
the
public
sort
of
the
words
may
come,
be
a
bit
overwhelming
and
sort
of
like,
but
what
are
they
doing
next
and
what
are
they
doing
now?
Is
there?
Is
there
some
thought
about
how
you
can
make
this?
Really
I
mean
we're
finding
it.
I
You
know,
sort
of
incredible
transformation,
that's
quite
digestible
and
easy
to
understand
and
comprehend
and
impactful
as
well
is
that
you
know
equal
thought
gone
into
how
we're
going
to
communicate
this
outwards
to.
C
Public
thanks
jared
I'll
hand
out
to
crowley
to
chris
in
a
moment,
but
I
think
in
headline
terms
what
we
want
to
try
and
make
try
and
do
is,
as
we
develop
these
the
this
new
thinking
that
we
are
working
alongside
the
public
and
and
public
representative
groups,
so
they
can
so
we
can
try
and
understand
what
it
is.
This
is
real
value
because
I
think,
on
a
very
practical
level,
if
you're
going
to
put
a
loved
one
into
a
care
home,
for
example,
you
will
probably
read
our
reports.
C
You
look
at
the
rating
on
the
on
that
care.
They'll
be
the
things
that
will
be
of
interest
to
you.
Do
you
just
read
the
the
summary,
or
do
you
read
every
single
word
of
the
of
the
report?
Do
you
understand
every
single
bit
of
it?
I,
I
suspect
people
tend
to
read
summaries,
they
tend
to
look
at
ratings
and
they
make
judgments.
Based
on
on
that.
C
So
I
think
what
we
want
to
try
and
do
as
part
of
this
next
phase
is
to
work
out
what
people
really
value
and
and
do
more
of
that
and
then
things
that
people
people
don't
value
so
much.
We
do
less
of
that.
So
I
I
think
we
want
to
keep
delivering.
C
Digital
products
which
people
can
look
at
and
make
judgments
around,
but
at
the
same
time,
capture
that
information
to
help
services
improve
in
a
much
more
structured
way.
Chris.
I
don't
know
whether
you
want
to
talk
to
that
a
bit.
J
Yeah
just
to
build
on
that
really,
I
suppose
what
you're
hearing
jorah
is
the
what
and
the
how
and
the
conversation
we've
had
with
the
with
with
public
goods.
Indeed,
with
provider
groups
is
very
much
focused
on
the
what
so
make
sure.
J
You
know
quite
quite
significant,
but
I
think
what
we've
tried
to
do
is
focus
on
the
things
that
we
know
add
value
to
both
the
public
experience
and
the
provider.
Experience
of
those
services
and
our
conversations
with
providers
in
the
public
and
actually
the
what
we've
really
found.
Is
that
really
there's
a
strong
sense
of
common
purpose
between
what
the
public
wants
and
what
providers
want
as
well?
J
So
we've
tried
to
put
those
together
and
talk
about
what
we
intend
to
change
and
what
we've
been
trying
to
use
simple
narratives,
to
describe
some
of
the
changes
that
we
want
to
put
in
place.
As
ted
said,
this
will
be
a
developing
and
a
testing
period.
So
what
we
want
to
do
is
to
develop
this.
We
developed
it
with
the
emergency
support
framework
and
the
conversation
we
had
with
public
groups
and
provider
groups
around
the
emerge.
J
Support
framework
gave
us
a
framework
for
what
we
wanted
to
do
there
as
we
move
into
our
provided
clubs
and
reviews
we've
again
been
having
those
conversations
with
those
groups
and
both
of
those
will
inform
our
thinking,
both
in
the
autumn
as
we
prepare
for
the
new
strategy
and
for
the
new
strategy
itself,
which
will
obviously
launch
at
the
beginning
of
next
year.
J
E
Thank
you
peter
I
mean
just
to
follow
up
on
that.
Kate
was
talking
about
the
strategy
session
she'd
done
earlier
this
week.
E
I
did
one
yesterday
with
a
similar
number
of
people
and
there's
a
really
powerful
message
that
that
that
I
led
in
the
in
the
strategy
group,
but
equally
got
back
from
the
from
the
delegates,
and
that
was
if
we
can
see
services
through
the
eyes
of
service
users
and
see
what's
important
from
the
eyes
of
service
users
that
could
be
transformative
both
to
us
as
a
regulator
but
to
the
services
themselves,
and
I
think
that's
really
powerful
and
we've
got
to
start
doing
that
in
our
new
methodology
I
mean
clearly
this
is
a
big
undertaking
and
it's
it
will
take
take
time
for
us
to
do
it
really
well,
but
we've
got
to
start
doing
that.
E
E
Thank
you.
Ted
robert.
K
Managed
to
unbeat
thank
you.
I
had
two
questions
one
following
on
from
what
ted
and
chris
have
just
been
saying,
and
one
about
hospital
discharges
to
care
homes.
I
absolutely
adore
the
idea
that
what
the
public
probably
want
most
of
the
time
is
an
overview
and
a
rating
and
and
so
on,
and
but
different
parts
of
the
public
again
actually
have
different
needs,
and
we
need
to
reflect
that.
K
I
would
have
thought
so
if,
for
instance,
I'm
I
have
a
res
a
relative
of
mine
in
a
care
home
and
I'm
a
bit
worried
about
what's
going
on.
I
might
actually
want
a
bit
more
detail
and
access
to
it,
and
I
wouldn't
have
thought
it's
beyond
the
width
of
mark
and
his
colleagues
to
ensure
that
people
can
dive
down
into
some
detail
if
they
want
it
and
I'd
like
that
assurance.
That's
been
at
least
being
thought
of
the
question
about
hospital
discharges.
K
Is
this
that
at
the
beginning
of
the
code
outbreak,
there
was
a
concern
about
emergency
discharges
in
very
short
periods
of
time,
allegedly
leading
to
infections
in
care
homes
that
I
think,
has
subsided
as
a
concern,
but
it
strikes
me
it's
an
example
of
the
need
for
us
to
work
across
the
inspectorates
in
the
sense
that
there
are
two
sides
to
that
equation.
A
So
ian
I
don't
know
whether
you
want
to
or
or
anybody
wants
to
try
and
answer
robert's
question.
I.
G
This
is
this
is
something
I'm
hoping
we'll
discuss
in
a
bit
more
detail
with
the
provider
collaboration
review
section,
that's
coming
up
on
the
agenda.
I
think
that
interface
between
providers
is
so
important,
and
particularly
between
health
and
social
care,
but
also
equally,
between
primary
care
and
acute
care
and
various
all
parts
of
the
system,
and
they
the
person
using
services.
G
Most
people
don't
use
just
one
service,
most
people
use
several
services
and
actually
how
they
interface
is,
is
so
important
to
to
make
sure
that
people
get
good
quality
care,
so
the
provider
collaboration
reviews
are
the
first
step
in
this.
If
you
like,
in
terms
of
our
thinking
pulling
on
the
information
that
we
learned
from
the
beyond
barriers
work,
the
local
system
review
work
that
we
did
a
couple
of
years
ago
and
I
think
we
will
be
able
to
capture
the
really
good
work.
G
That's
happened
between
providers
like
on
the
discharge
pathways
from
hospital
to
to
care
homes
and
the
other
good
work,
and
we
will
also
be
able
to
capture
some
of
the
learning
that
we
need
to
consider
going
forward.
We
do
want
to
look
at
how
we
can
consider
system
work.
It's
a
really
important
part
of
our
thinking
in
terms
of
our
strategy,
a
really
important
part
of
our
transforming
our
organization,
thinking
as
well
and
and
over
the
coming
few
weeks.
G
I
think
it's
something
that
will
feature
strongly
as
we
as
we
go
forward
in
terms
of
our
development
and
our
transformation
as
an
organization.
I
don't
know
if
kate
or
ted
want
to
add
to
that.
D
So,
just
just
very
briefly,
so
you
know,
I
think
we
want
to
regulate
through
the
lens
of
the
person
who
uses
services.
So
I
think
I
think
robert.
We
will
always
want
to
hold
individual
providers
to
account
for
their
individual
quality
of
care,
but
I
think,
as
we
move
forward,
we
want
to
place
an
increasing
emphasis
on,
in
addition
to
providing
good
quality
care
in
your
gp
practice
or
your
home
care
agency
or
in
your
acute
hospital.
D
We
also
want
to
know
how
you're
working
together,
in
partnership
with
other
health
and
social
care
providers,
to
ensure
that
people
get
joined
up
care.
So
I
think
we
want
to
have
that
dual
focus
on
individual
accountability,
but
also
demonstrate
to
us
how
you're
working,
in
a
way
with
other
health
and
social
care
providers
to
ensure
people
get
joined
up
care.
E
Ted
and
then
I
come
here
but
just
quickly,
because
because
I
just
endorse
everything,
rosie
and
cater
said,
but
just
in
the
in
the
board
papers,
there's
detail
about
the
inpatient
survey
which
we
published
last
month,
and
this
is
a
survey
of
77
000
inpatients.
So
it's
a
really
important
test
of
piece
of
people's
experience
of
care
and
for
the
first
time
we
analyzed
it
looking
through
the
eyes
of
people
who
declare
themselves
as
frail
and
what's
very
interesting,
and
it
comes
out
of
this
survey
for
the
first
time.
E
It's
a
demonstration
that
a
third
of
people
who
see
themselves
as
frail
do
not
get
the
support
they
expect
to
need
when
they
are
discharged
from
hospital.
You
know
that's
a
really
important
finding
and
it
comes
back
to
actually
looking
at
services
as
they're
experienced
by
individual
patients,
not
as
as
they're
provided-
and
I
think
you
know
this
is
a
real
challenge
for
us
as
a
regulator
to
understand
how
services
interact-
and
I
think
that
is
a
very
important
part
of
our
work
going
forward.
A
K
Has
just
said,
but
one
of
the
things
that
strikes
me
is
we
are
could
be
struggling
at
the
moment.
Excuse
my
voice
in
the
to
fit
all
this
into
our
current
regulatory
framework,
and
I
wonder
what
whether
it
doesn't
show
really
quite
an
urgent
need
for
some
sort
of
revision
of
our
powers,
because
it's
all
very
well
saying
you're
going
to
hold
a
individual
provider
to
account
when
actually
the
problem
is
the
systemic
one.
And
so,
of
course,
each
provider
has
their
part
to
play
in
that.
A
I
agree
john,
did
you
want
to
come
in
on
on
that
or
was
it
a
different
different
topic,
different
point?
