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From YouTube: CQC board meeting - November 2021
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A
Right
good
morning,
everybody
welcome
to
the
cqc
november
public
board.
We
have
apologies
for
absence
from
stephen
marston,
who
is
busy
in
his
university
and
sally
cheshire,
who
is
not
well
sally.
Hope
you
get
better
soon,
also
worth
noting
that
martin
harrison
our
normal
secretary
is
ill,
so
naomi
has
stepped
into
the
breach
to
take
the
minutes.
Thank
you,
naomi
for
that.
A
I
I
I
should
say,
as
I
said
in
previous
meetings,
if
it
looks
a
little
odd
if
you're
viewing
this
online,
it's
because
we
are
very
socially
distanced
in
this
this
room.
So
I
don't
know
what
it
looks
like
through
through
the
screen,
but
if
it
looks
odd,
that's
that's
probably.
Why
particular
welcome
to
andrea
tipping
who
is
our
equality
network
guest
this
this
week,
andrea's
from
our
carer's
network?
A
I
think
that
deals
with
welcomes
and
apologies
declarations
of
interest.
Does
anybody
have
anything
they
need
to
declare
okay,
and
I
should
just
say
that,
because
we've
had
to
move
out
of
our
own
building
for
this
particular
meeting,
we're
not
able
to
live
stream
the
meeting,
but
it
will
be
recorded
and
will
be
available
on
a
on
a
screen
near
you
soon.
A
So
that
takes
us,
I
think,
on
to
the
minutes
of
our
october
meeting.
Are
they
a
true
and
accurate
record
of
everything
we
discussed?
Okay,
thank
you.
So
we'll
take
those
as
approved.
A
B
Thanks
peter
and
good
morning,
everybody
just
three
things
I
wanted
to
to
to
pick
up
from
from
my
section
of
the
report.
The
first
thing.
First,
one
relates
to
our
fees
for
twenty
for
the
the
financial
year
2022-23
as
you'll
know.
If
we
are
increasing,
or
indeed
decreasing,
our
fees
in
any
given
year
in
terms
of
changing
the
fee
schema,
we
are
required
to
consult.
B
We
have
decided
this
year
that
our
fees
will
not
change,
which
means
that
for
many
providers
this
will
be
the
third
year
in
which
they
in
which
fees
have
been
frozen
in
in
real
terms
as
in
previous
years,
though,
it's
just
worth
just
noting
that
some
nhs
trusts
nhs
gps
and
some
community
social
care
providers
may
see
a
change
in
their
fees
either
going
up
up
or
down
slightly
as
the
fee
calculation
links
to
some
variables
of
their
business.
Things
like
that,
their
turnover,
their
list,
size
and
and
so
forth.
B
So
as
there's
no
change
to
the
fee
scheme
and
the
way
the
fee
scheme
is
constructed,
we
will
there.
There
is
no
need
to
to
publicly
consult
on
this
decision
to
freeze
fees.
I
think
it's,
I
think
it's
fair
to
say.
I
think
it's
a
broadly
a
good
thing,
and
I
think
it's
it's.
You
know
it's
it's
a
it's
a
support
for
for
providers,
a
modest
support
for
providers
in
in
these
difficult
times.
I
want
to
move
on
and
talk
about.
B
The
the
investigatory
powers
commissioner's
office
report,
ibco
carried
out
their
routine
biannual
inspection
in
relation
to
our
operational
readiness
to
use
our
regulation
of
investigatory
powers
act
powers.
This
is
something
that
that
that
had
that
means
that
we
have
been
judged
to
have
been
compliant
with
all
the
requirements
of
of
ripper.
It's
something.
We've
we've
always
taken
very
seriously.
Even
though
up
to
this
point,
we
haven't
used
our
ripper
powers
at
all.
B
We
have
got
an
item
later
on
the
agenda
where
we'll
talk
about
surveillance
and
use
of
ripper
powers
in
a
bit
more
detail,
but
I
can
confirm
since
the
since
this
report
was
written,
that
we
have
actually
had
the
feedback
from
from
ibco
and
we've
received
a
very
positive
report
with
no
issues.
So
so
we
are,
we
are
fully
compliant
and
and-
and
I
I
think,
that's
a
that's-
a
real
tribute
to
the
team
that
work
on
this.
B
It's
a
relatively
unknown
piece
of
work,
but
it
is
something
that's
incredibly
detailed
and
we
do
need
to
be
hugely
compliant.
It's
a
very
serious
area
and
finally,
before
I
hand
over
to
kate,
I
just
wanted
to
just
pick
up
a
couple
of
recruitment
issues.
B
B
I
should
say
in
in
the
next
in
the
next
few
days,
so
that's
it
from
me
peter
unless
there's
any
questions
and
then
I'll
hand
over
to
kate.
Thank
you.
D
D
This
is
one
of
the
many
actions
we've
taken
to
enable
us
to
really
effectively
identify
and
regulate
services
that
we
think
are
at
risk
of
closed
cultures,
so
that
has
been
published
to
support
transparency
in
our
tool,
and
we
are
evaluating
that
pilot
and
looking
at
next
steps
for
rolling
that
out
and
also
we've
been
piloting,
our
new
tool
around
talking
maps
to
aid
communication.
D
Again,
it's
been
quite
a
small
pilot
and
we
are
in
the
process
of
evaluating
that
and
looking
at
next
steps
for
roll
out-
and
if
I
may,
a
chair
just
want
to
mention
one
other
thing
before
I
hand
back
to
yourself
for
questions
since
our
last
board.
Vaccination
as
a
condition
of
deployment
for
care,
home
workers
and
those
visiting
or
attending
care
homes
has
gone
live.
It
went
live
on
the
11th
of
november.
D
Just
want
to
take
this
opportunity,
one
one
more
time
to
just
reiterate
to
all
our
the
way
that
this
is
going
to
be
implemented
from
us
as
a
regulator
is
that
we
will
be
proportionate
and
we
will
look
at.
We
will
look
at
everything
and
take
everything
in
the
round
when
we
consider
what
steps
we
might
need
to
take.
D
If
we
go
into
a
service
where
we
aren't
assured
that
that
the
registered
manager
has
taken
the
steps,
they
need
to
make
sure
that
their
staff
and
visiting
people
have
had
their
double
double
jabs,
so
just
wanted
to
flag
will
be
proportionate,
also
want
to
note
that
we
are
going
to
be
keeping
a
continuing,
close
eye
on
the
impact
on
workforce.
So
we
talked
in
state
of
care
about
an
exhausted
and
depleted
workforce
across
health
and
social
care.
D
That's
potentially
going
to
put
pressure
on
that
workforce,
so
we've
been
working
visually
with
mark's
team
in
intelligence
and
digital
to
look
at
how
we
may
draw
out
in
every
interaction
with
a
social
care
provider,
a
question
about
what
impact
workforce
is
having
on
their
ability
to
deliver
quality
care,
to
enable
us
to
have
a
good
understanding
at
an
individual
provider
level
of
that
impact,
but
also
be
to
be
able
to
tell
a
kind
of
national
national
story
about
what's
happening
with
the
social
care
workforce.
