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From YouTube: CQC board meeting - February 2019
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A
Right
good
morning,
everybody
welcome
to
our
February
board
meeting,
can
I
welcome
Gabrielle
Jones,
who
is
from
our
gender
equality
network
here
as
part
of
our
regular
guest
appearances
Gabrielle
you're
extremely
welcome
can
I
also
welcome
Ellen
Armstrong
who's
here,
because
Ted
Baker
is
away
and
your
deputizing
and
can
I
welcome,
mark
Edmonds
who's
here,
because
cursed
is
away
and
your
deputizing
for
her
paul
roux
is
also
an
apology
for
absence
he's
abroad
at
the
moment.
So
I
think
that's
the
apologies
and
the
world
comes.
A
A
B
Peter
I
think
I,
just
before
handing
over
to
the
respective
chief
inspectors
to
to
talk
about
their
sections.
I've
just
really
got
three
things
to
say:
firstly,
to
notice
that
Steve
field
will
be
leaving
us
I
know
Peter
will
say
the
formal.
Thank
you
on
behalf
of
the
overall
board,
but
from
an
executive
team
point
of
view.
I
think
I
just
want
to
record
my
thanks
in
public
for
all
support
the
work
that
Steve
has
done
with
executive
team.
B
B
Kate's
Kate
start
day
with
us
will
be
sometime
late,
April,
May
and
Kate
comes
from
a
background
of
being
the
director
of
adult
social
care
for
Oxfordshire
County
Council
and
comes
with
a
adult
social
care
background.
She's,
a
social
worker
by
training,
so
I
think
where
she
will.
That
she'll
be
a
very
good
addition
to
the
team.
I
think,
as
the
Chief
Inspector
of
adult
social
care,
we've
also
appointed
a
new
chief
digital
officer
at
its
executive
team
level
and
will
be
a
colleague
around
around
this
table.
B
Mark
Sutton
will
be
joining
us
from
teach
first
teach
first
is
an
organization
that
puts
graduates
into
into
schools
and
trains
them,
as
teachers
and
mark
mark
has
got
a
lot
of
experience
in
both
the
public
and
private
sector
in
doing
the
sorts
of
things
frankly
that
we
want
to
be
doing
around
a
digital
transformation,
so
we're
very
much
looking
forward
to
having
Mark
joining
the
team
as
well.
We're
expecting
mark
to
join
us
around
the
beginning
of
April.
C
D
Reporting
from
a
hospital's
perspective,
mental
health,
so
my
colleague
Paul
Elliot's,
who
leads
for
mental
health,
has
been
very
closely
involved
into
in
the
into
the
inquiry
around
attention
of
children
with
children.
Young
people
with
learning
disabilities
and
the
session
has
taken
account
the
inquiries,
taking
account
of
a
thematic
review.
To
look
at
some
of
those
issues.
Paul's
been
closely
involved
in
that
piece
of
work.
The
committee
has
yet
to
publish
the
report,
but
at
the
point
it
does,
Paul
will
remain
closely
engaged
in
reviewing
anything.
D
We
need
to
do
as
a
regulator
on
the
back
of
that.
The
second
issue,
then,
would
be
the
publication
of
the
Kok
review.
The
Kok
review
reported
on
for
Downton
the
6th
of
February.
This
was
an
independent
review
in
to
fit
and
proper
persons
requirement,
regulation
5
and
looked
into
some
of
the
challenges
that
are
faced
by
both
regulators
and
providers
in
in
compliance
against
that
regulation.
D
E
Thank
you
very
much,
Peter
three
things
from
me
this
month.
First
of
all,
just
for
the
board's
awareness
that
we
wrote
to
the
Health
Select
Committee
Sarah,
Watson
MP
as
part
of
our
ongoing
engagement
with
a
health
threat
committee
about
her
work
and
local
system
reviews
and
the
current
state
of
discussions
at
the
time.
Importantly,
we're
now
having
good
conversation
of
the
Department
of
Health
about
how
the
program
we've
taken
forward
in
1920.
E
We
also
going
to
look
at
what
early
engagement
with
providers
and
new
technologies
could
look
like
for
us
as
a
regulator,
so-called
Santos
and
boxing
as
part
of
this
work,
that
the
team
is
now
being
set
up
and
the
work
is
going
to
be
underway
throughout
the
year.
So
you'll
hear
more
about
that
in
the
future.
Of
course,
this
is
not
just
for
us
as
CQC.
This
is
also
for
other
regulators
in
the
system
and
we're
working
closely,
particularly
with
MHRA
and
the
Department
of
Health
and
Social
Care
in
this
in
this
space.
E
Thirdly,
we
had
a
very
good
conversation
in
January
about
cybersecurity
and
the
wider
risks
that
exists
to
be
aware
as
a
board
and
what
the
implications
are
for
us,
as
CQC
was
a
very
positive
conversation
in
January
that
we
will
continue
when
a
new
chief
digital
officer
arrives
as
Ian
just
set
out.
That's
it
for
me
I
hand
over
to
Chris
foreign
publications,
just.
F
A
few
things
to
talk
about
here.
First
of
all,
the
campaign
in
which
we
launched
this
week
declare
your
care,
which
has
designed
to
support
our
intelligence
driven
approach
and
particularly
targeting,
at
the
moment,
people
with
long
term
conditions.
We
know,
there's
lots
of
information
that
we
can
get
from.
Those
people
have
regular
contact
with
a
variety
of
services,
and
the
aim
is
to
encourage
more
people
to
talk
about
what's
working
well,
but
also,
what
isn't?
F
In
the
last
few
weeks,
we
published
our
maternity
survey,
which
is
the
sixth
survey
that
we've
done
of
this
of
this
kind.
The
survey
is
partly
about
describing
the
quality
of
care
that
people
receive,
but
also
it
points
as
an
interesting
around
access
to
continuing
care
after
birth
and
also
how
much
choice
people
feel
they
have
when
choosing
where,
where
to
have
birth,
have
their
birth,
I
say
the
six
areas.
F
G
G
Detention
of
children,
they
obviously
an
extremely
importance
highly
sensitive
issue.
I
just
wasn't
completely
clear
what
we'd
said
to
this.
The
the
committee
and
our
own
review
of
this
has
relatively
recently
started.
I
think
I'm
right
in
saying
and
has
a
time
scale
of
reporting
next
year,
although
I
think
there's
an
interim
report
at
some
point
this
year,
so
I'm
not
clear
what
what
we
then
said
so
tonight,
I
can
see,
we
might
have
told
them
we're
doing
a
review.
But
what
else
did
we
say.
D
F
F
So
we
can
perhaps
very
useful
to
share
that,
and
we
think
that's
published
online
anyway,
but
we
can
share
it
with
the
board
member
sent
to
make
sure
people,
so
I
think
that
we
were
partly
making
sure
that
they
were
happy
and
understood
what
our,
what
our
role,
that
our
turns
reference
have
being
this
in
the
review
and
that's
the
that's
part,
the
information
we
shared
with
them.
Okay,.
G
F
H
Robert
and
question
about
the
declare,
your
care
campaign,
which
I
very
much
welcome
as
a
campaign
to
two
points
really.
Firstly,
as
chair
of
HealthWatch
England,
we
can
offer
you
help
an
association
with
that.
We,
we
also
seek
to
encourage
people
to
talk
to
us
about
their
experiences
more
specifically
about
the
outreach
to
describe
actually
it's
sometimes
hard
to
reach
groups,
all
those
they
don't
have
such
a
voice.
Again,
you
might
might
want
to
look
at
the
HealthWatch
experience
in
relation
locally.
H
F
And
so
thank
you
Robert
for
your
support
for
the
campaign
just
to
say
that
HealthWatch
have
been
instrumental
in
helping
us
to
to
to
develop
this
campaign.
We've
also
been
working
with
about
30
other
organizations
that
have
reached
into
different
different
groups
so
that
we
we
can
make
sure
we
for
each
of
the
areas
that
we
want
to
cover.
F
F
It
is
really
important
that
we
can
demonstrate
action
with
with
the
with
the
work
that
we've
done
and
what
we've
begun
to
do
through
the
share.
Your
experience.
Work
would
bend
over
the
last
two
years
now
is
to
demonstrate
how
that
informations
being
used
as
part
of
our
regular
response
to
an
organisation.
So
if
it
contributes
to
it,
if
it,
if
it
tells
something
we
didn't
know
or
we've
got
information
like
it,
we've
we've
provided
that
information
back
to
people
are
sharing
experience.
F
What
we'd
like
to
do
with
this
is
to
build
a
portfolio
of
responding
on
giving
people
a
sense
of
what
we've
heard
and
showing
how
we've
how
we
dealt
it.