Okay,
so
can
we
just
robert?
You
had
two
questions
and
the
first
question
was:
you
were
looking
for
for
reassurance
that
the
the
slim
down
reports,
if
that's
the
right
way
to
describe
them,
will
will
will
have
the
information
that
that
different
different
people
will
will
need.
A
C
It
is
working
progress,
but
I
think
you
know,
I
think
be
assured
that
the
conversations
we're
having
with
public
groups
of
all
sorts
will
will
give
people
the
opportunity
to
to
delve
down
and
down
and
down,
and-
and
I
think
you
know,
one
of
the
things
that
we
we
are
very
keen
to
do
is
reflect
the
notion
of
transparency
and
all
of
the
work
that
we
do
so
so,
if
we're
capturing
information
as
part
of
the
inspection
process,
we
need
to
find
ways
of
rendering
that
so
that
it's
easily
easily
accessible.
C
But
but
we
equally
want
people
to
be
able
to
choose
the
level
of
detail
they.
They
may
want,
so
that
that
the
joy
of
of
the
of
the
the
technology
investment
is,
it
enables
that
to
happen
relatively
easily,
as
opposed
to
writing
multiple
versions
of
the
same
thing,
which
is
traditionally
how
we've
done
this
stuff
thanks
peter.
I
On
this,
or
was
it
something
separate
yeah?
No,
it
was
related
to
this
there's
sort
of
two
parts.
I
think
you're
sort
of
building
on
some
of
the
points
that
we
made
there's
sort
of
a
consultation
with
public
groups,
but
that's
that's
less
emotional.
I
think
I
think
it's
actually
when
you're
using
the
service
and
you're
going
through
the
service
that
you're
actually
saying
things
like.
Is
it
caring
and
responsive?
Is
it
effective
and
is
my
loved
one
being
cared
for
and
have
I
got
a
voice
that
you
know?
I
I
don't
feel
I
don't
know
where
to
go.
I
I
don't
know
how
we
capture
that
to
be
honest
with
you,
but
I
think
it's
a
different.
I
think
it's
quite
a
different
when
it's
cold
day
of
light
and
and
you're
being
consulted
versus
actually
when
you're,
actually
in
it
and
you'll,
probably
get
slightly
different
responses.
J
Yeah
chris,
so
one
of
the
reasons
is
what
you're,
absolutely
right,
you're.
One
of
the
reasons
why
the
work
we're
doing
will
talk
to
not
just
the
public
groups,
but
also
directly
to
people
who
use
services.
J
We've
also
got
our
experts
by
experience
program,
but
in
the
way
we
develop
our
response
to
this,
we
want
to
tap
into
the
very
local
groups
that
operate
in
in
local
areas
to
tap
into
their
perspective,
on
how
services
are
operating
and
tapping
onto
their
the
users
views
of
that
service
and
to
provide
more
of
a
real-time
commentary
about
how
services
are
operating
and
just
to
touch
back
to
to
robert's
point
one
of
the
ways
in
which
they
want
to
see
that
is
sort
of
what's
happening
over
time.
J
So
how
are
things
changing
over
weeks
and
over
months?
And
I
think
we
can
do
something
with
the
way
we
provide
some
of
the
information,
some
of
the
feedback,
alongside
the
inspection
reports
and
the
other
data
that
we
hold
to
provide
a
real
meaningful.
The
the
challenge
for
us
is
how
we
blend
the
views
of
people
who
use
services
alongside
data
and
other
information.
I
think
that's
how
that's
a
challenge
we
need
to
take
into
this
next
piece
of
work,
so
we
don't
just
have
an
inspection
report
and
then
some
other
data
we
have.
A
And
I
suppose
ian
the
other
point
to
make
is
that
this
is.
This
is
quite
an
israelite
process,
isn't
it
so
that
you
know
there
will
be
learning
as
we
go
along
and
and
we
can
adapt
our
our
whole
approach
in
the
light
of
that
learning.
C
Absolutely
I
mean,
I
think
one
of
the
things
that
we've
we've
been
slightly
hamstrung
with
in
the
past
is
systems
which
are
relatively
old,
they're,
probably
no
older
than
other
parts
of
government,
but
they
are
old
and
they're
difficult
to
change
so
change,
even
changing
small
things
can
sometimes
take
months.
We're
now
talking
about
changes
that
can
be
made
over
a
very,
very
short
period
of
time,
they're
days
if
necessary.
C
So
we
certainly
saw
that
during
the
covet
emergency,
where
we
we
started
to
iterate
different,
different
digital
forms
and
so
forth
that
we
were
using
for
different
purposes,
and
we
could
literally
operationalize
them
in
in
days
so
that
that
I
think,
means
that
if
we
do
discover
that
we're
not
quite
hitting
the
spot
on
a
topic
we
can
we
can.
C
We
can
change
what
we
do
and
and
and
then
do
that
in
a
way
that
seems
to
be
very
responsive
by
the
public.
A
Thank
you,
john
you've
been
incredibly
patient.
Your
turn.
L
L
Many
of
those
people
come
from
overseas
because
it's
been
historically
very
difficult
to
recruit
here
and
yet.
Last
week
we
heard
about
the
new
immigration
policy,
which
seems
to
provide
some
difficulty
for
sustaining
that
element
of
the
workforce
on
which
social
care
depends.
I
just
wondered
what
your
comment
was
on
that.
D
So
I
think
I
think
this
new
policy
is
really
good
news
for
our
nhs
staff,
but
I
think
it's
disappointing
that
the
role
of
social
care,
the
crucial
role
of
social
care
staff,
doesn't
appear
to
be
recognized
in
the
same
way,
I
think
we're
all
hopeful
that
a
legacy
of
this
pandemic
should
be
needs
to
be
proper,
long-term,
sustainable
funding
for
adult
social
care,
but
also
appropriate
reward
recognition
and
and
career
progression
and
opportunities
for
our
social
care
workforce
who,
alongside
the
nhs,
have
gone
to
extraordinary
lengths
to
protect
and
those
people.
D
So
I
think
the
potential
impact
of
this
decision
and
what
what
it
may
have
on
our
social
care
sector,
which
is
already
struggling
and
about
one
in
six
of
care
staff,
are
non-british.
I
think,
is
deeply
deeply.
Concerning.
M
Peter,
it's
paul.
Yes,
sorry,
my
hand
signal
isn't
working.
I
just
wanted
to
come
back,
I
mean
the
the
conversation
and
having
and
the
explanations
are
coming
from.
The
executive
have
been
tremendous
in
terms
of
the
ambition
for
the
for
change
and
and
the
agility
and
the
drive
towards
it.
I
just
want
to
come
back
on
time
scales
around
it,
though,
because
I
understand
sort
of
the
three
bits
of
now
next
and
future.
But
what
what
can
we
expect
to
be
in
place
in
early
21
which
to
me
sort
of
suggests
january
february?
M
C
Thanks
paul,
I
mean
I'll
bring
mark
in
in
a
second,
but
I
mean
I
think
in
essence,
I
I
would
expect
us
to
have
got
our
our
initial
policy
position
in
place,
that
we'll
have
a
position
on
ratings
and
frequency
and
those
sort
of
things
and
and
over
the
course
of
the
next
couple
of
years
we
will
iterate
that
as
we
go
along,
I
mean
there
is
the
usual
sort
of
covered
covered
and
winter
flu-based
warnings
that
underpin
all
of
this.
So
we
may,
we
may
have
to
shift
things
about.
C
I'm
that's
why
I'm
deliberately
using
fairly
loose
language
around
early
2021,
because
it
may
not
be
january,
it
may
be.
It
may
be
march,
but
I
would
like
to
to
get
I
see
this
as
a
as
an
iteration
from
where
we
are
now
to
something
which
is
a
bit
more
sophisticated,
and
then
you
know
my
my
expectation
is
that
is
that
the
what
we
see
in
2021,
we'll
we'll
have
a
read
back
to
the
transition
methodology,
we'll
be
able
to
see
that
there'll
be
some
familiarity
with
that
it
might.
C
I
doubt
it's
going
to
be
completely
different,
but
it
will
have
more
and
more
features
to
it
that
that's
that's
our
current
thinking,
but
I
do
want
to
stress
that
I
want
to
be
in
a
position
to
talk
to
providers
and
the
public
around
the
attributes
and
the
components
of
of
a
methodology
which
are
most
important,
try
and
get
those
in
place
first
and
then
build
on
on
detail
after
that.
I
hope
that
makes
sense
mark.
I
don't
know
whether
you
just
want
to
come
in
in
terms
of
your
thinking.
H
Yeah,
I
mean
just
to
support
that
if
we
look
at
our
overall
large
program
of
work
where
we're
looking
to
replace
all
of
our
existing
legacy
systems
with
with
with
new
modern
technology,
that's
a
that's
a
two
plus
year
program
of
work,
but
the
advantage
of
the
the
dynamics
platform
that
I've
described
before
is
that
it
allows
us
to
stand
up
using
some
core
foundational
called
pre-built
components,
new
products
very
quickly.
H
So
if
we,
if
we
can,
what
we
can
do
is
support
the
business
in
the
way
that
we
the
way
that
we
change
the
way
that
we
develop
very
quickly
with
with
a
an
initial
product
that
can
then
be
iterated
and
and
and
changed
very
quickly.
H
So
the
the
interim
methodology
that
that
ted's,
been
talking
about
will
be
fully
supported
by
the
technology,
will
allow
us
to
capture
information,
we'll
be
able
to
allow
us
to
publish
information
as
well
and
and
be
able
to
deliver
that,
according
to
the
time
frames
that
we've
that
we've
talked
about,
and
it
will
extend
and
develop
on
time
as
as
a
regulatory
approach,
changes.
C
I
I
think
just
just
to
add
to
that
as
well.
I
think
my
ambition
is
that
we
we
have
good
connectivity
with
other
other
people
in
a
sort
of
almost
a
data
bubble,
as
it
were
with
with
colleagues
in
in
mhs,
england,
nhs,
nhsx,
nhs,
digital
and
so
forth,
and
other
entities
over
the
course
of
time.
So
some
of
them
may
not
be
ready
to
to
work
with
us
initially,
but
but
if
we
can
create
that
data
bubble
idea
where
you
know
people
are
inside
the
inside
the
tent
as
it
were,
we
can.