D
E
D
Thank
you
mark,
so
a
smallish
number
of
inspectors
have
been
trained
on
talking
about
since
19
today,
so
we
wanted
to
develop
the
training,
run
the
training
and
then
evaluate
it
with
our
quality
of
life.
Tour
125
inspectors
today
have
had
briefings
on
it
and
have
have
had
the
tools
made
available
to
them
again.
This
is
the
moment
where
we
need
to
pause,
and
we
now
need
to
think
about
the
next
scale
of
roll
out,
which
again
I
can
update
on.
D
We
are
due
to
come
back
to
board
in
january
to
reflect
on
the
whole
of
the
close
cultures
program,
and
that
might
be
the
time
that
I
can
also
give
board
a
fuller
update
about
where
we
go
next
with
both
of
those
training
programs.
F
Else,
oh
robert.
Thank
you.
Thank
you,
john
just
a
question
about
care
homes.
If
I
I'm
okay,
there's
been
a
certain
amount
of
concern
expressed
in
the
press
about
restrictions
in
some
places
on
care
visiting
and
our
role
in
that,
and
I
wondered
if
you
had
any
comment
to
make
about
that
at
this
stage.
D
Thank
you,
robert,
so
and
throughout
the
pandemic
we
have
been
really
clear
on
our
expectations
that
care
homes
follow
the
most
up-to-date
government
guidance
on
on
visiting
and
also
we've
been
very
clear.
If
we
think
about
give
feedback
on
care,
the
extra
steps
we've
gone
to
say
to
the
public.
Please
tell
us
if
you
have
concerns
or
positives
to
say
about
the
quality
of
care.
Your
loved
one
is
receiving.
D
To
date,
we've
had
51
instances
where
we've
been
alerted
to
a
potential
blanket
visiting
ban
we've
taken
action
in
every
one
of
those,
those
51
instances
and
the
number
of
those
have
significantly
reduced
in
in
recent
months.
I've
said
before,
but
I
think
it
helps
reiterate
visiting
is
happening,
but
it
does
feel
very
different
for
families,
so
it
might
feel
that
they
need
to
phone
up
and
book
in
advance
and
it
might
be
a
time
slot
and
it
might
be
in
a
different
part
of
the
care
home
building.
D
So
I
don't
think
any
of
us
are
sitting
here
saying
that
visiting
is
exactly
the
way
it
was
before
the
pandemic,
because
it
does
feel
very
different.
But
what
I
can
give
the
board
assurance
on
is
in
every
instance,
where
an
alligator,
when
a
concern
about
blanket
visiting,
has
been
raised
to
us.
We've
taken
regulatory
action.
F
Thank
you.
I
just
wonder
I
mean
this
is
a
story.
That's
been
going
on
pretty
well
throughout
the
pandemic,
but
I
wonder
whether
you
have
any
reflections
on
why
some
places
are
still
having
blanket
bands
in
the
light
of
the
guidance
which
says
they
shouldn't
be,
and
in
the
night
of
you
know
our
organization's
view
that
they
shouldn't
as
well.
D
So
this
is,
this
is
less
of
an
issue
now
robert.
So
the
the
those
51
give
me
two
seconds,
and
I
can
tell
you
when
the
the
time
frame
that
they
came
in,
but
it
was.
It
was
a
while
ago
that
those
concerns
were
brought
to
our
our
attention
and
actually,
when
we
dug
into
it,
it
often
wasn't
a
blanket
visiting
band.
There
were
only
a
smaller
than
a
handful
number
of
instances
where
we
needed
to
actually
take
actions
such
as
issuing
breaches.
D
Often
there
was
a
mismatch
of
expectations
that
was
at
the
heart
of
of
what
was
going
on
with
those
51,
so
so
from
you
know,
we're
looking
at
visiting
on
every
care
home
inspection
that
we've
done,
and
today
in
this
financial
year
we're
talking
about
about
3000
inspections,
we've
done
of
social
care
providers
in
total-
and,
I
would
say
visiting,
is
happening,
but
it
feels
very
different
to
the
way
it
did
before
the
pandemic.
A
Thank
you
anything
else.
Kate.
Have
you
had
you
finished?
Okay,
I
didn't
want
to
cut
you
off.
Lisa
ted.
I
think
we
come
to
you.
G
Thank
you
peter.
So,
as
I've
been
discussing
with
the
board
over
the
last
few
months,
there
have
been
increasing
pressures
in
urgent
emergency
care
that
is
impacting
on
ambulance
services
and
emergency
departments
and
hospitals.
More
generally,
the
board
may
well
have
seen
the
latest
performance
figures
from
last
week
which
showed
that
the
situation
is
still
getting
worse
month
by
month.
G
Last
earlier
this
week
the
association
of
ambulance
chief
executives
published
a
report.
It
actually
came
from
january,
where
they're
looking
at
the
harms
that
the
patients
suffer
because
of
delays
in
ambulance
response
times
and
in
in
ambulance
handovers,
and
they
made
very
clear
the
real
concern
there
is
around
patient
risk
from
these
delays
in
the
emergency
care
pathway,
and
I
think
this
remained
really
very
much
the
forefront
front
of
our
minds.
G
This
affects
the
patients.
It
also
affects
the
staff
who
are
who
are
working
really
very
hard
to
deliver
the
service
under
immense
pressure
at
the
moment
and
talking
to
frontline
staff.
Talking
to
the
leaders
of
the
services
is
very
clear
that
their
staff
really
are
under
enormous
pressure
and
they
describe
exhausted
staff
who
are
really
working
very
hard
under
really
difficult
circumstances
to
keep
the
services
running
in
the
in
the
long
term.
G
As
we
said
in
state
state
of
care,
there
needs
to
be
new
models
of
care,
the
model
of
care
it
has
not
kept
up
with
the
demands
of
the
population.
There
needs
to
be
new
models
of
care
around
emergency
care,
but
also
around
elective
care,
but
in
the
short
term,
as
you
go
into
winter,
there
needs
to
be
more
capacity
in
the
whole
urgent
emergency
care
pathway
and
that
that
means
capacity
in
community
services,
so
that
people
can
access
the
care
they
need
in
the
community.
They
don't
need
to
go
to
hospital.
G
It
also
means
capacities
in
emergency
departments,
and
a
lot
of
emergency
departments
are
physically
still
quite
small
and
have
not
been
developed,
and
so
hospitals
need
to
find
more
capacity
in
emergency
departments.
It
means
more
capacity
in
hospital,
inpatient
beds
and
and
the
inpatient
bed
capacity
is
constrained
by
covered
restrictions
still
as
we
go
into
winter,
and
it
also
means
there
needs
to
be
more
capacity
for
hospitals
to
be
able
to
discharge
patients
when
they're
ready
to
go
home
and
again.
This
is
something
we
very
much
highlighted
in
state
of
care.