So
the
reason
why
the
campaign
is
is
structured
over
over
quarters
effectively
in
a
year
is
to
try
and
do
that,
so
each
each
campaign
group
will
have
a
mini
end
of
end
of
program
report
to
show
how
that
refers,
all
what
we
gathered,
what
it
said
and
what
we've
done
with
it.
We
ain't
doing
the
long
word
service
to
make
that
an
automatic
process.
F
I
Thank
you
Peter.
So
this
is
the
quarter
three
performance
report
which
sets
at
our
progress
against
their
plan
and
commitments
and
I.
Think
from
my
point
of
view,
I
think
this
is
actually
a
good
report
overall
good
news
report
in
terms
of
progress,
we're
making
particularly
wanted
to
flag
the
work
on
report
timeliness
because
that's
clearly
something
that's
an
important
indicator
of
measure
for
us,
but
it's
also
something
that
the
NAO
and
the
Public
Accounts
Committee
flagged.
I
So
two
men
PMS
with
the
first
richer
to
hit
that
targets
those
nice
to
better
record
that
with
Steve's
last
meeting
at
the
board,
but
also
had
all
social
care
they
hit
that
target
for
the
first
time
in
December
the
January
performances
hitting
that
figure
as
well
and
in
hospitals.
The
commitment
we
made
to
the
PA
C
around
50%
of
processing
at
the
reports
that's
been
exceeded
and
improving
so
has
been
steady
improvement
across
the
last
year.
I
I
was
really
good,
so
I
think
to
to
to
kind
of
record
that,
and
the
other
thing
just
wanted
to
flag
a
slightly
personal
basis,
but
they
work
the
work
on
the
response
we
make
to
all
the
in
to
all
the
internal
audience
that
we
get
around
the
areas
we
should
improve
in
terms
of
our
systems
and
controls.
The
fact
we've
now
hit
over
90%
of
delivery
of
all
the
improvement
actions
across
the
year
is,
is
I,
think
testament
a
lot
of
work.
I
That's
gone
on
within
the
organization
around
that,
and
the
final
thing
on
in
terms
of
some
positives
to
pull
out
is
on
on
the
backlog
we
have
been
doing
on
reports.
We've
shown
that
the
work
that's
been
going
on
in
the
spectrum
directors
over
the
last
year,
we've
seen
a
17%
reduction
in
the
backlog
that
inspectors
have
so
that's
free
and
up
time
to
make
sure
there's
actually
a
much
more
manageable,
stable
workload.
In
terms
of
the
report.
I
So
it's
clear
where
we've
we've
got
plenty
of
work
still
to
do,
but
I
think
the
the
trajectory
in
progress
is
one
of
one
of
improvement,
which
is
which
is
good
overall
and
clearly
at
a
moment
where
we're
reviewing
our
measures
and
targets
for
for
next
year,
but
on
the
finance
and
Chris
might
want
to
say
more,
but
we've
we're
forecasting
a
nought
point.
2
million
under
spend
on
now
revenue
and
at
0.8
on
our
capital
funding
at
the
moment.
A
Endorse
just
said
in
terms
of
the
improvement
and
I
think,
congratulations
obviously
to
PMS
for
this
steady
improvement,
cuz
you've
been
improving,
but
I
think
a
dramatic
improvement
Debbie
in
in
your
neck
of
the
woods
and
and
huge
congratulations
to
you
personally
and
to
your
team
for
achieving
this.
This
is
this
is
really
good
stuff
right,
John.
J
Really,
my
first
point
was
just
to
endorse
what
you
who
indeed
have
said
that
PMS
got
some
great
results
and
fantastic
stuff
in
ASC,
and
these
are
the
green
shoots
of
the
quality,
improvement
and
transformation
program.
We've
talked
about
a
lot
and
now
we're
seeing
some
results
actually
come
through,
and
indeed
in.
The
audit
response
that
Mark
was
alluding
to
my
question
is
really
just
a
point
of
clarification.
Is
that
our
expectation
is
that
those
sort
of
results
will
improve
productivity
yet
clearly,
the
slide
in
here
on
productivity
shows
a
decline.
A
K
It's
about
innovation,
it's
about
getting
the
team's
at
local
level
on
board
and
you'll,
see
if
you
burrow
down
into
the
staff
survey
that
we've
got
some
fantastic
staff
survey
results
in
PMS
for
engagement,
and
if
you
look
at
how
the
team
work,
it's
really
good
and
non
productivity
productivity
is
quite
difficult
one,
because
it's
a
balance
between
the
number
of
inspections
you
do
and
how
you
monitor
and
our
inspectors
are
helping.
Add
all
social
care
at
the
moment,
try
and
address
their
backlog
in
the
central
region.
K
And,
of
course,
when
we
start
to
look
at
productivity,
we
need
to
start
to
look
at
cross
CQC
productivity
and
work,
not
just
within
the
silo
of
a
particular
Directorate,
because
increasingly
we
will
need
to
have
cross
CQC
work
in
the
region's
in
the
seven
new
NHS
ie
regions,
because
we're
having
some
difficulties
in
in
London
trying
to
keep
that
product
to
be
going
as
well.
Well,
we've
got
very
high
levels
of
enforcement
still
in
in
the
capital
city.
K
Releasing
staff
and
working
for
other
directors
as
well
as
our
own,
and
how
we
record
that
to
make
sure
that
everybody's
clear
about
what
we're
trying
to
do.
But
I'm
delighted
by
the
results
and
I'd
like
to
thank
on
record
our
teams
all
the
way
up
from
inspectors
and
down
from
DC
eyes,
because
I
think
they've
done
a
wonderful
job
for
for
patients.
J
Questions
or
comments
Jorah,
just
a
quick
question
around
the
man
in
charge,
sources,
the
the
turnover,
the
avoidable
turnovers
22%
over
a
year
and
the
reasons
given
our
sort
of
opportunities
and
what
it
seems
quite
hybrid
I
know.
You
know
with
a
lot
of
knowledge
workers
leaving
game
and
because
the
way
the
organization
built
and
I
know
it's
it's
it's
not
it's
a
people
home
workers,
it's
sort
of
a
difficult
way
of
managing
milk
and
if
you've
got
a
plan
to
reduce
that
turnover,
I.
B
Don't
think
I,
don't
we
have
a
specific
plan
to
reduce
that
so
no
I,
think
turnover
and
sickness
are
things
which
we
we
look
at
at
an
individual
director
level
and
an
individual
team
level,
as
as
an
exec
team
is
something
we
look
out
on
a
very
localized
basis,
I
think
to
be
frank
about
it.
There's
there
is
people
come
from
and
go
back
to
provider
organizations
and
there's
a
lot
of
churn
in
provider
organizations.
So
I
think
what
we're
finding
is.
B
B
A
I,
just
just
add
to
that
I
mean
the
overall
turnover
level
feels
about
right
to
me.
I
mean
I'm,
not
sure
what
the
right
turnover
is,
but
you
know
you
if
you've
got
a
total,
12%
turnover
rate.
That
means
people
are
staying
on
average
for
about
ten
years,
which
is
you
know
pretty
good,
so
the
overall
level
I
I
feel
comfortable
with
personally
I.
A
You
know
people
are
missing
that
that
that
social
engagement,
so
a
lot
of
work,
was
put
in
to
try
as
best
we
can
to
make
sure
people
accepting
that
sort
of
role
really
understood
what
it
involved
and
we're
going
to
be
comfortable
with
it.
I
don't
know
Debbie
whether
you
want
to
add
to
that
at
all
or
Steve.
C
C
But
you
know
we
have
some
fantastic
staff
who
stay
a
long
time
and
we'll
go
back
and
benefit
the
provider
organizations
as
inside
and
also
we
benefit
from
people
coming
in
with
a
different
experiences
and
different
skills
and
seeing
how
they
sector
works
outside
compared
to
regulation
so
yeah.
It
is
that
balance,
but
something
that
we
need
to
look
at
and
plus
the
induction
program.
A
B
I
mean
just
babies,
come
back
on
a
number
of
those
countermeasures
that
are
absolutely
in
place.
I
think
I.
Think
the
the
the
only
thing
I
think
where
we
political
weakness
is
that
is
your
systemic
point.
Is
that
some
people
do
them
really?
Well,
some
leaders
do
them
really?
Well,
some!
So
maybe
don't
so
there's
something
about
systematization
of
all
of
those
things.
So.
G
Just
mention
two
things:
first
of
all,
the
issue
that
I
raised
the
last
public
poll
just
about
feeling
care
homes
and
the
and
the
information
that
we
have
about
them.
So
we
it
was.
There
was
a
commitment
that
the
last
board
that
we
would
have
some
more
detailed
information
about
to
direct
a
set
out,
a
sort
of
dynamic
picture
of
what
happened
from
rien,
spec,
ssin
and
enforcement
action
and
so
on,
and
that
that
did
come
to
us
from
Debbie
and
I.
Just
want
to
mention
how
useful
that
was.