C
We
can
work
collaboratively
with
a
range
of
partners
and,
of
course
that
will
that
that
that
will,
in
the
long
term,
enable
us
to
deliver
new
and
different
services
and
and
and
deliver
deliver
our
services
in
a
much
more
streamlined
way,
but
certainly
in
the
short
term.
The
experience
of
our
inspectors.
We're
trying
to
trying
to
streamline
that,
with
with
the
with
the
new,
the
new
microsoft
technologies
and
then
deliver
the
the
the
products
to
the
public
in
a
really
in
a
really
straightforward
way.
C
The
fact
that
some
of
the
wiring
behind
the
scenes
as
mark
described
may
take
a
couple
of
years
to
fully
exit
is
a
problem
for
us
to
manage
behind
the
scenes.
Really.
Thank
you.
N
Can
I
come
in?
Yes,
please
thanks.
Yes,
it
was
really
encouraging
to
hear
about
the
plans
for
sort
of
regulating
through
the
eyes
of
people
using
services
and
the
whole
range
of
ways
in
which
people's
views
can
be
heard.
I've
got
two
questions.
One
is
where
are
we
at
in
terms
of
how
people
who
fed
in
their
views,
know
what
happens
next
to
those
views?
N
So,
for
example,
if
people
use
the
give
feedback
on
care-
and
I
mean
really
good
to
hear
about
the
the
inspections
inspection
activity
being
triggered
by
whistleblowing
and
by
feedback
from
members
of
the
public,
for
example,
but
I
just
want
to
because
I
know
we've
discussed
this
in
the
past.
N
I
just
wanted
where
that's
reached,
and
my
second
question
is
we
over
the
last
year
or
so,
we've
taken
any
we've
placed
an
increasing
emphasis
on
human
rights,
and
it's
mentioned,
for
example,
in
in
the
report
on
in
relation
to
closed
cultures
and
the
training.
That's
been
going
on
with
large
numbers
of
staff
on
identifying
risks
in
close
cultures
and
intervening
effectively,
etcetera,
but
also,
I
know
in
our
mental
health
work
there's
been
a
big
focus
on
a
human
rights
approach
I
just
wanted
during
during
covid.
C
Peter
I
know
kate
will
want
to
pick
that
up
in
a
moment
on
her
section
in
the
next
part
of
the
report.
Would
it
make
sense
to
take
any
any
questions
from
this
first
part
of
the
report
before
we
move
on
to
kate's
next
section.
A
Yes,
let's:
let's:
let's:
let's
do
that
and
kate
you
can.
You
can
pick
up
lizzy's
point
john,
your
hand
is
up,
but
I'm
not
sure
if
that's
just
left
up
from
before
or
you
want
to
come
back
in
it's
not
up
anymore,
fantastic,
quick
reaction.
Does
anybody
want
to
come
in
on
anything
that
we've
discussed
so
far,
or
should
we
move
on
to
kate,
okay,
kate?
Please.
D
Lovely
thank
you.
So
I'm
just
going
to
take
you
on
our
closed
cultures
work.
So
in
your
papers.
You
will
see
an
update
on
our
plans
around
supporting
our
staff
to
have
training
around
our
supporting
information
guidance,
so
this
is
guidance
that
we
developed
at
pace
in
autumn
and
then
we
spent
a
bit
more
time
involving
stakeholders,
people
lived
experience
and
families
in
a
refreshed
version
that
we
published
in
june.
D
We
made
a
commitment
that
this
training
would
be
mandatory
for
all
relevant
staff
and,
as
of
yesterday,
yesterday,
1899
of
our
staff
have
had
the
training
and
all
staff
who
need
to
have
the
training
would
have
had
it
completed
by
august.
So
that's
where
we
are
on
that
front.
We
are
really
keen
that
the
close
culture
work.
This
is
such
an
important
agenda.
D
We
are
really
keen
that
people
with
experience
and
their
families
sit
alongside
us
as
we
go
through
this
program
to
make
sure
that
we
are
getting
this
absolutely
absolutely
right.
So
we
are
recruiting
to
an
expert
advisory
group
similar
to
ones
we've
had
before.
So
we've
had
a
fantastic
expert
advisory
group
who
have
been
working
with
us
on
our
publication.
D
Around
restraint,
seclusion
and
segregation,
which
will
be
coming
out
in
september
and
they've
really
helped
shape
our
thinking
and
think
about
our
recommendations
and
we're
looking
for
an
equal
kind
of
contribution
to
this
piece
of
work
around
close
cultures.
So
we've
got
a
very,
very
short
nomination
process
if
people
are
interested
and
we've
got
support
if
people
have
access
challenges,
so
we're
really
keen
that
50
of
this
group
of
people
with
lived
experience
and
family
carers,
so
I
just
want
to
give
a
bit
of
a
plug
for
that.
D
The
final
thing
on
this
before
I
just
respond
to
liz's
comments,
so
we're
doing
some
work
around
surveillance.
So
we
know
surveillance
is
a
hot
topic.
We
often
have
a
colleague
from
the
public
ask
us
questions
about
where
we
are
with
regard
to
our
surveillance
policy.
Again,
this
is
something
that
we're
taking
very
seriously
and
because
it's
so
important,
we
want
to
make
sure
we
get
it
right.
So
this
also
comes
out
in
the
glynis
murphy
findings
in
her
first
phase
of
her
work.
So
we've
done
a
series
of
workshops.
D
We
are
doing
a
piece
of
work.
Linus
is
supporting
us
with
a
piece
of
work
around
what
international
best
practice
tells
us
and
there's
also
a
literacy
review
going
on,
so
that
work
is
progressing
and
we
will
have
something
back
to
boarding
in
autumn
on
that
and
then,
with
regard
to
human
rights
liz,
I
think,
as
you
said,
if
you
strip
everything
back
and
look
at
things
through
the
human
rights
lens,
it
just
everything
else
kind
of
falls
away,
and
you
know
so.
D
I
think
human
rights
is
obviously
a
major
feature
in
the
work
that
you've
just
described
and
how
we
approach
close
cultures
and
the
work
around
mental
health
assessments
etcetera.
So
it's
an
example
of
where
we
see
things
that
we
think
are
breaches
of
human
rights
and
action.
We
take.
It's
probably
best
demonstrated
in
the
work
we
did
around
the
do
not
attempt
resuscitation
so.
D
Colleagues
may
be
aware
early
on
in
clovid,
we
became
aware
of
some
examples
where
ish,
where
blanket
issuing
of
do
not
attempt
resuscitations
were
happening
to
groups
of
people
living
in
care
settings.
So,
there's
notion
that
you
could
make
a
decision
you
could,
you
could
think
of
a
group
as
homogeneous
and
make
a
single
decision
about
them
without
consulting
them
is
absolutely
unacceptable.
D
So
rosie's
team
might
even
number
us
work
closely
together
with
the
british
medical
association,
the
royal
college
of
gps
and
the
care
provider
alliance
to
put
out
a
statement
to
say
absolutely
explicitly.
D
This
sort
of
behavior
is
unacceptable,
it's
a
breach
of
human
rights,
and
it
needs
not
happen
so
as
and
when
we
come
across
new
issues
that
are
potential
breaches
of
human
rights.
We
are
also
taking
swift
action
to
address
them.
N
Yes,
thank
you.
Yes,
it
does.
There
was
a
first
part
to
my
question,
which
was
about
how,
but
maybe
chris
would-
or
somebody
else
would
like
to
answer
that
which
was
about
how
people
have
given
their
feedback
know
what
happens
to
it.
J
So
yeah,
I
think
that's
it's
a
really
important
point
liz.
So,
as
you
know,
we've
been
through
to
give
feedback
on
care.
J
Pilots
we've
been
making
sure
that
inspection
colleagues
determine
how
that
information
has
been
used,
and
I
think
our
ambition
with
that
work
is
to
be
clear
and
clear
about
what
action
has
led
to
what
actually
has
led
from
the
comments
that
have
been
made
and
we're
looking
at
how
we
can
provide
potentially
updates
on
information
we've
received
as
part
of
that
described
earlier,
as
that
sort
of
always
on
view
of
quality
of
an
organization
so
receiving
receiving
comments,
and
the
action
that
we
take
is
more
is
more
clearly
understood
for
individual
organizations
and
local
systems
as
well.
J
But
at
the
moment
we've
got
that
in
for
give
feedback
on
care.
I
think
our
ambition.
We
should
think
about
how
we
can
use
that,
more
generally,
with
with
whistleblower
we're
safeguarding
with
other
information
that
that
comes
in
but
provider
what
one
member
of
the
public
talked
about
sort
of
a
timeline
for
that
organization.
So
you
can
see
the
things
that
have
happened
over
a
period
of
time
and
also
include
things
like,
for
example,
registered
managers,
changing
and
the
implications
of
that.
J
So
that's
some
of
our
ambitions,
but,
as
ian
said
earlier,
we
want
to
develop
that
thinking
over
the
course
of
the
next
few
months,
but
I,
I
certainly
think
the
ability
for
if
people
are
going
to
offer
their
views
of
services,
it's
important.
We
can
provide
the
response
back
to
them,
either
individually
or
collectively,
to
show
what
we've
done
with
that
information.
J
C
Thanks
peter,
I
I
think
just
to
build
on
that
point.
I
think
one
of
the
the
interesting
things
about
about
feedback
is
people
often
initially
give
it
to
us
anonymously,
so
actually
providing
feedback
directly
on
a
personalized
basis
can
often
often
be
quite
quite
difficult.
C
We've
made
an
effort,
some
of
our
public
communications
more
recently,
to
start
to
start
to
talk
a
little
bit
more
about
about
the
the
amount
of
work
that
we
do,
that
is
based
on
feedback
or
whistleblowing
and
so
forth
in
a
much
more
overt
way,
but
that's
still
quite
generic.
I
know
in
you
know
in
other
settings,
for
example,
if
you
give
blood
you're,
given
a
you'll,
send
a
text
message
to
say
where
your
blood
has
gone
to
which
hospital
it's
gone
to
and
that
that
that
creates
that
closed
loop.
C
So
we
we've
been
thinking
about.
How
can
we
create
that
automated
closed
loop
so
that
people
can
start
to
understand
the
value
of
the
feedback
that
they're
giving
us?
C
Even
if
the
the
answer
is
pretty
generic,
but
they
get
some
kind
of
personal
contact
that
they
that
there's
a
sense
that
what
they've
done
is
added
real
value.
So
I
don't
think
we're
there
yet
on
on
that.