D
Thank
you
ted,
so
in
in
state
of
care,
we
reflected
on
the
scheme
that
was
stood
up
in
the
run-up
to
last
winter,
around
designation
designated
settings,
and
this
is
where,
in
a
local
place,
commissioners
decided
to
purchase
capacity
within
care
homes
where
someone
in
hospital
who
was
covered
positive
could
go
to
that
designated
setting
as
a
as
an
interval
interval
arrangement.
Before
going
on
to
their
their
usual
care
home,
we
reflect
in
state
of
care
how
that
that
absolutely
did
add
additional
capacity
into
the
system.
D
I
think
it
is
at
its
peak
there
was
about
1
700
beds
in
designated
settings.
We
stood
up
a
new
inspection
methodology
that
meant
that
we
were
able
to
go
out
and
provide
assurance
that
the
setting
was
able
to
isolate
that
group
of
people
had
a
bespoke
workforce
so
that
there
wasn't
any
risk
of
transmission
etcetera.
So
we
reflect
and
say
that
designated
settings
worked
really
well.
D
G
So
so,
colleagues,
the
the
the
links
between
capacity
and
social
care
and
capacity
in
hospitals,
capacity
and
ambulances
are
really
very
close.
We
make
that
point
in
the
state
for
care
and
it's
never
been
more
important
for
assist
a
whole
system
approach
to
urgent
emergency
care
going
into
into
this
difficult
winter.
G
G
It's
making
sure
that
patients
are
kept
safe
in
whatever
way
they
can
be
in
the
system
under
pressure
and
as
we
go
into
into
our
approach
to
inspections
of
urgency,
emergency
care
is
going
to
be
a
whole
system
approach
in
a
coordinated
way,
trying
to
identify
where
systems
can
find
more
capacity
and
provide
more
consistently
safe
care
as
we
go
into
winter.
So
so
we
are,
we.
G
We
will
continue
to
inspect
services
over
winter,
but
we
recognize
that
our
normal
approach
to
inspection,
followed
by
enforcement
action
may
not
be
the
solution
that
the
system
requires
at
the
moment
it
needs
support.
It
needs
help
in
finding
answers
to
what
is
really
a
very
difficult
problem.
Thank
you,
peter
ted.
It
it.
A
We
all
know
this
is
probably
the
most
difficult
winter
that
the
nhs
has
faced,
but
actually
every
winter
in
the
last
few
years
has
been
pretty
difficult,
and
some
providers
and
some
local
systems
have
been
much
smarter
at
finding
ways
to
to
to
find
that
extra
capacity
you've
been
talking
about
and
others,
and
it's
really
a
rhetorical
question.
But
but
it
does
distress
me
that
we
are
still
not
unif
uniformly
learning
the
lessons
and
applying
things
that
have
worked
well
in
in
in
one
place
and
applying
it
in
another.
F
G
G
This
winter,
all
the
providers
I've
spoken
to
are
really
focused
on
trying
to
catch
up
on
the
the
backlog
of
elective
care,
they're
very
conscious
of
the
effect
this
is
having
on
patients,
and,
I
have
to
say
I've
been
impressed
by
some
of
the
work
they're
doing
to
make
sure
they
are
prioritizing
those
patients
in
the
greatest
need.
First-
and
I
know
they'll-
do
everything
possible
to
protect
that
elective
capacity
at
the
same
time
as
managing
the
the
really
difficult
problems
in
the
emergency
care
pathway.
G
But
I
think
there
is
a
tension
and
when
we
talk
about
new
models
of
care,
we
need
to
explore
how
we
can
protect
elective
care
from
the
annual
pressures
it
faces
from
the
winter
surges
of
urgency,
emergency
care,
and
that
means
more
dedicated
elective
centers,
and
I
think
the
board
will
probably
know
that
there's
already
plans
to
set
up
some
standalone
standalone
investigation.
Centers,
which
I
think
is
going
to
be
really
very
powerful
in
that
in
driving
forward.
Some
of
the
capacity
in
the
in
terms
of
doing
investigations
for
people.
A
Okay,
thanks
ted
tyson,
I
think
we're
on
to
you.
I
was
going
to
cover
in
the
performance
update.
A
Okay,
that's
fine,
that's
good,
so
that
then
takes
us
to
mark
who's
going
to
give
us
a
new
report.
I
hope
yes,
no
security.
It's
a
report
peter
right!
Well,
that
was
very
swift.
Oh
mark
sorry,
wasn't
that
swift.
E
I
know
we
have
an
anil
report
from
rosie,
but
I
have
a
couple
of
questions
for
rosie
if
we
could
take
them
now.
Absolutely
okay,
thanks
so
rosie,
just
looking
at
our
response
to
walton
hall
and
the
successful
trial
of
talking
mats
and
the
launch
of
our
quality
of
life
tool.
Are
there
any
learnings
from
this
work
that
could
help
us
and
her
majesty
prisons,
joint
inspections
for
adult
prisons
and
secure
training
centers
such
as
oakville
secure
training
center
that
we've
talked
about
before.
I
Thank
you
very
much
mark,
and
yes,
absolutely
is
the
the
short
answer
to
that.
So
we,
we
are
very
much
involved
in
the
close
cultures
work,
because
close
cultures,
as
you
know,
can
occur
in
all
settings
that
we
regulate
actually-
and
it's
not
just
about
not
just
about
people
in
in
in
buildings,
necessarily
as
well,
but
in
terms
of
the
secure
training
center
inspections
that
we
do
collectively
in
partnership
with
ofsted
and
with
her
majesty's
inspector
of
prisons.
I
We
don't
specifically
use
those
tools
as
yet,
and
we
will
be
certainly
very
interested
in
the
evaluation
of
the
the
pilots
that
are
happening,
but
we
do
speak
individually
to
the
people
on
site
it.
We
do
have
some
some
constraints
on
how
we
do
that,
because
very
often
we
need
a
member
of
staff
present
at
the
same
time
when
we
do
that
because
of
the
nature
of
the
settings
and
likewise
in
prisons.
I
Sometimes
we
because
of
the
nature
of
the
prison,
setting
we're
not
able
to
speak
to
prisoners
alone,
but
we
do
do
risk
assessments
to
see
how
we
can
get
information
from
prisoners
and
and
make
sure
that
the
custody
staff
are
happy.
If
we
can
see
some
prisoners
alone
to
get
more
information.
I
E
Okay,
rosie
we've
heard
this
week
that
we're
going
to
miss
the
target
for
appointing
new
gps
and
that
be
partly
missed
because
of
the
time
it
takes
to
train
new
gps.
E
So
I
just
wondered
whether,
in
your
discussion
with
other
albs
and
the
royal
college,
is
there
any
discussion
or
attraction
to
appoint
physician
associates
in
primary
care
because
there's
been
a
very
successful
launch
in
the
hospital
sector?
And
you
know
why
is
it
successful?
It's
a
lower
training
time
and
they
work
in
a
multi-disciplinary
team.
E
They
play
an
important
role
in
case
histories
in
referrals
and
triaging
and
soon
possibly
prescribing
so
it
seems
to
me
that
that
could
be
a
model
that
could
transfer
into
primary
care,
and
you
know
overcome
some
of
the
challenges
that
primary
care
is
facing.