G
It
was
incredibly
helpful
and
just
gently
say
slightly
more
helpful
than
our
own
performance,
which
I
think
have
been
very
valuable
but,
in
the
end,
have
told
us
a
I
sort
of
I
suppose
a
picture
that
has
repeated
just
to
put
it
so
gently
from
one
meeting
to
another.
Whereas
what
this
told
us
was
where
action
had
been
taken
where
the
care
homes
themselves
had
improved,
and
so
it
created
a
picture
of
our
role
as
being
one
that
was
either
driving
up
standards
or
driving
people
out
of
the
market
and
and
on.
G
C
Was
just
gonna
say
thank
you
very
much
for
that
and
I
think
you're.
Absolutely
right.
We
sometimes
need
to
tell
the
story
a
little
bit
more
because
dare
to
just
tells
you
sometimes
facts
and
figures.
It
doesn't
really
tell
you
what's
behind
it
and
all
the
hard
work
that
goes
behind,
encouraging
improvement
in
the
sector
or,
as
you
say,
making
sure
that
people
are
not
living
in
services
or
receiving
services
that
are
not
safe.
So
thank
you
for
that
and.
G
Other
things
related,
but
it's
on
the
general
theme
of
telling
the
story.
That's
the
Manoli.
A
previous
board
meeting
I
was
asking
what
it
what
change
we
would
expect
to
see
in
in
the
whistleblowing
system
out
there
in
the
NHS.
If
the
speak
up
architecture
was
successful
and
if
you
remember,
we
decided
that
it
might
lead
to
more
referrals
and
which
would
be
a
sign
of
success.
People
were
using
the
system
or
it
might
lead
to
fewer,
because
they
because
it
would
be
less
necessary
because
the
culture
would
change
so
either
way.
G
Things
would
get
better
more
or
less
didn't
ly
matter.
We
would
still
be
succeeding,
and
so
I
was
and
thought
well
that
isn't
a
very
satisfactory
sort
of
way
of
looking
at
change
and
I.
Just
wonder
whether
there's
something
in
our
whistleblowing
data
that
we
could
call
on
and
some
I'm
looking
I
was
the
blinis
which
goes
back
over
the
year
during
which
we've
had
speak
up
and
and
I
suppose
I'm,
predicting
that
the
the
requirement
to
use
CQC
for
whistleblowing
reports
would
go
down
if
the
local
system
was
becoming
successful.
G
So
as
my
assumption
and
I
suppose
at
the
moment,
and
that
it
hasn't
gone
down
and
I
wonder
if
whether
we
could
build
into
our
understanding
of
these
figures
an
expectation
that
it
will
change,
because
if
you
look
at
what
we've
got
here,
we've
got
a
fairly
steady.
You
relatively
high
number
several
hundred
every
month,
whistle
blowing
reports.
Our
own
response
to
those
whistle
reports
is
really
in
a
sense
of
doing
something
active.
It's
really
quite
small.
G
It
looks
like
it's
about
5%,
where
we
feel
that
we
need
to
either
respond
by
inspecting
or
bring
forward
a
previously
arranged
inspection
the
rest
of
the
time.
We
simply
make
a
note
of
it
for
some
future
date
or
we
pass
it
on
to
somebody
else
now.
I,
don't
know
whether
that's
the
right
or
wrong
I,
don't
know
whether
we've
examined
whether
that's
right
or
wrong.
G
Whether
we've
looked
at
a
sample
and
decided
whether
that's
the
right
decision,
but
in
any
case
and
that's
our
pattern
of
response
and
it
would
and
given
the
sensitivity
of
whistleblowing,
I,
suppose
I.
Would
it
would
be
useful
to
have
some
reassurance
that
the
whistleblowing
response
of
the
system
as
a
whole,
of
which
we're
a
part,
is
improving
and
I.
Don't
know
whether
we
we
at
the
moment
of
seeing
any
sign
of
that
or
whether
we
can
predict
when
we
would
see
a
side
of
it
and
check.
H
Is
there
some
way
we
could
break
that
down
a
bit
I
mean
I'm,
afraid
the
impression
I
guess
is
maybe
inevitable.
But
this
is
actually
we've
just
stored
the
information
and
it
disappears
into
a
matter.
This
is
not
encouraging
to
people
who
who
think
their
beeper
and
correctly
think
they've
been
quite
brave,
telling
us
about
stuff
and
I.
H
A
Interestingly,
I'd
actually
scrawled
on
the
slide,
while
I
was
reading
the
papers
at
the
weekend
that
we
should
review
that
we
have
taken
the
appropriate
action
and
I.
Don't
know
whether
that
should
be,
or
maybe
you
already
is
part
of
our
internal
audit
program,
there's
something
that
I
like
similarly
came
to
the
same
conclusion.
A
That
is
not
to
suggest
that
I
think
otherwise,
because
whenever
we've
looked
at
individual
cases,
we
have
almost
always
found
that
people
have
taken
exactly
the
right
action
and
I
think
it
is
to
your
point
well,
but
I
think
mostly
this
will
be
either
a
referral
to
a
local
authority
or
it's
information
that
goes
into
our
next.
Our
next
inspection
I
think
that's
that's
what
we
would
expect
to
happen
so
that
the
key
thing
is
we're
urgent
action
is
require.
A
D
I
would
absolutely
support
that
and
I
think
I
think
it's
the
point
well
made
about
telling
the
story
so
I'm
very
confident
that
we
respond
very
well
to
individual,
whistleblowing,
I'm,
not
sure
we've
maybe
joined
the
dots
up
with
them.
What
we
find
on
inspection
and
what
we,
what
we
then
do
with
that
so
I
think
through
the
well
led.
We
could
certainly
do
more
on
that,
but
I
would
absolutely
welcome
getting
involved
in
some
of
that
work.
B
I
mean
just
just
to
reiterate
the
point:
I
think
that
we
do
take
whistleblowing
very
seriously
and
click
on
Roberts
point
I,
think
part
of
in
being
an
intelligence
driven
organization
means
we
need
to
have
a
very
good
reputation
with
potential
whistleblowers,
so
people
feel
confident
they
can
report,
and
they
can
also
feel
confident
that
something
gets
done
at
the
end
of
it.
I
think
we
need
to
take
away
that.
The
fact
like
the
very
broad
point
of
Louis
makes
is
that
I
I
think
there's
just
two
issues.
B
One
is:
are
we
taking
the
right
action
to
the
people
who
come
and
talk
to
us
that
feels
like
there's
something
we
didn't
earn
Lourdes
or
something
could
pick
up,
and
we
could
review
that.
That's
something
we've
done
before
and
I
think
we
can
definitely
do
again
and
tell
our
story
in
a
slightly
different
way.
Are
we
gonna
change
the
whole
NHS,
which
I
sort
of
think
is
the
subtext
of
your
question?
I
am
I
I
think
we
need
to
think
about
that
in
a
different
way.
B
A
That
that
sort
of
comes
out
of
what
Ellen
was
saying,
I
mean
I
think
part
of
well-laid.
These
are
you,
is
your
organization,
one
where,
where
people
are,
is
culture,
one
where
people
can
speak
up
and
I?
Think
that's
that's
how
we,
how
we
would
look
at
that
you're
right,
it
doesn't
come
out
of
this
data
who
wants
to
raise
anything.
A
A
I
A
A
A
A
L
The
time
mark
and
not
fill
time
actually
chairman,
there
were
two
questions
that
that
I
had
from
not
in
the
in
the
pack,
but
from
the
communications
that
we
had
from
Debbie
in
in
in
the
last
month
and
Debbie
I
was
just
wondering
in
terms
of
the
enforcement
actions
that
we
take
in
your
report.
You
showed
that
there
were
several
appeals
to
Tribunal
for
a
variation
of
registration
to
remove
a
location
and
I
just
didn't
know
how
much
time
that
took,
and
so
that's
you
know,
a
Productivity
issue,
but
that's
not
under
our
control.
L
I
imagine
so
that
was
my
first
question.
If
you
could
just
give
some
information
on
that
and
the
second
one
was
your
report
on
the
close
working
between
yourselves
and
PMS
in
terms
of
supporting
the
central
region
with
with
additional
support
from
PMS
to
yourself,
and
you
you
said
that
you
know
that
would
give
a
good
insight
into
ASC,
which
I'm
sure
it
would
would
enhance
teamwork,
but
I
guess
the
critical
thing
there
is
how
we
capture
those
learnings
and
bring
them
back
into
the
organization
I.
Just
wonder
if
you
could
comment
on
those.
Yes,.
C
Thank
you
thank
you
mark
in
relation
to
enforcement
and
first
tier
tribunals.
Yes,
it
is
a
lot
of
work
for
our
staff,
because
that,
and
also
for
legal
colleagues
as
well.