But
it's
something
that's
definitely
on
the
on
the
on
the
high
up
on
the
list
of
things
to
do.
A
Okay,
liz,
okay,
lizzy
smile
good.
Thank
you,
liz
ian!
Should
we
move
on?
Is
it
to
ted?
It
is
yes,
ted.
E
Ted
that
thank
you
peter.
So,
in
light
of
the
time,
I
won't
reiterate
think
points
I've
already
made
about
the
inpatient
survey,
which
is
important,
but
can
I
just
highlight
also
as
detailed
in
the
report
the
work
we're
doing
with
emergency
medicine,
senior
emergency
medicine
collisions
from
all
over
england
preparing
for
next
winter,
even
before
kobe,
dad
already
raised
my
concerns
about
preparedness
for
next
winter,
clearly
with
kovid
with
the
impact
of
the
virus
itself,
but
also
with
the
effects
that
has
on
the
capacity
of
acute
trusts.
E
I
think
is
increases
our
concern
going
into
next
winter
and
it's
very
important
that
services
are
well
prepared,
we're
working
with
the
clinicians
to
understand
best
practice
to
understand
innovations
they
brought
into
play
both
within
within
the
emergency
departments,
but
also
within
the
hospitals
themselves
and
working
with
other
parts
of
the
system
and
we'll
be
sharing
that
best
practice
to
make
sure
that
emergency
departments
have
the
best
background
for
making
preparations
for
for
next
winter,
and
I
think
that's
really
going
to
become
increasingly
important
over
the
next
few
months.
C
Okay,
rosie
and
then
kirsty.
B
Thanks
for
coming
after
me,
thank
you,
so
I
just
wanted
to
I'm
going
to
just
talk
through
some
of
the
people
bits
and
then
I'm
going
to
hand
over
to
chris
who's
going
to
pick
up
on
the
performance.
So
the
people
report
pretty
much
is
as
read,
but
I
just
wanted
to
highlight
a
couple
of
areas.
I'll
draw
your
attention
to
a
couple
of
areas.
Our
people
plan,
which
has
come
to
this
board
before
was
launched
within
the
organization
on
25th
of
june.
B
Just
as
a
recap,
this
is
a
holistic
plan
that
looks
across
the
whole
broad
spectrum
of
the
people
agenda
to
ensure
that
we
have
both
the
culture,
the
skills,
the
capabilities
in
place
that
we
need
now
and
in
the
future,
and
I
think
it's
very
exciting
time
in
hr
that
we're
taking
this
sort
of
holistic
approach
to
moving
things
forward
and
with
that
real
aim
of
creating
that
truly
inclusive
organization
as
well.
So
I
think
that's
a
really
good.
B
A
good
success
point
to
have
got
that
to
to
to
launch
and
there's
quite
a
lot
of
work
going
on
already
within
that
so
yeah.
It's
not
just
the
start
of
the
process,
we're
well
on
the
way
with
that.
I
just
wanted
to
also
draw
out
the
work
we've
been
doing
on
the
success
profiles.
This
is
a
piece
of
work
which
is
a
really
inclusive
piece
of
work.
B
We've
worked,
we've
had
many
workshops
across
the
whole
of
the
organization,
take
working
at
different
different
jobs
and
different
grades,
where
people
have
all
come
together
and
they've
talked
about
what
success
looks
like
in
in
their
roles
on
a
number
of
fronts,
and
what
we've
managed
to
do
is
pull
these
together
now
into
into
a
set
of
job
outline
job
success,
profiles
which
we
are
now
just
about
to
finalize
we're
going
to
now
go
out
to
consult
with
our
unions
and
our
networks
and
our
colleagues
on
finalizing
these.
B
I
think
these
are
going
to
underpin
quite
a
lot
of
our
future
work
around
around
talent,
around
performance
and
also
around
progression
really
setting
out
those
behaviors.
We
expect
to
see
at
the
various
levels,
so
it
makes
it
really
transparent
for
people
about
what
they
need
to
do
and
how
they
need
to
behave
to
progress
within
the
organization.
So
I
think
it's
it's
it's.
It's
a
really,
I'm
really
good
with
getting
this
this
this
landed,
and
so
that
will
be
ready
to
be
launched
in
october.
B
We've
also
made
some
really
good
work
around
reviewing
our
policies.
That
work
is
ongoing,
we're
rolling
through
our
policies
that
are
batch
time
and
we've
nearly
finished
the
first
batch,
and
then
I
also
just
wanted
to
highlight
as
well.
The
work
we've
been
doing
around
our
professional
services,
professional,
professionalising,
regulation
services,
training.
B
We
have
now
had
that
first
cohort
go
through
that
piece
of
work,
piece
of
training,
and
that
gives
our
inspectors
a
formal
qualification
in
in
regulation.
B
It's
really
really
an
important
way
of
starting
to
to
recognize
that
the
skills
and
and
professionalism
of
our
inspectors
and-
and
it
is
a
nationally
recognized
qualification
that
is
portable.
We
are
now
going
to
roll
that
out
across
the
majority
of
our
inspection
workforce
over
the
coming
coming
coming
year,
and
I
think
it's
really
going
to
help
us
drive
that
professionalism
that
we
know
we
already
have
but
sort
of
quantifying
that
going
forwards.
B
So
that's
what
I
want
to
say
on
the
people.
I
I'll
just
move
on
to
to
to
the
performance
and
if
anyone's
got
any
questions,
maybe
we
could
pick
the
people
in
the
performance
bit
up
at
the
same
time.
If
that
would
be
okay,
chris
is
going
to
talk
mainly
about
the
performance,
but
I
just
wanted
to
just
touch
on
on
reg
performance.
B
As
we've
talked
a
number
of
times
on
the
board,
we
are
transforming
our
registration
services,
both
through
a
a
new
digital
service,
but
actually
also
looking
at
how
we
organize
the
registration
teams
to
ensure
that
we
can
deliver
excellent
service.
We
we
have
split
out
our
applications
into
those
more
simple,
straightforward
applications
and
then
into
those
complex
ones
and
allocating
resources.
Accordingly,
I
think
we
are
making
some
really
good
progress
with
the
performance
around,
particularly
our
simple
applications.
B
We've
now
got
those
down
to
on
average
of
26
days,
but
some
of
those
applications
are
being
done
within
ncsc.
They
they're
they're
sort
of
administrative
type
activities,
and
we
have
now
got
managed
to
get
those
down
to
an
average
of
six
days
compared
to
a
kpi
of
20
days,
and
I
think
that's
just
worth
noting
that
that
really
stellar
performance
there
from
the
ncs
ncsc
registration
team,
our
complex
applications.
We
don't
have
very
many
of
those
we
have
about
a
few
a
month
that
we
process
and
we
are.
B
We
are
starting
to
work
through
the
process
of
driving
down
those
that
very
much
is
much
more
of
a
collaborative
effort
between
ourselves
and
the
provider
as
we
as
we
as
we
iterate
through
their
applications,
making
sure
that
we've
got
information
and
moving
that
backwards.
But
I'm
hopeful
that
we
will
get
that
time
taken
to
get
those
down
through
some
of
the
process
improvements
we're
making
at
the
moment.
B
That
was
all
I
want
to
say
on
red,
I'm
going
to
hand
over
to
chris
now
he's
going
to
pick
up
the
rest
of
the
performance.
If
that's
okay,
so
chris
over
to
you.
O
Thanks
kirsty
yeah,
so
I'll
keep
this
brief,
because
we'll
do
a
proper,
thorough
review
of
performance
as
part
of
the
quarter
one
pack
next
month
with
the
full
full
pack.
So
it's
just
the
dashboard
included
for
now.
So
just
a
few
areas
to
mention
me
obviously
case
cases
covered
registration,
so
first
rating,
following
registration,
66
percent
of
new
providers
had
a
good
or
outstanding
rate
when
inspected
within
12
months.
That's
against
the
kpi
of
80.
O
So
it's
it's
one
under
review,
but
I
think
there's
relatively
low
numbers
proportionately
there,
which
is,
is
to
be
mindful
of
registration
representations,
79
registration
representations
received
over
the
last
12
months.
82
of
the
notices
have
been
adopted
following
representations
compared
to
a
target
of
90
so
just
below,
where
we
want
to
be
on
that.
A
good
news
story
on
safeguarding
continued
to
perform
well
in
terms
of
alerts
recorded
within
one
day
is
97
against
target
of
95
and
concerns
within
five
days
is
98
against
a
target
of
95..
O
On
a
report
writing
our
kpi
here
is
is
is
about
improving
on
where
we've
been
before
so
asc
is
just
slightly
under
in
terms
of
an
average
days
to
complete
reports
with
30
days
compared
to
29
in
1920
a
similar
story
in
pms
just
one
day,
our
32
days,
on
average,
compared
to
31
in
in
1920
in
hospitals,
is
the
other
side
of
that
target,
so
51
an
improvement
on
52
as
an
average
stage
in
1920
and
the
last
bit.
O
For
me,
just
in
terms
of
our
money,
our
revenue
side
is
our
revenue.
Expenditure
is
tracking
green.
We're
still
still
doing
work
to
just
understand
our
likely
out
of
turn
for
the
year
to
understand
the
impact
covert
had
both
in
terms
of
our
expenditure,
but
also
in
terms
of
the
income
we
anticipate
receive.
O
On
the
capital
side.
We
already
had
a
slight
pressure
at
the
start
of
the
year
as
we
manage
our
portfolio,
I
think
we're
expecting
that
our
response
to
covert
will
increase
this
pressure
on
on
the
capital
budget.
So
it's
another
one,
that's
under
review.
So
that's
it
for
me
happy
to
take
any
questions.
L
Thanks
chairman
kirsty
thanks
a
lot
for
your
very
full
report
again,
but
just
like
to
comment
on
the
people
piece.
L
If
I
could
great
to
see
the
people
plan
being
launched,
digitally
as
you
know,
that
came
to
cqc
subgroup
and
we
heard
a
lot
about
the
developments
during
during
this
period,
the
people
analytics
and
and
hub
that
that's
seems
to
me
a
really
big
development
for
the
organization
to
have
more
metrics
around
the
people
agenda
than
we've
we've
been
seeing
in
the
past,
and
so
I
really
hope
that
we
get
some
exposure
to
that
at
the
board
level
and
then,
finally,
just
to
say
that
the
well-being
piece
that
your
your
the
committee
is
going
to
be
looking
at.