I
just
wonder
if
any
discussion
like
that
that
you
could.
I
Yes,
certainly-
and
it's
it's
a
really
timely
question-
mark,
because
we
are
concerned
about
retention
and
and
the
numbers
of
gps
and
there's
there's
lots
of
vacancies
across
primary
care
and
and
as
just
to
echo
what
ted
was
saying
earlier.
The
demands
are
huge
at
the
moment
and
we
have
a
very
tired
and
exhausted
workforce
in
primary
care
in
the
same
way
we
do
in
in
our
other
settings
and
so
a
real
concern.
I
The
the
manifesto
commitment
was
for
26
000
new
members
of
primary
care
staff,
and
that
was
for
people
across
a
whole
range
of
different
professions,
including
physiotherapists
and
pharmacists
and
and
other
other
professions,
which
I
think
will
actually
really
improve
the
quality
of
care
for
people
if,
if
they're
deployed
in
the
right
way-
and
it
will
actually
also
support
the
primary
care
workforce
and
making
sure
people
get
the
care
they
need,
there
are
some
physicians
associates
already
in
primary
care,
but
not
very
many,
not
as
many
as
are
used
in
the
the
hospital
sector,
and
our
view
is
that
actually
it's
it's
really
beneficial
to
have
a
multi-disciplinary
team.
I
We
need
to
make
sure
that
anyone
going
into
primary
care,
there's
correct
supervision
and
governance
arrangements
and
and
people
are
supported
in
those
roles,
because
you
work
in
a
slightly
different
way
in
in
primary
care
than
you
do
in
a
hospital.
You
work
in
a
more
autonomous
way.
Very
often
you
don't
work
with
in
in
sometimes
in
the
same
team
structures
as
you
do
within
a
hospital,
but
very
much
welcome
multi-disciplinary
approach.
I
Welcome
physicians
associates
working
in
primary
care
and
I'm
looking
forward
to
considering,
with
with
other
stakeholders
and
other
partners
as
to
how
we
can
support
people
into
working
in
in
in
the
primary
care
setting.
E
J
Just
a
few
things
to
to
update
the
board
on.
Obviously,
since
our
last
board,
we've
published
the
state
of
care
report,
as
colleagues
have
mentioned,
there's
been
a
really
strong
support,
not
only
from
stakeholders
across
all
parts
of
the
the
system,
but
also
from
government
itself,
and
on
the
the
day
of
of
the
report,
which
has
a
strong
focus
on
workforce.
There
was
a
commitment
by
dhsc
to
provide
some
additional
funding
for
the
outsourcing
workforce.
J
So
a
really
really
strong
support
for
the
report
and
its
messages
and
a
good
debate
also
in
the
house
of
lords
on
the
day,
the
issues
around
staffing
which
which
ted
has
as
highlighted,
remain
and
actually
there
was
a
report
out
today
from
nhs
providers
which
uses
some
of
our
messages
in
state
of
care
and
elsewhere
to
talk
a
bit
about
not
only
what
what
the
what
the
concerns
are,
but
also
what
individual
organizations
are
doing
to
address
the
point,
and
it
goes
back
to
your
point
peter
about
there
are
some
good
there's
some
good
practice
out
there,
but
it
has
to
be
more
widely
shared
and
I
think
we've
got
a
strong
part
to
play
alongside,
and
it's
just
providers
in
in
that
work,
just
to
give
a
quick
update
on
the
bill,
we're
continuing
our
engagement
with
partners
across
the
system.
J
So
the
the
local
government
association,
adas,
nhsc
nhs
providers,
nhs
confed
around
the
bill-
we've
got
the
the
essentially
the
written
evidence
is
often
a
a
sort
of
it
gives
a
sense
of
where
different
stakeholders
are
and
there's.
I
think
the
strong
support
from
again
from
across
the
sector
for
our
future
role
in
the
bill,
the
issues
around
how
we
rate
and
what
and
and
how
we
rate
across
both
ics's
and
local
authorities,
I
think,
are
some
of
the
main
areas
of
top
topics
of
discussion.
J
But
I
think
there'll
be
some
further
developments
there.
That
will
put
us
into
a
good
good
place
and
then,
lastly,
I
just
want
to
just
talk
about
give
feedback
on
care
just
in
terms
of
the
the
current
contract.
I've
talked
before
a
bit
about
the
the
current
the
current
campaign,
but
we
begin
the
campaigning
process
again
in
january.
So
one
of
the
things
we've
been
doing
is
to
look
at
the
how
how
well
we've
improved,
not
just
our
general
reach
into
people
using
services,
but
particularly
to
bme
groups.
J
People
who
experience
maternity
services,
carers,
people
with
long-term
conditions
and
people
with
particular
disabilities
and
we've
actually
seen
a
a
really
strong
increase
in
those
particular
areas
where
we've
targeted
targeted
those
groups.
So
we're
going
to
continue
that
approach
in
the
campaign
from
january,
and
I
think
it's
a
testament
to
both
the
the
ability
to
bring
off
a
good
campaign
and
also
the
ability
to
create
a
platform
that
is
easily
accessible,
which
I
know
we've
done
with
our
colleagues
in
in
digital
some
18
months
ago.
That
was
it
for
me.
A
K
Thank
you
yeah,
so
it's
the
quarterly
update,
so
the
first
time
we've
got
visuals
against
the
new
business
plan.
So
I'm
going
to
pull
out
five
objectives
to
talk
about
and
then
open
it
up
for
comments.
So
the
first
one
was
in
terms
of
analyzing
data.
We
capture
and
interpret
it
to
identify
risk.
K
This
means
that
since
april,
60
of
registered
locations
have
had
a
published
statement
or
a
monitoring
call
or
an
inspection.
K
The
latter
two
involved
contact
with
the
provider
and
slide
four
shows
that
12
percent
of
registered
locations
have
had
this
regulatory
contact.
Since
the
1st
of
april
we're
currently
reviewing
our
trajectory
for
the
year.
What
is
forecast
and
potential
ways
we
can
increase
delivery
for
those
areas.
K
Alongside
that
slide,
5
outlines
that
whilst
the
kpi
focuses
on
the
contact
we
have
through
our
assessments,
we
also
have
regulatory
interaction
with
a
high
volume
of
providers
through
over
85
000
inquiries
received
each
month.
For
context
I'll
pause
there,
because
I
don't
tyson
if
you
wanted
to
come
in
at
this
point
and
just
talk
a
bit
more
about
what
we're
doing
around
the
regular
contact.
H
Yeah,
if
I
take
it,
okay
with
the
chair,
I
mean
I'm,
I'm
focusing
particularly
on
the
on
the
kpi
in
the
report
to
do
with
our
regulatory
contact
and
some
work.
I've
been
doing
with
the
the
senior
leadership
of
the
inspection
teams
about
how
we
can
what
we
can
do
to
to
to
increase
that,
and
in
doing
that,
that's
particularly
to
focus
on
whether
we
can
free
up
capacity
elsewhere
to
do
some
of
the
other
priorities
of
the
board
and
of
the
chief
inspectors.