So
there
are
a
number
conversations
that
go
on
before
we
even
reach
a
first
tier
tribunal
in
relation
to
we
know
stem
have
to
be
prepared,
have
to
be
submitted
and
then
sometimes
as
a
conversation
that
the
service
has
improved
and
then,
ultimately,
we
can
withdraw
from
tribunal.
C
However,
if
we
do
end
up
in
the
first
tier
tribunal,
it
can
be
anything
from
one
to
five
days
where
our
members
of
staff
and
collies
inspection
inspectors
and
the
inspection
managers
and
legal
colleagues
as
well
have
to
attend.
So
it
can
have
an
impact
on
productivity.
It
can
have
an
impact
on
on
the
other
work
that
we
do,
although
we
do
take
it
into
consideration
as
part
of
our
and
workforce
and
projections
going
forward.
So
I
hope
that
says
that
question
in
relation
to
the
work
that
we
are
doing
with
them.
C
Pms
colleagues,
fantastic
opportunity
for
us
to
share
resources
and
put
our
resources
in
the
right
places
at
the
right
time.
I'm
really
grateful
for
Steve
and
PMS
colleagues
for
helping
helping
and
to
have
that
oversight
and
be
that
the
second
inspector
we
as
far
as
Learning
and
Development
Goals.
We
have
offered
PMS
colleagues
and
some
learning
slots
to
help
them
understand
a
little
bit
about
adult
social
care,
the
inspection
and
what
their
role.
D
C
Seemed
very
very
early
days:
we've
actually
just
started
the
inspections,
but
we
will
evaluate
and
review
going
forward
because
I
think
it
is
something
as
Steve
alluded
to
earlier
this
morning
that
we
need
to
look
at
as
an
organisational
from
an
organisational
perspective,
so
that
we
do
support
one
another,
because
I'm
sure
there
may
be
a
time
when
PMS
may
need
some
assistance.
Our
hospitals
may
need
some
assistance
and
we
can
share
those
resources
in
a
better
way,
with
an
eye
on
integrated
models
and
what
the
future
may
be
as
well.
K
It
would
be
useful
for
a
percentage
of
those
inspectors,
time
to
be
spent,
doing,
say,
hospital
inspections.
If
it's
a
problem
in
that
area
or
a
dull,
social
care
or
indeed
lead
London,
as
you
say,
it
might
work
the
other
way
around.
You
know
if
you
can
recruit
more
because
I
think
the
more
even
though
the
specialization
of
the
inspectors
is
is
I.
Think
really
really
important.
K
J
John
I
completely
endorsed
the
framing
of
that,
but
just
a
slight
caution
not
to
drift
back
to
the
generic
inspector,
because
that's
the
problem
that
had
to
be
solved
a
number
of
years
ago,
I
agree
completely,
which
is
why
I
I
hope
I
phrased
it.
That's.
Why
I
like
your
framing
just
endorsing
the
framing
and
underlining
it
mutual
admiration
of
a
mark.
L
Just
to
say,
I
think
it's
quite
a
nice
segue
into
the
next
section
that
why
I
ask
the
question
is
that
there
is
a
challenge
to
the
organisation
from
the
survey
in
terms
of
skills
and
career
opportunities,
and
so
the
opportunity
to
not
be
generic
but
to
move
between
and
build
skills
across
the
directorates.
I
just
think
that's
an
opportunity
for
us.
Thank
you.
K
So
can
I
add
to
that,
because
this
is
really
never
what
CQC's
about
it's
about
the
people
and
would
be
I.
Think
I'm,
correct
in
saying
I
haven't
got
the
figures
in
front
of
me,
but
I
think
the
most
successful
team,
certainly
in
the
operational
Directorate
on
the
staff
survey,
with
the
local
system,
review
team
and
I.
Take
lots
of
credit
for
that.
Thank.
K
K
We've
got
lots
of
training
in,
but
in
fact,
comprised
people
from
all
of
the
directorates
and
not
just
out
of
social
care
hospitals
in
us,
but
there
were
fantastic
strategists
analysts
policy,
people,
people
supporting
from
Kirsty's
Directorate,
and
we
had
really
good
finance
input
as
well
to
me
Chris
from
you,
which
was
great
so
having
got
that
team
together,
it
really
performed.
Well,
we
delivered
the
local
system
reviews
on
time
within
budget
with
the
best
staff
survey
results.
K
It
shows
what
you
can
do
working
across
CQC
and
that
sort
of
cross
CQC
work
needs
to
be
replicated
going
forward,
and
it
is
fantastic
that
we've
had
the
promise
from
the
secretary
of
state
that
that
some
funding
will
come
forward
to
continue
that
works.
I,
think
that
is
them
he's
great
and
each
first
all
of
us
having
Debbie
played
a
role
and
Ellen
and
everybody
great.
A
A
I
So
thank
you
and
welcome
to
Karen
and
and
Paul
from
organizational
development.
So
the
survey
is
is
from
the
October
2018
survey.
Again
we
had
a
really
good
response
rate
to
that
survey.
80%
overall
staff
completed
it.
So
a
really
good
view
on
from
staff
in
the
organisation
I
think
the
the
results
the
analyses
have
come
through
have
been
discussed
with
the
executive
team,
with
the
leadership
team
and
actually
within
directorates
and
across
all
parts
of
the
organization.
I
So
there's
a
conversation,
that's
been
going
on
since
the
results
and
it
came
out
which
is
important
to
kind
of
recognize
in
terms
of
our
action
planning.
I.
Think
the
the
headlines
speak
for
themselves,
there's
some
improvements
in
some
important
areas,
but
overall
I
think
there's
the
remains
general
frustration
from
staff
that
we
need
to
do.
I
The
activities
and
improvements
that
we
want
to
see
and
the
link
with
the
business
plan,
which
will
be
coming
back
to
the
board
in
March,
is
making
sure
that
were
actually
some
of
the
improvements
we're
setting
out
featuring
as
high
priorities
for
us
as
an
organization
and
for
the
next
year.
So
the
opportunity
for
the
board
to
to
look
at
the
day
to
the
information
and
to
have
a
conversation
about
what
that's
telling
us,
and
particularly
what
to
seek
endorsement
to
the.
What
we
see
is
the
priority
areas
for
us
to
move
forward.
M
I
think
I
mean
and
supportin
kind
of
going
to
a
little
bit
more
around
the
data
and
just
kind
of
pull
out
some
of
those
highlights
and
that
as
kind
of
Mark
said,
I
think
it's
a
similar
picture
to
previous
years
and
and
we
continue
to
kind
of
have
strengths
in
some
areas.
But
those
frustration
areas
are
also
the
same,
and
so
it's
important
that
we
continue
to
focus
on
it.
M
N
N
Minor
increases
in
feeling
proud
to
work
for
CQC
and
levels
of
personal
morale
that,
alongside
a
small
number
of
large
increases,
particularly
around
equipment
in
technology
which
we've
seen
before,
and
the
understanding
of
and
commitment
to,
CQC
strategic
direction
which
which
we
haven't
seen
previously
and
that'll,
be
reflected
on
on
the
work
that
we
take
forward
and
that's
kind
of
resulted
in
an
overall
level
of
engagement.
That's
that's
decreased
over
the
over
the
year,
so
we
have
two
ways
of
measuring
engagement.
N
In
addition
to
the
historic
index,
we
we've
introduced
a
new
way
of
measuring
engagement
this
year,
a
way
that
is
a
bit
less
less
complex,
so
more
easy
to
understand.
Both
the
colleagues
and
and
one
that
kind
of
enables
us
to
benchmark
in
a
more
robust
way,
and
so
that's
a
similar
method
that
is
used
in
the
civil
service
people
survey,
for
example.
So
that's
whether
people
it's
a
three
3s
model.
It's
called
whether
people
feel
that
they
can.
N
They
save
positive
things
about
the
organization
whether
they'd
like
to
stay
working
for
the
organization
and
whether
working
here
essentially
inspires
people
to
do
the
best
work
that
they
can.
So
that's
a
strive
and
model,
and
generally
we
see
that
colleagues
are
more
positive
in
these
areas,
which
which
gives
us
a
quite
a
positive
engagement,
score
and
wonder
benchmarks
well
with
other
organizations
that
might
be
similar
to
us,
for
example,
and
so
in.
N
In
some
broader
terms,
the
survey
tells
us
that
commitment
to
CQC
is
strong
and
people
are
very
much
connected
with
our
purpose,
our
values
and
believe
that
our
work
makes
a
difference.
So
we've
got
some
really
strong
high
scoring
scores
there.
The
local
level
support
is
good,
so,
whether
that's
from
immediate
team
members
or
and/or
line
managers,
and
this
year
we
saw
that
colleagues
were
more
positive.
N
Around
learning
development,
albeit
that
scores
still
some
way
to
to
improve
and
I,
think
it's
important
to
say
that
we
do
have
some
high
really
high
score
in
scores,
results
across
the
organization,
so
around
half
of
the
the
scores
of
70%
or
above,
which
is
really
good.