L
You
know,
I'm
sure
this
is
relating
to
the
challenges
of
homeworking
the
challenges
for
all
our
employees
for
for
crossing
the
threshold.
But
again
I
think
that
will
be
a
very
interesting
piece
of
work
for
us
to
hear
more
of
once.
They've
they've
gone
through
it
and
I'm
sure,
in
addition
to
that,
the
experience
the
strategies
and
policies
that
we
will
move
towards,
I'm
sure
will
be
very
useful
for
providers
as
well.
J
Perfect
chris,
okay,
very
quickly,
conscious
of
time
just
going
to
give
a
couple
of
updates
one
on
parliamentary
activity
and
a
bit
on
the
the
new
campaign.
So
parliamentary
activity.
First,
we've
been
briefing
health
security
committee
members
are
the
parliamentary
ministers
of
state
and
also
the
shadows
on
our
response
to
koved,
and
we
continue
to
get
requests
for
individual
briefings
from
mps.
J
We
had
about
sort
of
60
or
70
of
those
in
the
past
four
weeks,
so
we
would
continue
to
give
our
understanding
about
what
we
are
doing
now
and
what
we
intend
to
do
next
and
those
have
been
very
positively
received
from
the
individuals
that
we've
spoken
to.
I'm
conscious
that
there
isn't
an
august,
a
ball
beater.
Just
to
give
you
a
sense
of
what's
coming
up.
J
Ian
will
be
participating
in
a
virtual
roundtable
event
with
parliamentarians
tomorrow,
just
to
talk
a
bit
about
our
future
strategy
in
the
context
of
health
and
care
and
regulation.
This
is
to
help
inform
the
development
of
the
strategy,
but
also
to
give
parliamentarians
an
opportunity
to
comment
directly
with
the
senior
team
and
cqc
in
a
different
place.
J
We've
we're
also
contributing
to
the
women
of
quality
select
committee
inquiry
into
an
equal
impact
of
covid
on
people,
protected
characteristics
and
kate
is
giving
some
moral
evidence
on
the
22nd
of
july
alongside
other
colleagues
in
other
areas
and
the
wilson
third
opportunity
is
some
written
evidence
in
august,
there's
also
an
independent
inquiry
into
child
sexual
abuse
that
we're
submitting
written
evidence
for,
and
we
think
there
may
well
be
another
opportunity
for
all
evidence
again,
probably
in
october
later
this
year.
J
The
other
thing
I
wanted
to
mention
we
mentioned
it
a
couple
of
times,
but
the
the
cosby
all
care
campaign
has
been
a
a
for
me.
It's
a
tremendous
collaboration
between
healthwatch
and
all
the
local
health
watches
across
the
country
and
also
ten
of
the
of
the
the
main
national
third
sector.
J
Charity
organizations
that
support
different
groups
of
people,
the
logic
of
the
campaign
and
it's
built
on
some
research
that
we've
collectively
done
is
that
people
we
want
people
to
contribute
to
the
improvement
in
health
and
care
by
giving
their
views
on
how
the
how
they
are
receiving
services.
J
What
the
the
industry
researchers
underpins
the
campaign
talked
about
is
that
many
people
would
be
more
inclined
to
give
their
their
feedback
if
it's
to
help
improve
the
way
health
and
care
services
are
delivered.
So
that
is
very
much
the
the
form
the
campaign
is
taking
to
the
national
campaign
campaign
over
the
next
12
months.
J
As
I
say,
with
a
number
of
points
where
we're
looking
to
get
the
views
of
of
people,
sometimes
people
who
wouldn't
normally
provide
their
normal
feedback
on
on
care
and
we're
looking
for
spikes
in
the
give
feedback
on
care
information
as
we
deliver
the
campaign,
and
so
I
want
to
thank
colleagues
in
healthwatch
england,
also,
my
own
team
and
and
the
the
other
national
charities
involved
in
this
work.
J
A
You,
chris
okay,
so
that
completes
the
report
back
from
the
et.
I
am
very
conscious
that
we
are
running
horribly
behind
our
our
schedule.
I'm
also
conscious.
We've
been
running
for
about
an
hour
and
a
half,
so
I'm
going
to
propose.
A
A
Thank
you
right.
Okay,
so
we're
all
ready
to
go
again,
so
we
can
get
started
and
roxy.
I
think
no
we're
sorry,
sir,
here
and
over.
If
you
want
to
introduce
the
code
inside.
C
J
Hi,
yes
I'll
just
this,
I'm
just
gonna
give
you
a
quick
sort
of
potted
summary
of
the
coveted
third
code
insight
report.
The
feedback
from
the
first
two
has
been
very
much
that
people
really
enjoy
understanding
our
reflections
on
what
we
feel
has
gone
well,
understanding
and
learning
from
what
experiences
haven't
gone
well
and
how
collectively
that
can
help
shape
improvements
in
the
health
and
care
system.
J
So,
in
this
report
we
again
touch
on
the
feedback
that
we've
had
from
local
systems
and
what
and
how
they
how
they
feel.
They've
responded
to
the
covid
crisis.
We've
also
talked
a
little
bit
about
when
we've
gone
back
into
inspect
responsively,
to
risk
what
we've
found
and
what
we've
seen
and
we've
given
some
updates,
as
we
have
in
the
past
on
other
areas
of
interest,
particularly
around
declaration
of
liberties
and
mental
health
and
ld
peter.
I
was
gonna,
do
a
more
a
more
complete
picture
of
that.
J
But
I'm
just
aware
of
time,
and
I
wonder
if,
if
because
colleagues
have
had
their
that
the
document,
whether
close
might
just
want
to,
I
can
respond
to
questions
as
a
way
as
a
way
into
the
discussion
rather
than
to
go
through
it
in
any
more.
A
Detail
you've.
Never
in
all
the
years
I've
known
you
you've
never
been
so
brief.
This
is
fantastic,
so
anybody
want
to
ask
any
questions
of
chris.
It's
a
really
good
good
report,
john.
L
Thank
you
very
much
notice
in
the
document
that
you
mentioned
correctly,
the
3.7
billion
the
government
is
using
sport
to
serve
care
and
600
pounds.
That's
factually
correct.
Is
it
practically
useful
in
the
sense
that
I
hear
a
lot
about
it
not
getting
through
and
maybe
a
question
for
kate?
What's?
Secondly,
what
happens
when
it
stops.
L
D
Was
just
going
to
thank
john
for
his
easy
questions,
so
I
think
so.
What
we
can
reflect
back
is
what
we
know
through
market
oversight,
so
our
providers
are
in
market
oversight,
where
we
have
regular
conversations
about
finances,
describe
a
mixed
picture,
so
some
of
those
providers
talk
about
relationships
with
local
communities
where
money
was
passported
through
very
rapidly.
Some
talked
about
an
automatic
uplift
at
the
other
end
of
the
spectrum.
D
Providers
have
talked
about
having
to
go
through
long
application
processes,
and
some
providers
have
not
described
at
all
having
the
money
passport
or
through
that
adequately
meets
the
increased
costs.
So
in
terms
of
market
oversight,
it's
it's
a
mixed
picture
and
I
think
that
mixed
picture
reflects
what
the
wider
sector
is
experiencing
as
well,
which
we
know
through
other
other
sources
in
terms
of
the
short-term
nature
of
the
injection
of
money.
D
Well,
I
think
it's
a
bit
of
welcome
to
the
world
of
adult
social
care
where,
over
years,
there
are
short-term
injections
of
money
sticking
a
bit
of
a
sticking
plaster
on
a
situation.
But
what
we
absolutely
need
now
is
that
long-term,
sustainable
funding
solution
for
adult
social
care
providers
so
that
they
can
focus
on
transforming
and
innovation
and
not
just
keeping
their
heads
above
water.
J
I
think
john,
it
reflects
what
we've
tried
to
do
is
to
balance
what
we,
as
you
say,
what
we
know.
The
the
department
of
health
and
social
care
has
committed
to,
but
also
as
kate
described,
balance,
what
we
are
hearing
from
providers
on
the
ground,
and
I
think
both
things
are
true.
The
challenge
is,
how
do
you
turn
it
into
a
sustainable
long-term
investment
that
is
required
to
provide
a
stable,
long-term,
adult
social
care
system?
And
it's
something
we've
touched
on
in
the
state
of
cares
over
the
last
few
years.
J
I
was
on
a
conversation
yesterday
with
colleagues
from
across
health
and
care,
and
if
we
are
to
see
sustainable
systems,
we
need
sustainable
partnerships
and
that,
and
that
requires
a
sustainable
future
for
our
social
care,
which
that's
why
it's
in
there
we
recognize
the
investment,
but
we
want
to
see
that
as
a
as
a
long-term
sustainable
investment
that
definitely
reaches
providers
at
the
front
line.
A
Yeah
big
big
big
topic,
robert:
you
wanted
to
come
in.
K
K
Useful
as
it
is,
I
wondered
whether
how
wondered
how
useful
it
is
to
the
public
as
opposed
to
the
people
who
read
this
stuff,
namely
providers
geeks
like
people
I
can
see
on
the
screen
in
front
of
me
and
and
so
on,
when
what
is
here
about
care
homes,
in
particular,
it
seems
to
me,
is
vital
that
the
public
get
to
know
about
and
he's
kept
in
front
of
them,
and
I
just
wonder
if
there's
some
way
of
thinking
about
how
this
could
be
packaged
in
a
more
accessible
way
for
the
public
and
people
who
use
services
as
opposed
to
the
people
who
provide
them.
K
That's
my
question,
but
I
I
also
had
a
very
small
question,
which
is
to
demonstrate
my
ignorance.
The
graph
about
outbreaks
is
useful
and
revealing,
but
could
someone
tell
me
what
an
outbreak
means?
Does
it
mean
just
one
case,
or
does
it
mean
more
than
one
case?
What
does
it
mean?
What
does
it
mean.
J
Let
me
do
the
first
one
so
really
important
question
that
first,
one
about
how
this
is
used.
So
this
is
there's
a
number
of
different
ways
in
which
we'll
share
this
information
and
not
least
of
which,
this
afternoon
after
this
report
is
out
we'll
be
tweeting
particular
comments
that
come
from
the
report
with
partners
so
rather
than
having
people
to
access
all
the
information
about
this
report.
There'll
be
particular
key
messages
that
we
want
to
give,
and
we've
also
been
shown.