H
So
working
with
the
deputy
chief
inspectors,
we've
come
up
with
a
three-point
plan.
The
first
point
is
about
increasing
capacity
and
in
particular
whether
we
are
making
enough
use
of
our
bank
inspectors.
The
bank
inspectors
are
people
who
are
a
search
capacity,
so
to
speak.
They
they
are,
they
are,
they
are
trained
and
they
are
experts
in
what
they
do
and
they
are
currently
being
deployed
on
some
of
our
inspections
and
with
some
of
our
inspection
teams.
H
But
the
question:
what
we've
asked
is:
are
we
making
enough
use
of
them,
and
can
we
actually
deploy
them
in
more
frequently
in
order
to
increase
our
capacity?
If
we
do
that,
we
will
need
to
make
sure
that
they
are
properly
trained
and
they
have
the
most
up-to-date
training
further
for
the
task
we
want
them
to
do
so.
Work
is
underway
on
that.
H
The
second
one
is
it's
really
to
have
a
look
at
the
the
core
role
of
the
inspector
and
are
there
tasks
that
the
inspectors
are
doing
at
the
moment,
because
our
workforce
is
clearly
very
busy
that
can
be
done
elsewhere
within
within
the
cqc
and
in
the
in
the
inclusive
report.
You
will
see
that
not
only
has
there
been
a
bit
of
an
uptick
in
inquiries,
but
actually
not
captured
in
this
report.
H
The
complexity
of
the
inquiries
has
increased
and
therefore
we've
done
we're
doing
a
bit
of
work
with
the
leadership
of
the
national
customer
service
center.
As
to
whether
some
of
those
inquiries
particularly
give
feedback
on
care
inquiries
can
be
dealt
with
by
the
skill
teams
in
in
newcastle
in
the
in
the
customer
service
center
that
a
number
of
us
saw
on
a
visit
a
few
weeks
ago.
A
task
and
finished
group
has
been
set
up.
H
H
The
final
point
is
we're
having
a
look
at
the
way
in
which
we
undertake
direct
monitoring
the
direct
monitoring
approach,
which
is
our
new
approach,
our
more
intelligence-based
approach
to
regulatory
contact
with
what
we
call
bantu
providers
and
it's
looking
at
the
options
for
increasing
doing
some
things
differently
and
maybe
increasing
the
efficiency
of
of
doing
those
at
dma
activities,
but
clearly
making
sure
that
we
maintain
strong
relationships
with
our
providers.
Again.
H
A
Chris,
before
you
go
on,
can
you
just
go?
Go
back
to
slide
four,
and
I
apologize
of
this,
but
the
this
is
our
regulatory
con
contact
with
locations,
but
we've
had
a
lot
of
regulatory
contact
with
corporate
providers
and-
and
I
just
suspect
that
this
is
understating-
that
the
amount
of
contact
we've
actually
had.
A
So
it
might
be
worth
thinking
about
for
the
future
that
we
we
either
have
on
this
slide
or
on
another
slide,
that
the
contact
with
the
with
the
corporate
providers,
which
I
think
will
give
us
a
much
clearer
idea
of
the
the
volume
of
contact
we
actually
have
had.
K
A
very
good
point:
I
was
just
writing
that
down
so
I'll
continue,
so
I've
mentioned
the
short
statements
we
publish
it's
really
important.
We
want
to
undertake
quality
insurance
inspections
to
test
our
approach
and
findings
slide.
Six
shows
that
we've
undertaken
116
of
these
qa
inspections.
So
far,
we
continue
to
analyze
and
aim
to
do
more.
Granular
statistic:
analysis
by
the
end
of
this
quarter,
as
we
gather
more
information
that
really
supports
our
future
learning.
K
We
offer
a
timely
registration
service
so
slide
seven
brings
out
the
registration
performance
today,
we're
aiming
to
reduce
the
average
number
of
days
across
our
registration
process
by
15,
as
you
can
see
in
the
data
simplify
simple
applications
is
currently
at
20.1
reduction,
so
kind
of
exceeding
our
expectations
and
very
much
on
track
with
normal
applications,
which
is
twelve
point
three
percent
again
cursive
and
if
you
wanna
come
in
at
this
point,
just
talk
about
what
we've,
how
we've
done
that.
L
Yeah
thanks
chris,
so
you
may
recall
that
we've
been
running
a
program
of
improvement
in
registration
over
the
last
last
18
months,
probably
now
and
really
focusing
on
on
individual
productivity,
but
also
looking
at
the
systems
and
how
we
can
really
streamline
those
and
and
get
ourselves
ready
for
the
new
technology
that
comes
into
and
also
working
with
providers
and
the
the
the
groups,
the
the
support
groups,
to
make
sure
that
that
we
understand
that
the
providers
understand
that
the
changes
that
we're
making
around
that.
L
But
I
think
the
key
bit
has
been
really
on
on
driving,
looking
at
how
our
management
is
working
and
how
they're
working
with
their
their
teams
to
really
to
really
look
at
our
productivity.
And
I
think
it's
really
starting
to
pay
dividends
now
and
I
think
we're
not
almost
at
the
position
where
everybody
is
meeting
their
targets
week
in
week
out,
which
is
really
really
good.
The
quality
is
also
being
maintained.
L
So
it's
not
just
we're
not
just
driving
productivity
at
the
cost
of
quality,
and
I
think
it's
it's
really
starting
to
to
pay
some
dividends.
I
can
see
that
the
complex
data,
the
complex
figures
are
still
are
still
very
variable,
but
there's
very
they're,
very
small
in
number,
and
quite
often
very
bespoke
applications.
So
it's
very
hard
to
try
and
get
those
standardized,
but
where
we've
really
looked
at
driven
improvement
around
those
simple
and
those
normal
ones,
is
really
looking
to
standardize
our
processes
and
really
look
at
how
we
can
reduce
reduce
time.
L
That
is
nugetry
and
also
reduce
sort
of
duplication
of
activity.
And
I
think
it's
really
starting
to
pay
off
now
and
I'd
just
like
to
say
a
big.
Thank
you
to
the
registration
guys
because
they
have
been
working
really
really
hard
and
really
trying
to
get
us
into
it
into
a
good
place
here,
and
that
work
is
now
starting
to
pay
off.
K
So
the
next
objective
is
around
responding
to
concerned,
safeguarding
whistleblowing
and
appropriate
and
timely
way.
We've
aimed
to
increase
through
external
engagement,
the
volume
of
good
feedback
on
care
we
receive
and
we're
seeing
a
71
percent
increase
in
the
volume
compared
to
the
same
period
last
year,
which
is
shown
inside
eight.
A
driving
factor
behind
that
increase
is
primary
medical
services,
in
particular
in
particular,
general
practice
sector,
where
we've
seen
161
percent
increase
for
the
year
to
date
in
terms
of
what
we
do
with
this
data.
K
It's
just
it's
obviously
insightful
information
for
our
inspection.