Yep,
the
lowest
scoring
areas
and
the
areas
of
improvement
are
similar
to
what
we've
seen
in
previous
years
so
and
again
mentioned
it
before
equipment
in
technology
as
schools.
M
Approach
to
action
planning,
as
their
marker
suggests,
it
is
to
kind
of
set
out
the
corporate
action
sandwiches
in
the
paper,
and
so
Paul
alluded
to
kind
of
the
number
of
people
who
believe
actions
being
taken.
That's
41
percent,
so
it's
important
for
us
to
demonstrate
that
actually,
the
feedback
is
important
and
we
are
taking
actually
and
we
are
listening
and
that's
why
the
ownership
of
the
planet
et
is
a
really
important
move
for
us
in
terms
of
the
corporate
action
plan.
M
M
Well
review
progress
on
the
action
plan
at
a
quarterly
basis
at
ET
to
really
make
sure
that
we're
making
a
difference
and
we're
looking
at
different
ways
in
which
we
can
gather
the
upward
feedback
from
the
organization
outside
of
just
the
annual
survey,
to
really
demonstrate
how
things
are
landing
and
how
and
how
improvements
are
being
made.
I
think
it's
important
again
to
reflect
that.
M
This
corporate
action
plan
is
underpinned
by
local
action
planning
across
directorates,
which
you
know
we
know,
is
really
crucial
to
addressing
specific
issues
within
teams
and
building
on
specific
strengths
within
teams.
So
we
continue
to
encourage
that
to
happen
just
really
quickly.
In
terms
of
next
steps.
We've
been
engaging
with
the
et
leads
on
each
of
these
strands
around
the
activity
within
their
or
communicate
this
plan
to
all
our
colleagues
in
March
as
part
of
the
kind
of
internal
communications,
and
we're
also
going
to
be
using
our
kind
of
existing
leadership
forums.
M
The
leadership
group
to
kind
of
share
best
practice
across
teams
to
get
continue,
that
ongoing
conversation
about
the
results
and
how
we
are
taking
action
in
response
to
them
and
then
also
just
to
highlight
that
the
overall
organizational
scorecard
will
be
published
on
our
internet.
After
today's
meeting
excellent.
A
Thank
you
both
very
much
for
both
the
survey
and
and
and
for
the
presentation.
I,
always
like
research.
That
confirms
my
own
prejudices
and
the
findings
were
exactly
what
I
would
have
predicted
from
the
various
informal
conversations
I
have
with
staff
around
the
patch,
so
I
know
they
were.
Survey
must
therefore
be
very
accurate.
B
Build
all
the
things
that
people
have
said,
I
think
in
some
respects
there's
a
lot
to
a
lot
to
like
about
the
survey.
In
the
sense
it
demonstrates
a
values
driven
organization
it
develop.
It
demonstrates
an
organization
that
where
people
believe
in
its
mission
but
I,
think
I
think
we
as
a
senior
exec
team
need
need
to
need
to
recognize
this
criticism
of
us
here
in
terms
of
our
expect
to
be
our
visibility.
B
There's
also
I,
think
unconcerned
around
we've
clearly
talked
about
change
over
the
last
year,
but
we
haven't
necessarily
articulated
what
that
really
means
in
terms
of
the
journey,
so
we've
kind
of
made
people
uncomfortable
but
not
told
them.
Why
why
things
are
going
to
be
better
I
think
is
probably
one
of
the
things
I
would
take
away
from
this
I
was
very
keen
that
the
action
plan
was
clear.
B
The
reasons
on
a
single
page
is
because-
and
there
is
it's
got
exec
sponsorship
and
that
regularly
revisiting
quarterly
refresh
activity
is
to
try
and
make
sure
that
we
keep
a
really
strong,
important
view
on
this,
because
you
know,
however,
you
you
look
at
this.
It
is
more
than
try
it's
more
than
a
little
trite
to
say
we're
a
people
organization.
Well,
we
actually
are
because
85%
of
our
revenue
is
spent
on
people.
B
So
you
know
we
need
to
get
this
the
we
need
to
get
this
right
if
we're
going
to
be
a
high-performing
organization,
I
think
what
we,
what
we
also
recognize
I,
think
we've
been
doing
things
in
the
background
that
haven't
necessarily
talked
about
them,
overly
much
so
things
like
just
before
Christmas,
we
quadrupled
the
number
of
connect
connectivity
servers.
People
are
getting
new
mobile
phones
this
month,
things
which
are
which
in
early
and
you've,
always
start
to
finally
address
some
of
these
technology.
B
Queries
which
I
know
have
been
have
been
a
bit
in
the
mix
for
the
last
couple
of
years.
So
I
think
it's
it's
not
a
it's,
not
a
great
picture,
but
it's
equally.
It's
not
an
utterly
terrible
picture
either
and
there's
a
lot
of
activity
which
is
already
in
hand
which
we
hope
is
going
to
address
some
of
these
things,
but
there's
definitely
a
big
communication
element
to
this
around
around
making
sure
that
we
are
talking
about
what
we
are,
what
we're
already
doing
and
that
we
are
senior
people
are
very,
very
visible.
B
So
my
executive
team,
for
example,
now
goes
on
the
road,
so
we
have
exec
team
meetings
in
different
offices
that
sort
of
thing.
So
it's
a
lot
of
small
things
in
many
respects,
but
is
about
culture
as
one
or
two
people
were
saying
earlier
on
and
I
think
I
think
there's
a
good
base
to
build
on,
but
there's
work
to
do
done.
J
Thank
you
to
that
stood
out
for
me.
One
you've
been
talking
to,
which
is
the
decline
in
I,
feel
committed
to
the
CQC
strategic
direction.
I
also
noticed
there
was
a
decline
in
the
understanding
and
I
guess,
if
you
don't
understand
you
can't
commit,
and
that
harks
back
to
our
articulation
were
clear,
a
narrative
that
begins
that
process,
but
a
secondary
thing
is.
J
Are
we
confident
that
underlying
that
is
just
a
communication,
or
is
there
an
element
of
perception
that
there's
a
there
isn't
a
resonance
with
the
very
strongly
expressed
core
values:
I
I'm,
not
saying
I'm,
just
sort
of
floating.
There
may
be
other
things
underneath
that,
and
is
there
a
differentiation
of
positivity
or
negativity
amongst
the
different
groupings
in
CQC?
Is
there
a
segmentation
of
this
that
will
give
us
a
handle
on
that,
because
clearly,
it's
important
that
the
transformation
requires
people's
buying
and
ownership
of
it?
J
B
I
can
just
pick
up
the
first
one,
I
I
think
it's
difficult
to
know
the
answer
to
your
question
around.
Do
we
know
I
think
what
we
do
see
is
big
variation
across
teams
and
that's
not
necessarily
between
Directorate
is
between
teams,
and
that
would
lead
me
to
suggest
that
there's
variation
in
terms
of
quality
of
leadership
at
a
frontline
level
and
the
skills
that
individual
leaders
have
so
we've
got.
We've
got
working
progress
to
to
support
frontline
leaders.
F
F
A
Reassurance
a
little
bit
if
I,
if
I
know
all
those
anecdotal,
amande,
III
I
quite
frequently
talk
to
groups
of
our
of
our
people
on
on
our
strategy
and
when
they,
when
we
get
into
the
more
detail
of
what
the
strategy
really
means.
I
have
never
had
anybody
come
and
say:
I
think
that's
the
wrong
strategy.
I've
had
people
come
and
say:
I'm,
not
sure
you
can
deliver
it,
and
you
know
that.
A
But
that's
that's
a
different
conversation,
but
if
it
just
give
you
one
example
of
where
I
think
people
misunderstand
and
therefore
get
concern-
and
this
is
both
external
to
the
organization
as
well
as
internal
yeah,
we
talked
about
being
intelligence,
driven
and
I.
Think
when
we
wrote
the
strategy
when
we
talked
about
the
strategy,
we
see
that
as
a
process
that
will
happen
over
time
and
you
don't
that,
but
some
people
think
it
means
on
a
day
to
be
determined.
A
We
will
stop
inspecting
and
we
just
you
know
just
just
be
intelligence,
driven
when
you
explain
that
absolutely
it's
not
going
to
happen
on
my
lifetime
anyway.
You
know
that
then
people
start
to
relax.
So
I
think
this
doesn't
take
away
from
the
central
point.
We
need
to
communicate
all
this
better
so
that
people
come
in,
but
I,
don't
think
many
people.
If
anybody
and
really
unhappy
with
with
the
strategy,
can
I
bring
in
Gabrielle
and
then
Paul,
please
and
then
Jorah.