J
Is
this
information
with
partners,
so
both
public
partners
and
provider
partners
so
that
they
understand
it
and
they
can
both
respond
to
it
and
use
it
in
their
own
conversations,
and
particularly
with
the
public
groups,
making
sure
that
it
is
accessible
and
mean
and
meaningful
to
them.
J
So
what
you
see
here
is,
in
the
sense
that
the
the
the
universe
of
things
that
we
talk
about
for
this
edition,
but
we
will
have
particular
pieces
of
information
and
I've
got
a
a
cue
of
them
waiting
to
go
after
we've
after
this
report
is
published
to
make
sure
we
and
others
can
share
the
information.
The
thing
that's
so
important
to
the
public
about
what
this
report
says.
I
think
in
terms
of
the
outbreak
information,
so
it
comes
from
public
health
thing.
Oh,
do
you
want
to
go?
D
Sorry,
I
was
just
checking
it
because
so
it's
more
than
one
outbreak
in
a
care
home.
J
Yeah,
that's
what's
going
to
be
able
to
get
this,
but
they
can
give
the
information.
So
that's!
So
it's
more
than
one
person,
it's
that
that's,
but
it
comes
from
public
health,
england,
so
it's
their
their
categorization,
their
knowledge
that
there
has
been
an
outbreak
in
a
in
a
home
or
in
a
hospital.
A
So
majesty
is
a
really
really
good
report
and-
and
I
just
echo
the
comments
from
robert
and
john
and
and
thank
you
and
the
team
behind-
it-
really
really
excellent.
So
if
we're
happy
then
to
move
on
rosie,
I
think
we
come
to
to
to
you
for
the
provider
collaboration
reports.
Please.
G
Thank
you
peter,
and
can
I
introduce
the
the
team
that
joining
me,
victoria,
carolyn,
charles
and
dominique,
who
have
been
working
incredibly
hard
alongside
many
other
colleagues,
I'm
just
going
to
say
a
few
words
and
then
hand
over
them
to
to
present
the
paper
and
take
questions
as
we've
talked
about
at
this
board.
G
And
I
think
what
we've
seen
over
the
the
last
few
weeks
during
the
coronavirus
pandemic
is
that
actually
providers,
working
together
has
become
much
more
important.
It's
always
been
important,
but
even
more
so
with
all
of
the
challenges
that
there
have
been
to
meet
those
challenges
to
to
meet
the
needs
and
we've
seen
some
really
fantastic
examples.
G
We've
heard
about
some
fantastic
examples
of
where
providers
have
worked
together,
particularly
across
health
and
social
care,
across
different
parts
of
primary
care
and
secondary
care
and
the
community
services,
and
really
great
innovations
to
meet
those
challenges.
G
We've
also
heard
some
examples
where
things
haven't
gone
as
well,
and
what
we're
really
keen
to
do
is
to
be
able
to
capture
those
great
examples
that
good
practice
that
innovation
capture
the
learning
capture,
maybe
the
things
that
haven't
gone
so
well
as
well,
to
be
able
to
share
that,
and
particularly
in
advance
of
any
further
peaks
of
coronavirus.
G
And
there
will
be
challenges
as
we
go
forward.
Can
we
continue
and
encourage
providers
to
adopt
that
good
practice
and
that
learning?
We
feel
that
that's
going
to
have
a
significant
impact
on
on
the
future
ability
of
a
system
to
be
able
to
look
after
people.
So
so
that's
all
I
wanted
to
say
other
than
there
has
been
a
very
rapid
piece
of
work
done.
G
It's
it's
very
impressive
and
I
think,
having
joined
one
of
the
interviews
yesterday
for
one
of
the
provider,
collaboration
reviews-
I'm
really
excited
about
this,
because
I
think
the
amount
of
information
that
we're
going
to
get
is
going
to
be
very
rich
and
very
beneficial.
So
over
to
you,
victoria.
F
Hi,
thank
you
rosie,
so
I'm
victoria,
watkins
interim
deputy
chief
inspector
and
yes
exactly
to
follow
on
from
rosie,
really
pleased
to
be
here
to
talk
about
the
the
progress
so
far
with
the
the
pcrs.
Absolutely
the
responses
to
the
pandemic
have
highlighted
the
innovation,
the
creativity
and
the
benefits
of
of
work
and
efforts
within
systems
in
terms
of
those
provider,
collaboration
responses,
I'm
going
to
assume
and
I'm
mindful
as
well
of
you
the
time.
F
So
I'm
going
to
assume
that
people
have
seen
the
paper
had
access
to
all
of
that
information
and
probably
just
zoom
in
on
a
few
key
things
and
then
make
it
more
about
conversation
and
and
queries
if,
if
that's
okay,
so
the
first
thing
to
say
is
is
to
highlight
the
objectives.
F
So
so,
what
is
it
that
we
are
hoping
to
achieve
through
the
pcr
approach
and
that's
absolutely
about
driving
learning
and
improvement
both
at
system,
regional
and
also
national
level
and
and
that
being
aligned
to
drawing
out
the
experiences
and
the
outcomes
of
those
who
have
accessed
the
health
and
care
system
within
within
these
areas
and
sharing
that
well
and
we'll
be
sharing?
F
It
at
local
level
and
national
level
at
local
level,
it
will
be
unpublished
and
slide
packs
brief
impacts
back
to
the
system
and
also
a
summary
of
findings
meeting
with
some
of
those
senior
leaders
from
the
areas
and
then
at
the
national
level.
It's
through
the
the
coveyed
insight
releases
and
and
subsequently
state
of
care,
probably
important
to
highlight
pcrs,
are
absolutely
about
connecting
the
data
and
intelligence
story
to
the
real
life
experiences.
F
The
efforts
of
those
teams
staff
across
the
organizations
to
work
together,
as
well
as
the
lived
experiences
of
those
accessing
health
and
care.
So
absolutely
critical
in
terms
of
the
approach
for
our
teams
out
on
site
is
to
hear
those
experiences
of
people
who
have
been
in
and
receiving
care
from
from
within
the
system.
F
The
pcrs
knit
together
nicely.
I
think
some
of
our
ambitions
certainly
immediate
ambitions
in
terms
of
using
our
powers
well
and
and
delivering
an
approach
that
sees
us
function
within
systems
focusing
here
on
providers
and
also
telling
the
story
well
to
drive
improvements
and
also
knits
to
our
ambitions
in
terms
of
next
steps.
F
Our
next
steps
around
what
comes
next
for
our
future
approaches,
as
we
think
about
transition
through
to
transformation
in
terms
of
what
we
do
and
what
activity
looks
like
within
systems
and
before
I
hand
over
to
carolyn
who
is
live
and
amidst
the
pcrs
as
we
speak
to
hear
more
about
phase
one
just
just
to
flag.
F
Subsequently,
in
the
paper
you
will
have
seen
that
the
ambition
is
is,
is
noted
to
be
beyond
this
first
phase,
this
first
phase,
focusing
on
11
of
the
areas
and
the
interface
between
health
and
adult
social
care.
So
what
you
will
see
there
is
that
actually,
the
ambition
continues
that
we
get
to
all
of
the
43
national
areas,
be
they
ics
or
stps,
and
also
we
build
some
different
focuses
for
the
pcr
approach,
so
so
I'll
pause
there.
F
P
Hi
everybody
so
I'm
carolyn
jenkinson,
I'm
a
head
of
hospital
inspection,
but
I'm
leading
as
head
off
for
the
pcr
reviews
and
so
we're
doing
11
systems,
as
you
know,
and
we've
kicked
off
this
week
with
two
systems
and
bedford,
saluton
and
milton
keynes
and
friendly
health
and
care
and
then
we're
carrying
on
and
our
last
three
reviews
will
take
place
the
week
of
the
third
of
august.
So
it's
really
rapid
working
at
an
extreme
pace
to
get
this
delivered
and
we've
got
teams
of
inspectors.
P
Each
review
is
led
by
an
inspection
manager
and
what
we
do
is
we
interview
key
people
from
the
system
and
also
try
and
do
as
much
work.
We
can
in
focus
groups
and
you
know,
join
different
forums
that
are
already
out
there
to
try
and
hear
about
what's
been
happening
in
in
covid.
But
I
thought
it
might
be
quite
nice
for
you
to
hear
a
few
early
things
that
have
come
through
already
and
we're
only
sort
of
in
on
day
three
really.
P
But
what
we're
hearing
is
that,
if,
if
providers
collaborated
well
pre-covered,
then
things
were
better
when
covert
hit,
which
I
suppose
this
goes
without
saying
really.
But
it
just
shows
about
the
importance
of
of
having
relationships
that
you
know
are
decent
with
with
each
other.
There's
a
sense
that
pandemic
plans
weren't
fit
for
purpose
out
there.
P
There
seems
to
be
a
concern
coming
from
lots
of
different
areas
around
the
impact
on
elective
procedures,
again
no
surprise
there,
but
particularly
orthopedics,
and
what
I
thought
was
then
quite
an
interesting
thing
for
you
to
hear
was
around
some
of
our
dca
providers.
Now.
Obviously,
this
is
only
in
one
area
at
the
minute,
but
you
know
they've
said
that
whilst
normally
dca
providers
would
normally
be
working
in
competition
with
each
other,
what
it?
P
What
it
meant
was
that
that
competition
sort
of
went
a
bit
and
that
they
worked
together
better
and
more
in
partnership
with
each
other,
as
opposed
to
being
in
competition,
and
I
think
we
have
in
a
sense
that
there
might
be
a
difference
between
how
providers
that
are
commissioned
were
directly
commissioned,
got
support
as
opposed
to
those
providers
that
weren't
directly
commissioned
by
local
authorities
or
the
nhs
and
receive
support.
And
then
there
are
discrepancies
there
and
so
we'll
explore
that
a
bit
more.
P
But
I
mean
that's
only
a
tiny
fraction
of
things
that
we've
picked
up
already
and
there'll
be
lots
and
lots
more
information
that
we'll
be
able
to
to
glean
from
these.
I
think
it's
really
nice
to
hear
that
we've
been
we
haven't,
met
any
resistance
from
any
of
the
systems
that
we've
been
to.
P
There
seems
to
be
an
appetite
for
this
and
I've
heard
from
several
different
system
leaders
and
that
they
think
that
this
is
quite
a
nice
opportunity
for
them
to
take
stock
and
take
a
breath
and
actually
reflect
on
a
lot
of
the
things
that
they
have
been
doing
and
and
just
you
know
it's,
it
is
nice,
isn't
it
sometimes
it's
quite
therapeutic
to
actually
talk
and
share
what
you've
been
doing
through
a
difficult
time.