Colleagues
and
actions
depend
upon
the
information
received
and
that
could
range
from
contacting
the
provider
being
used
as
intelligence
for
inspection
planning
or,
in
some
cases,
a
referral
to
safeguarding
adults
authority
teams.
K
It's
also
important
to
note
that
a
lot
of
the
feedback
is
positive
and,
although
it's
not
increasing
at
the
same
rate,
we
are
seeing
increase
in
the
positive
feedback
we
are
receiving
chris.
I
don't
know
if
you
want
to
come
in
on
some.
J
More
thanks
chris
yeah,
just
a
couple
of
things
to
say,
obviously
we're
delighted
about
the
increase
in
the
volume
of
give
feedback
on
care.
I
think
there's
also
true
to
say
that
the
quality
of
the
information
we're
receiving
back
is
more
helpful.
To
is,
is
more
helpful
to
colleagues
in
inspection
teams.
Have
this
impact
a
lot
on
technology
I'll
continue.
A
A
Okay,
so
so
can
I
just
say
to
anybody
who's
watching
this
remotely
that
we've
had
some
problem
with
the
light
so
we're
carrying
on
in
rather
different
lighting,
which
is
why
it
will
look
a
little
different
and
a
little
odd
on
your
screens.
Maybe
the
lights
will
come
back
on
before
we
finish,
maybe
they
won't.
I
don't
know
but
chris
over
to
you.
J
Thanks
and
and
just
to
respond
to
chris's
note
about
give
feedback
on
care.
There
has
been,
as
colleagues
have
mentioned,
a
a
70
rise,
which
is
fantastic,
we're
particularly
pleased
and
grateful
for
the
rise
from
healthwatch
that
their
their
their
own
increase
has
been
23
in
terms
of
the
amount
of
feedback
we
see
from
them,
and
alongside
keras
uk
disability
rights
uk,
mind
patient
association
and
the
relative
rule
association,
we've
seen
a
real
partnership
about
encouraging
that
feedback.
J
What's
really
important
about
the
feedback,
is
it,
as
chris
says
it
is
leading
to
responsive
inspection
activity
and
importantly,
we're
able
to
do
that
and
also
make
sure
that
individuals
themselves
are
both
supported
through
the
process
and
protected
through
the
process
as
well.
So
many
of
that
many
of
the
feedback
is
very
detailed
and
gives
a
real
sense
of
what
needs
to
be
achieved
or
what
needs
to
be
done,
and
we
can
use
that
information
both
anonymously
and
also
when
we
receive
the
details
of
the
individuals.
J
I
think
it's
a
a
tremendous
improvement,
I'm
hoping
we
can
maintain
and
grow
that
as
we
enter
the
next
campaign.
As
I
mentioned
earlier,
thanks
chris
back
to
tell.
F
Chris,
that's
very
encouraging,
obviously,
that
the
greater
the
feedback
there
is,
the
more
information
we
have
to
act
on
one
area
of
feedback.
I
was
wondering
if
we
have
considered
what
we
can,
whether
it
can
be
exploited
more
and
we
and
healthwatch
are
keen
to
try
to
do
this,
but
haven't
yet
found
how
to
do.
It
is
the
textual
feedback
that
is
used.
It
comes
into
the
friends
and
family
of
tests
which
the
family.
F
Of
us
which
feedback,
which
is
a
score,
but
also
people,
have
the
opportunity
of
putting
text
comments
which
apparently
there
are
it's
a
massive
amount
and
at
the
moment
it
may
be
used
by
some
providers
internally.
But
it's
not
used
anywhere
else,
and
that
would
of
course
provide
both
positive
and
negative
feedback.
J
So
mark
may
want
to
come
in
as
well,
but
what
I
would
say
is
that
probably
the
most
important
place
where
that
that
feedback
is
used
is
with
the
provider
and
one
of
the
things
that
we
do
when
we
go
in
and
we
talk
to
a
provider
is
to
is
to
help
understand
how
they
are
using
feedback
directly
from
their
service
users,
because
actually,
information
which
comes
directly
from
a
service
that
that
is
actioned
by
the
service
and
released
an
improvement,
is
the
best
solution.
J
And
so
we
do.
We
do
monitor
it
as
part
of
our
ongoing
assessment
of
how
organizations
are
responding
to
the
needs
of
their
their
service
users,
and
I
know
it's
used
as
part
of
our
thinking
around
the
inspection
activity.
But
I
we
are
encouraging
organizations
to
use
that
feedback
directly.
I
was
talking
to
a
an
organization,
a
month
or
so
ago,
around
maternity
services,
where
they've
used
that
feedback
directly
to
change
the
way
the
return
services
operate.
So
we
will
keep
an
oversight
of
it.
We
do
as
part
of
our
ongoing
dialogue.
J
We
also
receive
it
ourselves.
I
know
into
into
our
intelligence
team's
work.
So
it
is,
it
is
captured
by
us,
but
I
think
it's
it's
it's
as
important,
if
not
more
important,
it's
dealt
with
locally.
We
have
to
have
oversight
of
it
to
make
sure
we
understand
it,
but
I
think
it's
important
for
the
organization
to
be
able
to
action
it
locally.
M
Mark
sorry,
thank
you
yeah,
so
so
so
yes,
I
think
the
important
thing
is
every
piece
of
kind
of
textual
feedback
that
we
get
is
is
identified
against
a
provider
and
that's
put
put
in
front
of
an
inspector.
So
an
inspector
will
get
the
opportunity
to
to
see
all
of
that
feedback
as
part
of
their
normal
regulator,
regulatory
activity
and
that's
reviewed
as
part
of
that
process.
K
Good
thanks
everybody
chris
thank
you
so
in
our
objective,
around
developing
a
diverse
cqc
workforce,
with
equal
opportunities
for
everyone
and
a
culture
of
inclusion.
So
just
to
talk
a
bit
about
that,
so
we've
been
focused
on
how
we
can
improve
our
representation
of
disabled
and
black
and
minority
ethnic
colleagues
and
as
well
at
senior
level
so
slide.
18
and
19
provides
some
of
the
current
statistics
to
support
this
age.
K
Our
colleagues
are
looking
at
the
conversion
data
from
attraction
to
appointment,
to
help
understand
what
we're
doing
well
and
what
we
can
improve,
attraction's,
a
key
focus
and
how
we
can
look
to
support
this,
such
as
potentially
targeted
attraction
campaigns.
Things
things
we're
looking
at.
We've
also
have
an
anonymous
application
process
now
and
independent
panel
members
for
senior
recruitment
and
all
managers
are
receiving
or
received
appropriate
training
on
recruitment.
So
just
trying
to
demonstrate
some
of
the
things
that
we
are
doing
to
improve
in
this
area.
K
The
final
area
for
me
is
around
managing
our
finances
and
resource
effectively.
So
just
a
couple
of
lines
on
our
money.
At
the
end
of
september,
the
revenue
budget
is
underspent
by
10.1
million,
that's
forecast
to
increase
by
11.9
million
to
11.9
million
our
budget
assumed
kind
of
an
uplift
and
activity.