A
O
You
so
I
just
wanted
to
make
a
point
on
point
three
point:
six:
it's
really
really
positive
to
see
the
pointer
and
carrying
out
additional
analysis
of
results
by
demographic
groups,
I
think
at
the
moment
we
can
only
see
that
cut
via
a
single
demographic
group
and
understanding
the
intersection
between
different
groups
will
really
help
us
understand
where
we
need
to
prioritize
in
terms
of
inclusion
strategy.
So
that's
really
good.
Thank
you
and
a
second
point
related
to
that
is
it's
really
important
that
CQC
encourages
self
reporting
of
protected
characteristics
via
ESR
and
I.
O
P
Was
interesting
is
interaction
you
have
begun
is
that
you
use
the
example
of
you
going
out
and
having
conversation
and
the
conversation
changes
something
and
at
the
end
of
it,
people
understand
some
of
they
didn't
before
that.
Now
that's
sort
of
what
all
this
is
about.
It
means
those
conversations
aren't
happening
or
not
happening
as
you're
saying
in
across
the
board,
so
they
can't
be
guaranteed.
P
Am
they
happen
when
that,
when
certain
men's
staff
have
the
capacity
and
confidence
leadership
staff
have
the
capacity
and
conference
that
have
those
conversations
to
have
precisely
quite
a
difficult
conversation
who
said
about
intelligence-led
not
happening
on
a
day,
so
it
seems
to
me
it
is
I
think
these
results
taken
as
a
whole
aren't
remarkable
because
they
are
there's
a
consistent
difference
between
a
top-line
about
values
and
the
practice
of
implementing
something.
So
it's
quite
interesting
that
80%
of
people
filled
this
in,
but
only
42%
think
anything
will
happen
now.
That
is
really
interesting.
P
All
right,
so
they're
filling
it
in
because
they're
sort
of
trying
to
be
helpful,
but
they
don't
think
actually
we're
going
to
use
what
they're
being
helpful
with
now.
That
is
I
still
I
find
that
remarkable
that
people
are
doing
it
because
they
really
say
here
we
are,
you
know,
we'd
like
to
help,
but
actually
they
don't
think
we're
gonna
do
anything
with
it
and
actually
then,
when
you're
saying
this
is
what
we're
going
to
do.
P
So
we're
doing
it
because
we're
going
to
do
it
in
any
case,
so
we
gave
everybody
a
laptop
because
it
was
the
right
thing
to
do.
It
wasn't
the
result
of
the
survey.
That
means
nothing
ever
happens
as
a
result
of
the
survey
and
somehow
another
we
actually
have
to
have.
This
laptop
comes
to
you
by
courtesy,
courtesy
of
the
survey
you
filled
in
us,
so.
D
P
Need
to
we
need
to.
We
need
to
underline
that
there
is
a
so
for
me
what's
remarkable
about
it.
Is
that
the
vision
and
the
belief
is
really
quite
strong,
no
80
90
and
92
percent
believe
when
we
are
doing
something
important
for
the
health
care
of
the
population
and
only
42
percent
feel
they're
recognized
for
the
thing
that
they're
doing
so
it
is
when
it
gets
practical.
We
get
low
marks
when
it
gets
mul.
P
We
get
high
marks
and
I
think
so.
I
think.
All
of
that
is
quite
a
consistent
message
from
very,
very
different
areas.
It's
not
it's!
Not
it's
not
to
say
anything
different
from
people
been
saying,
but
it
is.
It
really
seems
that
there
is
quite
a
gap
between
our
success
in
feeling
in
getting
people
to
feel
they're
doing
something
morally
good
and
then
the
fact
that
the
thing
they're
doing
in
their
hard
work
relates
to
that.
A
Yes,
that's
that's.
That's
well
said,
I,
think
looking
back
for
one
of
the
one
of
the
things
that
I
would
do
differently
for
you,
if
we
could
go
back,
is
put
more
emphasis
on
how
long
it
would
take
for
the
building
blocks
to
be
in
place
before
people
would
see
the
outcomes
so
I
think
part
of
the
problem
is
that
we've
been
promising
for
a
long
time.
We've
all
seen
loads
of
work
going
on
to
get
ourselves
in
the
position
to
deliver
on
that
promise,
but
nobody
else
has
seen
us
delivering
because
that
hasn't
happened.
A
Yet
it's
just
starting
to
happen
now
so
I
I
think
you
save
had
my
time
again.
We
that
would
have
been
one
things
we
do
differently
Dora
you
wanted
to
come
in
and
then
Chris
and
then
Ducey
yeah.
J
Sure
one
of
the
challenges
given
the
size
and
complexity
of
the
organization
they're
trying
to
get
that
quick
feedback
loop
that
you
want
to
get,
and
you
can't
wait
for
a
survey
once
a
year
because
then
it'll
take
you
another
year
to
put
implement
something
and
then
test
it
and
I.
Wonder
if
there's
an
opportunity
to
create
sort
of
cross-functional
focus
groups
which
you
can
bring
a
broad
set
of
you
know
either
strongly
sort
of
Pro
strongly
against
I
mean
large
organizations
and
political
parties.
J
Do
this
all
the
time
just
to
get
a
sense
of
of
feeling?
And
then
you
could
then
test
and
learn
so
you've
delivered
laptops
or
mobiles.
And
then
you
look
at
the
focus
group
and
say:
did
that
make
any
difference
ET
of
improve
the
communication?
They
feel
they've
improved
the
communication,
and
then
you
get
a
feedback
quickly
back.
So
it's
a
quick
way
of
not
doing
a
massive
survey
having
a
cross-functional
team
and
learning
from
data
and
then
seeing
if
your
messages
are
resonating,
just
a
suggestion.
Q
That
really
plays
to
the
point
I
was
going
to
make
really,
which
is
so
the
highest
negative
score
in
question,
is
around
this
change
effectively
implemented
and
I.
Think
we
just
need
to
really
understand
that
everyone's
perception
of
change
will
be
completely
different.
What
change
means
to
people
to
be
different?
All
of
our
responses
are
around
strategic
change.
Now
we
get
our
message.
It
easy
to
change
out.
Q
That's
really
important,
but
people
will
have
been
filling
this
in,
because
they've
had
a
team
restructure
because
we've
taken
too
long
to
fill
in
vacancy,
because
we've
moved
their
desk
to
another
side
of
the
office.
It'll
change
is
different
to
everyone.
To
that
point
about
checking
in
are
we
really
address
in
the
what
the
action
we're
doing?
Does
that
really
address?
The
point,
I
think
is
really
important.
Thank.
G
So
it's
a
health
education,
England
report,
it's
launched
by
secretary
state
today,
but
you
can
see
I
chose
to
be
here
rather
than
go
to
the
launch,
so
I
just
wanted
to
have
that
noted
and
the
the
the
it
and
it
is
a
focus
on
about
on
the
NHS
and
but
it
says
that
this
might
have
or
equally
apply
to
NHS
related
organizations.
And
it's
just
and
struck
me
that
in
the
survey
we
we
do
have
some
a
lot
of
the
well-being.
Items
are
really
about
bullying
and
that's
very
important
and
not
very
reassuring.
G
Actually
and
but
but
well-being
is
much
more
than
whether
you're
being
bullied
and
I
would
like
us
to
be
looking
more
at
that
as
one
of
our
priorities.
So
when
we
think
about
what
are
the
main
messages?
Well,
the
main
areas
of
action
I
would
have
thought
that
the
health
and
well-being
of
the
staffers
is
it's
critical,
particularly
at
a
time
when
they're
going
to
be
difficulties
in
recruiting
people
in
all
organizations.
So
retention
of
existing
staff
will
be
most
important.
G
Keeping
people
healthy,
so
they're,
not
off
sick,
will
be
really
important
because
of
the
possible
difficulties
in
in
recruiting.
And
if
you
look
at
one
tier
of
our
results,
we
get
only
57%
of
people
said
that
they
thought
CQC
supports
the
health
and
well-being
of
staff
on
the
related
items
of
workload,
we
didn't
do
particularly
well
on
work/life
balanced
and
do
particularly
well
worse
than
significantly
worse
than
the
UK
benchmark
figures
on
those
items,
so
I
would
just
suggest
that
this
is
a
coming
issue.
G
This
is
this
is
going
to
get
a
become
a
bigger
issue
about
the
response
of
our
responsibility
to
the
well-being
of
staff
and
to
create
the
circumstances
that
the
the
workload
patterns,
but
also
there's
the
day
to
day
working
experience
and
supports,
and
that
would
keep
staff
in
work
and
relatively
healthy.
If
it's
possible
to
think
think
of
that,
as
a
major
theme,
I
feel
that
would
be
positive.
B
As
quick
on
the
well-being,
point,
I
think
I
think
I'm
probably
slightly
disagree
with
having
that
as
a
theme
I
say
it's
a
consequence
of
the
other
things
that
we're
doing
for
all.