So
I'm
hoping
that
that
might
be.
You
know
useful
as
well.
P
A
So,
karen
just
to
build
on
what
you
were
just
saying
just
now
I
mean
I've
probably
spoken
to.
I
would
guess
a
couple
of
dozen
trusts
informally
in
informal
settings
where
they
can
tell
me
what
they
really
think
about
anything
and
they
usually
do
and
as
far
as
their
reaction
to
pcrs
are
concerned,
I
mean
it's
been
uniformly,
really
really
positive.
A
So
that's
in
addition
to
what
we've
heard
through
the
representative
group
so
very
much
supports
what
you've
just
said.
John.
You
wanted
to
come
in.
L
Yes
and
congratulations
to
the
team,
not
least
for
getting
this
up
and
running
so
swiftly,
I
think
it
would
be
important
to
be
clear
about
what
this
is
and
what
it
isn't
and
to
manage
those
expectations.
L
I
think
your
other
challenge
will
be
that
the
richness
of
the
data,
the
the
real
learning
across
systems
and
across
the
country,
will
come
from
distilling
that,
in
a
way,
that's
sufficiently
granular
in
a
way
in
poly,
as
you've
just
been
doing
carolyn
that
allows
people
to
take
that
learning
and
institute
it
in
their
own
places,
and
I
hope
that
the
insight
review
will
have
sufficient
depth
to
allow
people
to
do.
G
Can
I
just
come
in
on
that,
if
that's
okay
about
what
this
is,
what
it
isn't,
because
I
think
it's
a
really
important
point.
John,
thank
you,
and
what
this
is
is
absolutely
an
opportunity
for
us
to
identify
really
good
practice,
identify
learning
and
share
that
learning,
and
do
that
in
a
way
that
doesn't
point
fingers
at
people
doesn't
blame
people.
We
know
that
there's
been
a
huge
amount
of
kind
of
heroic
efforts
right
across
the
country.
G
There's
there's
a
lot
of
variation,
there's
a
lot
of
different
ways
that
people
have
tried
to
adapt
and
meet
the
challenges
that
have
arisen,
and
we
very
much
want
to
share
those,
and
we
want
to
share
those
in
a
way
that
people
can
learn
from.
I
think
the
the
point
about
distilling
those
into
a
useful
format
that
people
can
learn
from
is
really
important,
but
this
is
about,
as
as
victoria
said
earlier,
this
is
very
much
about.
G
A
Thank
you
rosie
chris,
you
lost.
If
you
wanted
to
come
in
or
not.
J
You're
on
mute,
if
you
did
I'm
just
going
to
say
it's
one
of
the
few
okay
just
to
sort
of
back
up
your
point
really.
We've
had
really
positive
support
from
right
across
both
public
and
provider
groups.
So
everybody
from
manchester
providers,
the
rcgp
confederation
national
care
forum
from
public
groups
like
the
richmond
group
agk.
J
Obviously,
colleagues
in
healthwatch
power
all
have
been
supportive
of
the
reason
to
do
this
because
all
recognized
the
mutual
relationship
that
that,
in
terms
of
how
people
deliver
care-
and
I
think
all
of
them
are
looking
for
this-
to
provide
some
of
the
some
best
practice
around
how
people
prepare
for
this
winter,
but
also
how
people
prepare
for
the
the
the
types
of
service
that
will
be
created
in
the
future.
J
So
lots
of
very
good
and
very
strong
support
for
this
work
and
a
great
deal
of
really
good
conversations
that
have
been
happening
happening
locally
and
I
think
the
ability
to
use
this
and
use
what
we've
learned
from
this
experience
to
drive
our
understanding
and
indeed
public
and
providers,
understand
about
how
to
prepare
for
winter,
I
think
will
be,
will
be
invaluable
great.
Thank
you
so
bored
where.
N
We're
at
I'm
sorry,
I
just
wanted
to
mention
that
regulatory
governance
committee
looked
at
this
in
a
bit
more
detail
yesterday
and
I
think
we
were
assured,
first
of
all
on
that
point,
about
the
tightness
of
the
scope
really
important
and
and
keep
track
on
that
and
and
the
the
rapid
learning
potential
both
to
the
local
system
and
more
widely
between
different
systems.
But
the
other
things
that
we
looked
at
were
the
relevance
of
inequalities.
N
So
you
know
who's
been
most
affected
by
covert,
for
example,
people
from
black
asian
minority
ethnic
communities
and
the
importance
of
factoring
that
in
and
also
the
follow-on-
and
I
think,
victoria
and
carolyn
mentioned
this-
that
you
know
at
the
moment
it's
11
and
at
the
moment
it's
focused
on
older
people,
but
we
started
having
clearly
the
team
are
already
thinking
about
where
that
could
go
next
and
there's
some
good
thinking
going
on
about
that.
So
just
to
let
the
board
know
that
that
discussion
happened.
A
So
thank
you,
liz
and
that's
a
very
good
segue
into
what,
as
a
board,
we've
been
asked
to
endorse,
which
is
the
the
current
program
which
I'm
sure
we
do,
but
also
the
subsequent
development
of
the
program
over
the
coming
months.
So
are
we
all
happy
to
endorse
that
and
carolyn
and
and
victoria?
Can
I
just
thank
you
on
behalf
of
the
board,
and
would
you
thank
everybody?
A
M
Yes,
thank
you.
Thank
you,
peter
there's,
both
the
annual
report
and
the
report
of
the
last
meeting
in
which
was
in
june,
and
I
think
the
two
things
run
together,
so
I'll
focus
more
on
the
annual
report.
The
there's
a
note
there
about
the
timetable
for
actually
issuing
our
annual
reports
and
accounts,
which
we
expect
to
happen
after
the
recess
now,
which
is
down
to
a
a
slight
sort
of
problem
with
there's
no
problem
with
the
accounts.
M
There's
no
problem
with
the
audit
they're,
almost
all
complete
in
that
respect,
but
there
is
one
particular
area
which
relies
on
auditors
of
local
government
pension
schemes
for
the
nao
to
to
look
at
what
those
that
have
done
and
that
that
is
running
late
because
of
covered
implications.
This
this
this
time.
M
So
we
were
able
to
get
these
in
before
the
recess,
but
we
will
be
putting
them
in
after
the
recess
now,
but
a
good
set
of
accounts
were
just
about
ready
to
go,
and
that
was
a
feature
of
what
the
committee
looked
at
in
june.
F
M
At
a
number
of
other
things
which
are
in
the
document,
the
annual
reports,
I
think,
picks,
brings
things
together,
as
it
says,
for
the
year.
I
pick
out
a
couple
of
points
there.
I
think
there's
been
a
the
the
subgroup
of
acgc
spent.
I
think
seven
meetings
on
the
transformation
and
change
program,
which
I
think
has
been
very
good.
M
We
have
seen
an
enormous
amount
delivered
over
the
last
year
in
that
programme
and
also
a
considerable
improvement
and
strengthening
of
the
program
management
within
there,
which
has
been.
We
we're
really
pleased
to
see
that
happen
over
the
year.
We've
got
a
good
good
grip
on
things.
Now
that
doesn't
mean
so.
There
aren't
challenges.
There
are
lots
and
lots
of
those,
but
there's
a
much
better
grip
on
the
the
management
and
the
reporting
and
the
risk
management
around
it.
M
F
M
Of
to
the
fore,
I
think,
as
we
go
forward
around
delivering
benefits
so
that
there's
a
record
there's
much
better
identification.
What
the
benefits
are
within
the
different
programs
and
projects,
but
we
need
to
deliver
those
and
monitor
the
delivery
of
that
and
around
intelligence,
not
just
in
the
the
intelligence-driven
enablers,
which
are
kind
of
technology
aspect
of
it,
but
also
how
we
deliver
being
intelligence
driven
in
our
regulation
and
that,
I
think,
will
come
to
the
fore
as
we
go
go
through
the
next
year.
M
Some
positive
work
on
quality
improvements,
which
I
think
is
great.
The
team
they've
been
growing
with
a
lot
of
a
lot
of
input
from
john
john
oldham
on
that
which
I
think
has
actually
keyed
us
up
well,
has
got
off
into
the
future
a
lot
lots
more
to
do,
as
I'm
sure
john
would
agree.
But
it's
it's
it's
going
in
the
right
direction
there,
which
is
really
good
and
a
little
bit
on
the
impact
of
curbing
19.
M
Where
you
talk,
we
talked
about
the
effect
of
how
we
work,
but
there's
also
been
a
lot
of
monitoring
by
the
finance
team
of
both
the
impacts
on
our
own
costs
etc,
but
also
on
potential
impacts
on
our
income
over
the
the
next
year
and
some
good
processes
and
they're
really
really
on
the
ball
in
that
respect
and
monitoring
that
what's
going
forward.
So
we're
pleased
with
that.
So
I
think
that
probably
summarizes
the
main
points
that
I
wanted
to
bring
out.
A
In
which
case,
I
think
we
just
need
to
to
note
the
report,
but
thank
you
paul
and
thanks
to
everybody
at
acgc,
because
it's
been
a
really
really
busy
year,
but
a
very,
very
productive
one.
So
thank
you
liz.
Can
we
move
on
to
the
the
rgc
and
again
you
probably
want
to
report
briefly
on
our
meeting
yesterday
or
although
you've
already
touched
on
that.
So
it's
probably
a
part
two
you
want
to
touch
on
and
then
your
annual
report,
please.
N
Yes,
thanks
very
much
peter,
maybe
I'll
start
with
the
annual
report
and
then
I'll
just
touch
on
what
happened
yesterday.
So
the
regulatory
governance
committee
has
the
opportunity
to
do
deep,
dives
into
areas
of
our
regulatory
activity
on
specific
topics
and
to
to
give
them
more
air
time
if
you
like,
and
more
thorough
excruciatingly
than
can
be
done
by
the
full
board,
but
in
the
course
of
this
year
we've
done
two
other
things.
N
The
first
was
under
the
previous
channel
lewis
appleby,
where
we
introduced
discussions
about
cross-cutting
issues
across
the
whole
organization,
for
example
our
work
with
people
with
in
relation
to
people
with
dementia
across
all
inspectorates
or
our
work
in
relation
to
people
with
learning
difficulties
or
health
inequalities,
and
the
other
thing
we've
done
because,
because
we're
in
a
the
lead
up
to
a
new
strategy,
we've
also
done
some
scrutiny
of
plans
in
the
development
of
that
new
strategy
and
the
development
of
new
regulatory
methodologies.