K
We
are
starting
to
see
this
now,
but
but
the
the
the
early
parts
of
the
year
kind
of
represent
we're
kind
of
us
still
adapting
to
our
ways
of
working
in
a
significant
reduction
in
travel
costs,
for
example.
So
we're
just
looking
at
what
that
all
means
in
terms
of
our
future
budget
requirements,
bring
that
back
at
a
later
stage
on
the
capital
side,
we're
underspent
by
2.9
million
and
that's
forecast
to
be
underspent
by
1
billion
by
the
end
of
the
financial
year.
K
N
Hi
just
go
back
into
slide,
8
and
slide
10.,
so
in
slide
8
you
spoke
about
161
increase
in
concerns
from
prime
medical
services.
I
just
wondered:
if
you
could
talk
about
those
if
there
any
trends
or
patterns
and
then
slide
10,
you
spoke
about
the
response
to
surveys
of
227
returns.
I
just
wondered
how
many
was
sent
out.
I
Shall
I
come
in
on
the
primary
medical
services
one,
so
we
are
seeing
a
significant
increase
in
giving
back
on
care
for
primary
medical
services.
The
vast
majority
of
this
relates
to
concerns
that
we're
seeing
about
access
to
care
in
general
practice
and
we're
working
at
the
moment
to
look
at
how
we
follow
up.
We
are
following
up
all
of
those
concerns
that
are
raised
with
us,
and
inspectors
have
that
information
which
they
are
looking
at
as
part
of
their
review
of
of
providers.
So
that's
the
majority.
I
J
In
terms
of
the
the
slide
10,
it's
fair
to
say
that
we've
been
piloting
this
approach
about
individual
pieces
of
work,
so
normally
it's
about
it
that
would
represent
about
40
or
so,
but
we're
trying
to
target
it
more.
So,
for
example,
a
report
on
dentistry
only
has
a
relatively
limited
number
of
providers
or
stakeholders
that
you'd
expect
to
follow
it.
So
we've
we've
done
some
pilot
work,
of
which
this
is
this.
This
shows,
I
think
what
we'll
do
is
we'll
refine
it
more
because
we
asked
in
the
pilot
work.
J
We
asked
a
broader,
broader
group
of
stakeholders
and
you
might
really
expect
to
have
a
view
on
each
individual
product,
so
we're
going
to
refine
it
more.
So
we
we
target
a
group
of
people
that
we
expect
to
read
and
see
it
there's
also
an
issue
of
timing
for
me,
so
things
like
state
of
care,
for
example,
you
are
still
getting
responses
to
it.
12
months
after
it's
it's
published,
and
actually
you
want
people
to
to
see
it.
J
You
want
people
to
understand
it
and
you
want
people
to
use
it,
and
I
think
the
c
is
early
and
you
can
get
that
they
understand
it.
It
comes
a
bit
later
and
then
the
use
probably
goes
within
the
next
six
to
12
months.
So
we'll
probably
redo
these
surveys
with
that,
without
with
those
things
in
mind,
but
targeting
particular
audiences,
each
individual,
independent
voice
product
now
has
a
group
of
people.
It
is
targeted
at
so
we're
going
to
try
and
be
a
bit
more
precise
about
where
we
go
to
measure
the
success
of
them.
C
Dura
and
just
a
quick
question
on
on
the
learning
and
development
slide,
where
we're
talking
about
the
the
qi
training
for
for
gold,
silver
and
bronze,
I
mean
we,
we
had
a
large
initiative
about
a
year
and
a
half
ago,
two
years
ago,
around
qi,
but
am
I
reading
this
right?
The
word
either
we're
not
investing
in
the
gold
learning
or
not
enough.
People
are
interested,
but
it
seemed
about
a
year
and
a
half
ago.
L
Yes,
so
we've
we've
been,
we
did
we
took,
I
can't
have,
and
it
was
and
get
the
data
for
you
and
a
number
of
people
through
the
gold
program
and
they're
the
sort
of
they
they
were
going
to
be
the
leaders,
so
we've
invested
quite
heavily
in
them.
They
are
now
helping
and
supporting
some
of
our
really
strategic
projects,
but
they're,
also
working
with
the
silver
team
and
we've
been
investing
more
on
the
silver
level
and
then
also
getting
everyone
up
to
us
of
baseline
under
level
of
competency.
L
So
at
the
moment
we
don't
need
any
more
gold
people,
because
if
we've
got
we've
got
they're
fully
occupied
the
layer
that
we
really
want
to
put
the
effort
is
in
is
in
that
silver
training.
We've
got
cohorts
running
constantly
around
those
and
they're
the
ones
that
are
taking
up
the
sub
programs
that
are
making
a
difference
of
tactical
programs
that
are
really
starting
to
make
a
difference
and
add
the
value.
L
So
I'm
going
to
update
on
our
change
change
program
and
also
our
people
we'll
do
the
change
first,
take
some
questions
and
come
back
to
people
if
that's
okay.
So
it's
been
a
busy
few
months
across
the
change
portfolio.
Since
we
last
reported
some
really
good.
Progress
has
been
made,
particularly
around
planning
and
resources,
and
that's
resulted
in
the
portfolio
now
sitting
at
an
amber
green
rating,
which
I
think
is
is
showing
an
upward
trend
and
I'm
hoping
that
will
continue
as
we
move
forwards.
L
What
we've
been
looking
at
over
the
last
few
months
is
thinking
about
the
work
around
our
implementation,
really
starting
to
think
about
how
we're
going
to
do
that
and
then
also
enabling
us
to
really
start
to
think
about
how
we
want
to
prioritize
our
delivery
and
what
that
means
in
terms
of
work
that
we
have
to
bring
forward.
So
we're
really
ensuring
that
we're
focusing
on
the
right
things
at
the
right
time.
L
We've
split
our
work
into
four
key
phases,
so
the
first
phase
is
to
deliver
in
march,
and
that's
going
to
give
us
some
some
enough
processes
and
systems
and
structures
to
enable
us
to
test
out
our
new
ways
of
working
in
pilot
form
that
that
work
will
is,
is
on
track
and
that'll
enable
us
to
really
understand
what
we
want
to
how
we're
going
to
work
going
forwards
and
really
be
able
to
fine
tune.
L
In
terms
of
the
work
across
the
three
pillars.
I
will
hand
over
to
kate
shortly
to
talk
about
the
the
regulatory
leadership
function,
but
on
the
organizational
design
and
development
that
work
is
progressing.
Well,
all
our
keystone,
key
milestones
have
been
met
and
the
focus
has
been
around
delivering,
designing
and
delivering
thinking
about
our
new
structures
and
how
we're
going
to
support
our
new
ways
of
working
to
deliver
on
our
strategic
ambition
as
we
move
forward
so
kate.
Do
you
want
us
to
update
on
the
pillow
one.
D
Thank
you
kirsty.
Thank
you
board,
so
I'm
the
exec
sponsor
for
pillar
one,
which
is
the
redesign
of
our
model.