Ironically,
all
the
reasons
you've
just
described
that
he
did
a
lot
of
work
on
well-being
over
over
a
long
period
of
time
and
again,
I
think
there
is
something
of
a
an
organizational
generational
question
here
as
well,
but
when
I
speak
to
new
people,
induction
who've
been
here
a
couple
of
months.
B
B
I
suppose,
as
other
people
have
said,
become
a
little
jaded
perhaps
to
to
what's
going
on,
but
I
am
really
keen
that
we
keep
this
really
focused
and
that
we
think
things
like
well-being
is
a
consequence
of
the
things
we're
doing
rather
than
trying
to
chase
well-being
as
a
set
of
actions
in
and
of
itself.
If
that
makes
sense,
just
say.
R
Yes,
thank
you
and
so
I
think
I
mean
everybody's
been
saying
this.
This
survey
tells
a
slightly
different
picture
from
previous
surveys,
which
have
mainly
been
fantastic
on
commitment
to
purpose,
but
can
a
lot
of
pregnant
people
lacking
the
tools,
whereas
I
think
this
time
there's
a
bit
more
uncertainty
about
supporting
the
strategic
direction,
understanding
the
strategic
direction
a
little
bit
more,
maybe
about
the
the
the
leadership
and
obviously
there's
a
lot
of
change
that
people
are
experiencing
in
the
organization.
So
two
things
I'd
be
really
I,
really
support.
R
What
Gabrielle
said
about
it
would
be
really
useful
and
interesting
to
see
the
breakdown
in
terms
of
diversity
characteristics.
We
saw
from
the
report
by
Roger
Cline
that
there
were
some
quite
worrying
differences,
for
example,
people
from
black
Asian
minority
ethnic
communities
in
amongst
our
colleagues
having
much
less
confidence
in
the
fairness
of
promotion
opportunities,
and
things
like
that
and
we'd
see
this
something
generally
in
here
about
you
know:
is
there
a
chance
to
develop,
but
actually
is
that
act
in
different
groups
of
people
differently
and
I?
Think
we
need
to
understand
that.
R
F
Your
turn,
hopefully
I,
can
provide
a
link
to
answer
tip
2
to
those
those
two
questions.
So
as
you
go
back
to
George
point,
so
we've
just
done
some
work
recently
to
talk
to
both
the
network's,
obviously
that
we
have
regular
conversations
with
and
come
home
to,
colleagues
from
across
the
organization.
We
have
some
three
questions.
What
about
when
do?
F
You
have
a
last
type
of
conversation
with
your
manager
about
the
strategy
being
implemented
and
when
you
did
have
that
conversation
to
describe
what
we,
how
you'd
be
working
differently
and
if
you
want
to
find
out
more,
where
would
you
go
and
your
Liz's
makes
a
really
good
point.
People
see
this
when
they
see
this
relation
to
their
role.
So
how
well
that
the
local
leaders
are
describing
the
context,
so
not
just
repeating
the
information
that
they've
seen
somewhere
else,
but
this
interpreted
it
for
their
team
and
describing
what?
What
will?
F
What
will
be
different
for
their
team
is
really
clear,
wet
and
you
know,
with
you
know,
without
embarrassing
Debbie
and
in
an
assertion
ratings
from
the
radio's
registration.
Whether
there
was
a
general
sense
of
being
a
much
clearer
about
the
about
the
implications
of
change.
There
was
a
stronger
support
for
what
the
strategy
was
trying
to
do
and
the
implementation
of
it
I
think
the
challenge
for
us,
it's
how
to
zazz
Paul's
offer
described
in
terms
of
narrative,
is
making
the
story
meaningful
to
each
each
group
and
part
of
that
is
about
equipping
leaders.
F
So
they
can
have
those
conversations
apartment
having
clear
ourselves
about
what
the
intentions
are
for
next
year.
So
I
do
hope
as
we
get
into
nineteen
twenty
we're
clear
about
what
the
intentions
are
for
next
year,
and
we
can
interpret
that
in
a
way
that
supports
that
ongoing
engagement.
One
of
the
things
we're
trying
to
do
with
that
is
to
have
groups
of
people
responsible
for
the
change.
So,
rather
than
have
the
the
narrative
story
be
symbolic,
it
will
be
actual.
F
J
John
yeah
just
briefly
John's
point
about
taking
a
sense
check
on
a
more
regular
basis.
I
just
wanted
to
throw
in
the
example
of
Leeds
NHS
Trust
had
a
big
transformation
program
called
the
Leeds
way
and
they
set
up
digital
communication
between
ET
and
all
the
staff
in
auditors
to
a
identify,
misperceptions
that
were
occurring
and
being
able
to
deal
with
it
quickly,
but
also
create
a
consistency
of
message
and
not
relying
on
sort
of
the
Chinese
whispers
as
it
trickled
down
the
guy
responsible
for
it.
J
H
Not
losers,
don't
mention
it,
but
I
just
like
to
ask
a
question
about
the
results
concerning
bullying
and
harassment.
Obviously,
as
always,
the
numbers
absolute
number
see
was
small,
much
more
important,
probably
than
the
numbers
and
I
thought.
There
was
a
slightly
concerning
figure
there
about
the
source
of
the
alleged
bully
harassment,
which
seems
to
be
equally
divided
between
peers
line
managers
and
more
senior
managers.
H
One
can
quite
understand
with
numbers
this
size
that
one
wouldn't
particularly
wish
to
publish
this
or
a
more
narrow
breakdown
of
where
that
is.
But
two
questions
really
one
is:
do
we
have
breakdowns
available
as
to
the
if
impact
of
this
type
of
behavior
on
BM,
a
BM,
the
AME
groups
and
others
and
I'm
not
sure,
because
there's
a
different
question
about
discrimination
which
may
or
may
not
open
that,
and
the
second
is
given
the
granularity
presumably
available
these
figures.
What
action
is
taken
in
relation
to
them?.
M
So
in
terms
of
the
breakdown
of
all
of
the
results,
but
particularly
the
bullying
and
harassment
and
discrimination
questions,
we
can
only
report
on
them
where
the
numbers
are
more
than
ten,
and
so
that
often
means
that
pettite.
When
you
break
it
down
to
the
demographic
groups
that
we
can't,
particularly
not
to
the
questions
around
where
that
perceived
either
bullying
or
harassment
or
discrimination,
is
coming
from
and
I.
Think.
M
Some
of
our
work
has
a
we've
found
out
that
people
might
be
working
within
the
same
office
and
not
know
each
other's
names,
not
know
what
teens
are
and
I
think
that
all
kind
of
can
lead
to
people's
perception
of
what
is
kind
of
bullying
harassment,
it
all
feeling
connected
to
one
another.
So
you
know
in
two
points
one
there's
only
so
far.
We
can
drill
out
into
the
actual
figures,
but
there
is
something
about
getting
underneath
through
conversation
within
teens
as
to
what
might
be
underneath
and
addressing
those
specific
issues.
M
A
D
From
a
hospital's
perspective
and
I
suspect,
PMS
and
ASCO
be
very
similar,
absolutely
support
the
action
plan
and
will
be
part
of
this
structure
etc,
and
there
was
there's
three
big
issues
for
Feroze
in
hospitals.
Our
three
priorities
have
to
be
around
lightening
the
load,
because
I
think
what
our
staff
survey
results
were
as
a
result
of
people
not
seeing
a
change
in
the
way
that
we
work
so
the
lightening.
The
load
is
really
really
important
for
us
and
I.
D
Think
when
you
allow
people
to
have
that
space
to
think
a
little
bit
more,
they
become
more
connected
with
the
strategic
intent
because
they
feel
they
haven't,
got
the
time
to
do
so
currently,
and
all
everything
I'm
saying
links
to
everything,
everybody
else
that
said
but
I
think
actually
getting
really
down
to
the
nitty-gritty
of
making
people's
working
life
much
easier.
We
absolutely
need
to
put
100%
behind
internal
communications
and
engagements
linked
back
to
the
business
plan
and
Kristi
point
is
well
made
about
making
sure
that
it's
re
Paul.
Your
point
around.
A
Then
that's
brilliant,
because
I
was
going
to
have
a
heroic
attempt
to
summarize
and
I
was
gonna,
say
almost
what
you've
just
said
so
I'm
not
gonna,
summarize
now
I'll
take
take
your
your-your-your
summary
is
the
summary
this.
This
is
about
working,
smarter,
not
harder,
taking
the
load
off
and
then
a
lot
of
the
other
things
will
start
to
fall
into
place.
That
doesn't
mean
we
don't
need
to
concentrate
on
individual
detail
and
I
do
think.
A
A
Thank
you
guys
for
your
work.
Sorry,
you
could
stay,
but
thank
you
from
that
need
to
go
off
and
do
a
survey
or
something
that's
great.
So
it
is
Susan
here,
good,
excellent,
so
I
need
to
embarrass
you
properly
and
I.