N
So,
to
give
you
some
examples
of
the
kinds
of
topics
that
we've
discussed:
we've
we've
on
the
strategy
point
we've
looked
at
how
we
understand
our
impact
learning
from
academic
research
into
the
different
levels
that
regulators
have
you
know,
ranging
from
guidance
through
to
enforcement
or
using
our
independent
voice
and
how
we
select,
which
of
those
different
approaches
we
use
to
be
most
effective
and
to
use
the
tools
in
our
toolbox
to
make
most
difference,
and
I
think
that's
been
an
important
input
into
the
strategy.
N
Similarly,
we've
looked
at
research
and
development
and
what's
our
role
in
gathering
good
research
evidence
and
just
emphasize
the
huge
importance
of
partnerships
that
we've
developed
with
different
academic
institutions.
So
we
do.
We
do
fast
evidence
reviews,
but
we
work
in
partnership
to
get
that
greater
depth
and
range
of
evidence
from
people
with
the
right
expertise.
N
But
then
we've
done
these
real,
deep
dives.
So,
to
give
an
example,
medicines
optimization
so
the
huge
challenge
of
medicines-
errors
that
I
think
we're
all
familiar
with,
and
we
were
able
to
really
look
at
that
in
detail
at
the
work
that
was
done
both
in
terms
of
our
inspection
and
regulation,
but
also
our
work
more
upstream
with
other
bodies
nationally.
That
could
make
a
difference
to
the
level
of
medication
errors.
N
We
also
looked
at
enforcement
when
we
use
enforcement.
Why?
On
what
topics
and
the
learning
from
that
and
how
we,
how
we
measure,
how
successful
we
are
in
that
enforcement
activity?
So
lots
and
there
are
lots
of
other
topics
as
well,
and
we
always
in
we
always
direct
these
discussions
to
giving
assurance
to
the
board
or
in
some
cases,
to
giving
advice
and
input
to
the
teams
who
then
go
away
and
do
further
work,
and
that
may
be
for
something
that
comes
back
to
the
board
the
decision.
N
So
I
think
that's
what
we've
done
through
the
year
and
we
welcome
input
into
into
our
future
plans
from
the
board
yesterday.
Well,
we
we
had
the
the
the
deeper
dive
into
the
pcrs
that
were
I've.
Given
the
feedback
on
that,
the
other
issue
that
we
discussed
was
our
work
on
mental,
the
mental
health
act
and
it's
a
very,
very
important
area
of
activity
and
and
not
one
that
we
looked
at
very
recently.
N
But
I
think
we
learned,
for
example,
that
the
second
opinion,
dr
so
ed
system,
that
we
organize
at
cqc
that
those
second
opinions
in
25
percent
of
cases
lead
to
a
change
in
the
treatment
plan.
So
you
can
see
at
an
individual
level
where
some
of
the
work
we're
involved
in
makes
changes
happen
for
individuals,
but
also,
we
spent
some
time
looking
at
what
had
happened
during
covid
and
the
way
that
we'd
used
that
the
teams
had
used.
N
Remote
methods
to
keep
in
strong
contact
with
people
using
detained
under
the
mental
health
act
were
obviously
in
vulnerable
situations
and
so
with
no
sort
of
let
up
to
doing
it,
but
sometimes
needing
to
do
it
in
different
ways,
but
also
continuing
to
cross
the
threshold
and
inspect
where
that
was
found
to
be
necessary.
Due
to
information
that
we
gleaned
either
from
people
who
were
detained
or
from
advocacy
organizations.
N
So
there
was
a
strong
in
emphasis
on
reaching
out
to
user
groups
and
advocacy
organizations
proactively
to
find
out
what
was
going
on
so
a
very
important
discussion
on
how
how
this
area
of
work
had
been
handled
during
cove.
I
think
those
are
the
the
key
points
and
more
will
come
up
in
minutes.
A
Good,
thank
you.
Does
anybody
want
to
add
anything?
So
I
think
we
can
endorse
the
the
the
annual
report
liz
and
it's
probably
worth
just
saying
it's
a
really
great
set
of
contributions.
We
get
or
you
get
at
the
the
rgc
and,
and
you
know,
I
think
we
should
just
thank
all
the
teams
that
to
come.
A
I
know
you
always
thank
them
very
nicely
at
the
end
of
each
meeting,
but
I
mean
a
lot
of
work
goes
in
to
the
briefings
they
provide
us
and
I
think
it's
it's
something
that
certainly
I
greatly
appreciate,
and
I
think
colleagues
do
as
well
so
that
then
takes
us
to
any
other
business.
A
I
have
one
item.
Does
anybody
else
have
anything?
So
my
one
item
is
to
say
that
the
end
of
this
month,
john,
your
your
term
of
office
on
our
board,
comes
to
an
end.
I
want
to
make
the
point
that
it
doesn't
come
to
the
end
today.
So
I
know
you've
got
at
least
one
more
meeting
and
two
more
weeks
work
worth
of
work,
but
this
is
the
last
board
meeting.
A
A
Your
your
contribution
on
on
qi,
which
I
think
has
been
transformational
for
the
organization-
and
I
greatly
thank
you
for
that,
but
I
think
you
just
contributed
in
in
in
in
many
other
discussions
that
we've
had
in
the
board
and
in
the
subcommittees
and
you've
also
been
a
a
huge
personal
supporter
to
me.
Not
you
know
nudging
me
occasionally
to
do
things
that
I
might
not
otherwise
have
wanted
to
do
or
thought
of
doing,
but
also
been
incredibly
supportive,
and
I
and
I
personally
have
really
valued
that.
So.
Thank
you
very
much.
A
Indeed.
I
have
a
horrible
feeling,
john
we're
going
to
be
getting
questions
from
a
member
of
the
public
in
the
future
or
whether
we're
maintaining
qi
and
other
other
things.
So
I
look
forward
to
that,
but
but
thank
you,
my
friend
fabulous
contribution,
which
we
we
all
greatly
appreciate
and
if
we
were
actually
all
seeing
around
the
boardroom
table
rather
than
remotely
I'm
sure
there
would
be
a
spontaneous
burst
of
applause
standing
ovation.
They
are,
it's
happened.
A
It's
happened.
Excellent!
Thank
you.
So
that
then
concludes
the
formal
board
meeting,
but
we
have
a
couple
of
questions
from
members
of
the
public.
The
first
is
from
robin
pike
and
I'll
read
the
question
out.
It
is
how
is
cqc
monitoring,
non-coveted
patient
access
to
nhs
and
independent
hospital
treatments
ted?
I
don't
know
whether
you
can
just
just
just
say
a
few
words
on
that.
E
Yeah,
thank
you.
Thank
you
robin
for
the
question.
It's
an
important
question
and
it's
a
strong
focus
of
where
we
we
are
monitoring
trusts.
At
the
moment.
I
talked
earlier
on
about
our
plans,
monitoring
trusts
and
one
of
the
the
questions
we're
asking
all
organizations
is:
how
are
they
restoring
care
for
patients
who
have
their
care
care
delayed
because
of
the
covered
pandemic,
and
we
will
be
reporting
back
on
that
and
sharing
good
practice
wherever
we
can.
E
The
arrangement
is
very
different
in
different
parts
of
the
country,
so,
in
some
cases,
trusts
are
providing
that
care
themselves.
In
many
places
there
are
arrangements
with
local,
independent
hospital
and
we'll
be
monitoring
that
and
of
course,
also
maintaining
close
working
relationships
with
the
independent
hospitals.
So
so
we
we
are
keeping
close
on
that.
We
are
also
doing
work
nationally
with
nhs
improvement
to
to
explore
what
they.
E
So
we
can
understand
the
progress
that
that
is
being
made
and
our
regional
teams
are
working
with
the
local
regional
teams,
from
nhs
improvement
in
england
to
monitor
issues
with
them.
So
we're
keeping
a
close
eye
on
it.
And
we
are
working
very
carefully
with
providers
to
help
and
support
them.
Provide
the
care
in
in
the
most
expedient
way
possible.
A
Thank
you
ted.
I
hope
that
answers
the
question
robin
then
there
are
three
questions
in
fact
from
mr
peter
bell.
A
The
first
one
is:
could
the
board
comment
on
the
references
to
the
cqc
in
the
recently
released
cumberlands
report
and
provide
a
list
of
actions
and
deadlines
that
cqc
has
identified
as
a
result
of
that
report
and,
as
the
question
recognizes
that
the
report
only
came
out
in
fact
last
week,
so
so
the
answer
is
yes,
we
will
be
doing
that
and
there
will
be
a
feedback
in
the
september
board
meeting,
but
it's
too
soon
to
do
that
today.
A
The
second
question
relates
to
an
individual
and
it's
our
long-standing
practice
that
we
do
not
comment
on
matters
relating
to
an
individual
in
the
public
board.
A
So
we
will
come
back
to
you,
mr
bell
separately
on
that,
but
we
can't
do
it
here
in
the
the
open
board
and
then
the
the
third
question
is:
could
the
board
consider
allowing
the
public
to
observe
meetings
of
the
board
held
via
microsoft
teams,
and
I
I
I
think,
that's
what
we're
doing,
but
I
I
understand
from
sort
of
supplementary
that
that
some
of
the
other
albs
are
doing
it
in
a
different
way.
So
I'm
very
happy.
A
I
only
got
this
question
last
night
very
happy
to
take
away
and
and
look
as
if,
if
there's
anything,
we
could
do
differently.
That
would
be
better
that
didn't
either
adversely
affect
the
the
way
the
board
operates
or
or
adds
to
cost.
So
can
I
just
take
that
one
away,
mr
berlin?
Well
we'll
come
back
to
you
on
that
as
well,
so
that
I
think,
completes
the
questions
from
the
public.
A
So
I
think
that
is
the
end
of
the
session
public
session
of
the
board.
So,
thank
you
all
very
much
indeed,
and
we
are
due
to
start
again
at
a
quarter
to
two
we're
about
10
minutes
behind
schedule
about
no
half
an
hour
behind
you
is,
is
35
minutes
long
enough
for
a
break,
or
do
you
want
to
yep
everybody's
nodding
so
start
again
at
quarter
to
two
perfect?
Thank
you
all
very
much
indeed
see
you
shortly.