Can't
embarrass
you.
If
I
can't
see
you
so
Susan
Sebenza
is
a
inspector
in
prime
and
medical
services
and
you
have
one
are.
You
are
the
Darmon
winner
for
our
outstanding
contribution
to
CQC
and
I'm,
just
going
to
read
out
the
the
the
citation
because
trying
to
summarize
it
wouldn't
do
it
justice.
A
So
you
you
received
the
award
for
actions
taken
in
response
to
a
confidentially
Inquirer
which
resulted
in
the
police
prosecuting
a
doctor
for
acting
inappropriately
with
female
patients.
She
went
above
and
beyond
what
was
expected
her
to
ensure
the
police
took
action
when
initially
they
said
there
was
no
cause.
You
refused
to
accept
the
initial
police
assessment
that
this
was
just
a
disciplinary
matter
rather
than
an
offense
and
escalated
the
issue
within
the
police.
You
kept
the
original
correspondent
informed
of
your
actions
and
you
encouraged
them
to
persevere.
A
This
obviously
took
some
determination
on
your
part,
but
the
end
result
was
the
successful
prosecution
of
the
doctor
who
received
a
jail
sentence.
This
was
a
hugely
sensitive
case
you
persisted
throughout.
Even
then,
when
you
could
reasonably
have
said
you
had
done
all
that
was
needed
to
be
done
and
all
that
you
should
have
done
and
I
think.
That
is
an
exemplary
piece
of
work
which
shows
that
you
were
putting
the
interests
of
patients
in
this
case
ahead
of
everything
else,
which
is
what
CQC
is
here
to
do.
So
very
many
congratulations.
A
But
that's
only
part
of
your
Directorate
and
you
know
I,
spend
time
talking
to
your
dentist
colleagues,
to
your
justice.
Colleagues-
and
this
said
earlier,
you
and
I
were
up
at
the
the
medicines,
optimization
team
and
so
on
and
so
on
and
and
all
of
them
done
a
fantastic
job
and
I'm
really
proud
to
be
associated
with
what
what
they
do.
And
then
there
was
all
the
local
system
work
which
you
led,
and
that
was
parney
ring
work
for
us
as
an
organization
when
it
when
we
started
to
think
we
were
going
to
do
it.
A
I
personally
was
not
I.
Didn't
expect
it
to
tell
us
things
that
we
didn't
already
know,
because
we're
all
out
and
about
in
the
system
and
I
didn't
expect
anything
very
dramatic.
Therefore,
to
happen
as
a
result
and
I
was
wrong
on
both
counts.
It
told
us
and
the
system
things
they
didn't
know,
and
we
saw
change
as
a
result,
and
that
was
that
was
hugely
down
to
your.
Your
leadership,
so
I
think
you've
done
a
fantastic
job.
You've
been
a
terrific
colleague,
I'm
and
I
really
enjoy
working
with
you.
A
I
know
people
around,
though
the
board
enjoy
working
with
you
we're
going
to
miss
you.
We
really
are
so
I
just
want
to
say.
Thank
you.
Keep
in
touch
with
us,
I'm
sure
you
will
and
good
luck
with
the
next
part
of
your
career,
because
I
know
that
the
R
word
has
been
banned.
You're
just
moving
from
here
to
the
next
thing,
so
Steve
colleagues
can
I
just
say.
Thank
you
very
much
indeed,.
A
So
bored
is
there
any
other
business?
Anybody
on
the
board
needs
to
raise
right,
so
that
closes
the
the
meeting
as
such,
but
that
does
give
us
an
opportunity
to
have
some
questions
from
the
public
you
are
here
and
I
know.
There
was
a
question:
oh
I've
completely
lost,
who
it
was
from
I.
It
was
it
from
Robin
Robin.
Do
you?
Would
you
like
to
take
the
mic
and
ask
your
question.
S
This
might
view
the
meeting
with
some
morning.
Press
fitting
would
declare
your
care
and
I
should
say
that
back
in
the
day
before
the
days
of
CQC,
I
attended
the
board
meetings
of
the
strategic
health
authority
for
Midlands
and
East
as
a
member
of
the
public
representing
hartfordshire,
and
they
had
a
patient
story
at
the
beginning
of
every
board
meeting,
which
I
think
was
very
valuable
to
the
board
and
may
I
say
that
dr.
Paul
Watson,
who
at
that
time
was
the
medical
director
and
he's
now
reason
Frank
ever
supported
this.
A
So
Robin
we
have
to,
we
have
considered
it
and
I
I.
Think
patient
stories
are
really
really
important
and
when
I
was
chairing
Yeovil
hospital,
we
started
every
board
meeting
with
the
patient
story
because
it
linked
into
an
action
that
on
activity
that
we
as
the
hospital
were
responsible
for
the
reason
I
said
we
considered
it
and
the
reason
that
we
haven't
done.
It
is
twofold.
A
A
You
need
at
least
half
an
hour
and
given
that
we
aren't
the
provider
of
the
care
that
would
be
involved,
which
were
when
you're
in
a
trust,
you'd
actually
need
to
have
the
provider
and
the
patient
to
get
the
full
story.
So
half
an
hour
would
be
a
minimum
and
I
just
don't
think
we
can
link
from
the
board
day
any
further
and
the
reason
I'm
not
too
worried
about
that
is
that
there
were
many
other
forms
of
engagement
so
that
board,
colleagues
jointly
and
severally
have
with
with
patients
and
service
users.
A
F
Certainly
is
very
powerful
to
to
hear
the
voice
of
people
use
services
in
our
work
and
a
lot
of
the
work
we've
done
around
driving
improvement
has
taken
the
the
the
voice
of
people
alongside
the
voice
of
providers
and
has
shown
the
difference
that
organizations
make
I've
been
looking
for
myself.
Oh
no
Brenda's
here
today,
I've
been
lucky
enough
for
myself
to
to
go
into
different
communities
and
hear
the
impact
of
both
good
provision
and
poor
provision.
You
know
in
our
work
I
think
the
Maps
is
something
which
links
to
as
we
change
ourselves.
F
I
do
think
it's
important
that
we
can
have
a
good
conversation
about
those
changes,
bringing
the
voice
of
people
and
the
voice
of
providers
and
others
to
that
conversation
and
I
think
perhaps
that's
an
opportunity
to
perhaps
bring
bring
those
voices
into
the
conversation
at
the
board
as
we
discuss
those
important
changes,
so
I
think
we
can
do
that
and
we
we
certainly
have.
As
you
know,
we
as
alongside
HealthWatch,
we
have
a
network
of
about
150
organizations
that
we
have
regular
engagement
with.
F
So
we
we
understand
work
with
them
to
the
do
share
your
care.
A
campaign
is
one
example
of
that,
but
there
are,
there
are
others
as
well.
So
I
think
it's
important
that
we
keep
doing
that.
That's
important
that
colleagues
and
a
bordo
involved
and
exposed
to
that,
and
as
we
say
as
we
bring
those
changes
to
this
discussion
at
the
board,
it's
important
that
it's
framed
in
the
context
of
what
it
means
for
people
of
your
services,
as
well
as
what
it
means
for
providers.
A
So,
thank
you,
Robin
and
we'll
keep
it.
You
know
if
we
ever
got
to
a
happy
day
when
the
board
de
genders
took
an
hour
and
a
half,
and
we
had
some
more
time
than
we
might
get
in
in
the
formal
board,
if
not
rest,
assure
that
the
voice
of
the
service
user
and
the
patient
is
heard
by
us
as
I,
say,
individually
and
collectively,
but
in
other
fora.
So
thank
you
for
the
point.
Are
there
any
other
questions?
David.
T
L
A
So
there
could
be
intelligence
driven,
even
because
we
could
think
of
that
as
a
strategy,
one
seriously
David
one
of
the
reasons
it's
a
very
thin
green
line
is
the
scale
of
the
graph
and
actually
rather
more
why
it
does
look
smaller
than
it
is
it's
a
small
percentage
of
the
total
there's
actually
quite
a
lot
of
activity,
and
your
second
point
just
give
you
absolutely
assurance
that
any
safeguarding
alert
is
captured
and
is
taken
into
account
in
in
in
inspection.
So
nothing
is
lost
and
indeed
a
whole
lot
of
other
information
that
we
get.
C
Just
from
an
ASC
perspective
and
I'm
sure
it
probably
the
same
for
hospitals
and
PMS,
we
actually
felt
it's
a
mixture
of
the
two
yeah,
but
we
actually
found
as
well
found
as
well
and
that
a
number
of
whistleblowers
contact
us
wells
were
inspecting
or
just
after
the
inspection.
And
that's
because
they've
got
the
confidence
in
the
inspector
they've
met
them.
They're
already
had
a
conversation
with
them
and
they
contact
them
either
during
or
just
after
the
inspection.