Our
approach
to
regulation
in
this
one
of
the
core
pieces
of
work
is
our
new
single
assessment
framework
that
we
are
developing,
along
with
the
new
responsibilities
that
we
are
taking
on
as
an
organization.
D
So
there's
a
there's,
a
vast
array
of
work
that
sits
within
this
new
model,
this
regulatory
framework
that
we
are
that
we
are
designing
as
we
speak,
and
we
are
working
closely
with
pillar
two,
which
is
the
org
design
and
pillar
three,
which
is
the
regulatory
services
to
inform
what
we
need
from
those
two
parts
of
the
business
to
deliver
the
ambitions
of
the
the
first
pillar.
So
cassie
you've
already
talked
about
org
design.
So
I'll
hand
over
to
mark
now
use
these
exponents
of
the
regulatory
services.
M
Thank
you,
so
the
there's
some
key
key
areas
involved
in
in
this
pillar
are
the
transforming
data,
insight
program,
regulatory
platform
and
our
hr
and
finance
programs.
M
So
in
transforming
data
and
insight,
we've
made
really
good
progress
in
our
work
to
establish
this
new
unit
and
we're
on
track
to
complete
our
organizational
changes
by
the
end
of
this
financial
year.
Our
work
to
develop
the
new
enterprise
data
platform
is
also
progressing
really
well.
We've
launched
our
first
survey
using
this
new
technology
capabilities
for
our
annual
provider
survey,
which
not
only
gives
providers
a
much
easier,
more
intuitive
experience,
but
allows
our
teams
real-time
access
to
anonymized
data
and
insights
that
hasn't
been
possible
before
in
our
regulatory
platform
program.
We.
M
Work
is
also
underway
to
establish
our
transformation
programs
for
our
finance
and
hr
technology.
We've
made
strategic
technology
decisions
in
both
areas
and
will
be
undertaking
procurement
exercises
and
planning
for
a
phased
implementation.
A
I'm
really
sorry
for,
for
it
must
be
very
difficult
trying
to
trying
to
watch
this,
but
thanks
mark
kirsty.
L
A
It's
not
a
question
from
me,
but
I
I
just
wanted
to
make
the
comment
that
I
think
a
huge
amount
of
work
has
been
done
and
a
lot
of
progress
has
been
made
and
I'd
just
like
to
congratulate
not
just
the
executive
leads,
but
but
your
teams
for
the
the
work
that's
been
done.
It's
been
really
good.
Thank
you.
Thank
you
for
that.
Peter.
L
L
Okay,
so
it
does
continue
to
be
very
busy
across
the
people
directorate
with
a
lot
of
work
going
on
on
a
number
of
fronts.
We
are
focused.
We
have
been
spending
quite
a
lot
of
time,
focusing
on
building
our
talent
for
the
future
and
looking
at
how
we
can
use
various
development
schemes
open
to
us
to
ensure
that
we
can
bring
our
people
on
so
they
have
the
skills
that
we
need
to
help
us
be
successful
into
the
future.
L
There's
lots
of
work
going
on
across
our
diversity
and
inclusion
agenda
and
I'm
pleased
to
say
that
we've
been
able
to
replace
our
diversity
and
inclusion
manager,
who
will
be
sadly
missed.
But
we've
got
a
new
new
person,
starting
which
is
really
really
positive,
and
we've
also
been
doing
lots
of
work
in
terms
of
inducting
our
new
diversity
and
inclusion
coordinators,
and
these
are
people
that
have
applied
to
join
the
diversity
and
inclusion
team
they're
people
from
across
the
business
who
are
going
to
work
within
the
directorates.
L
To
be
this
point
of
contact
to
ensure
that
our
diversity
and
inclusion
programs
are
fully
embedded
across
the
various
bits
of
our
business
and
they've.
They've
now
started
and
have
got
a
detailed
training
program
to
get
them
up
to
speed
so
that
they
can
really
start
to
add
value
quickly.
And
I
think
it's
really
really
a
really
positive
move.
We've
also
in
the
process
of
pulling
together
the
work
for
our
disability,
equality,
standard
report
and
our
workplace.
L
Four
we're
also
looking
at
building
our
capability
in
terms
of
our
line
management
capability,
particularly
looking
at
the
skills
and
capabilities
we
need
to
lead
through
change
and
also
the
capabilities
we're
going
to
need
into
the
future
and
as
part
of
that,
we've
developed
a
new
program
of
work
that
was
released
a
few
months
ago
for
the
first
few
first
few
modules
and
was
incredibly
successful
and
we
were
sort
of
sold
out
within
within
within
a
few
few
days
on
that.
L
So
we've
actually
put
on
some
additional
courses
for
our
colleagues
to
really
particularly
focusing
on
on
leading
through
change
and
leading
leading
in
uncertainty,
and
I
think
those
are
going
to
stand
us
in
good
stead.
L
Also,
at
the
end
of
this
month,
beginning
of
december,
we
are
hosting
our
second
or
colleague
virtual
conference,
which
is
a
really
good
opportunity
for
everyone
to
come
together
across
the
organization
to
look
at
key
messages
around
our
strategy
and
also
our
future
way
of
working.
L
We're
also
about
to
launch
our
annual
survey.
That's
just
gone
live
from
today.
I
think,
and
that's
again
a
really
important
tool
in
our
employee
engagement
to
really
understand
and
take
a
temperature
across
the
organization,
and
these
are
our
annual
surveys
that
we
do
and
give
us
a
real
sense
of
progress
that
we're
making
year
on
year,
because
we're
able
to
compare
compare
year
on
year.
So
again,
that's
just
gone,
live
and
we'll
be
reporting
back
at
some
point,
probably
after
christmas.
In
terms
of
those
results,
any
questions
on
any
of
that.
A
E
Thank
you
chairman,
and
thanks
kirsty,
for
a
very
full
report.
In
terms
of
listening
to
our
employees,
I
was
really
pleased
to
see
in
terms
of
organizational
design
and
development
the
extensive
engagement
with
our
colleagues
across
the
organization,
so
that
was
that
was
really
good
to
hear
in
terms
of
the
survey.
E
I
just
wondered
again:
we've
engaged
with
the
organization
in
terms
of
the
design
of
the
the
fuller
survey,
but
you
know
we're
surveying
a
lot
at
the
moment
and
listening
to
to
our
employees,
and
I
just
wondered
if
there
is
some
evidence
that
shows
how
effective
our
feedback
is
to
employees
about
the
survey
results
and
the
actions
we
take
based
on
those
results.
L
You
said
we
did
so
that
we
can
really
sort
of
particularly
pick
out
themes
and
in
each
one
of
the
direct
individual
directorates
will
have
a
action
plan
related
to
the
staff
survey
because
and
then
we've
also
pulled
out
some
common
themes,
so
things
around
leadership.
So
if
you
look
at
the
work
that
we've
done
around
building
our
leadership
capability
and
capacity
and
some
of
the
training
programs,
some
of
those
are
a
direct
feedback
as
a
respon
response
to
some
of
the
staff
survey
feedback.
L
But
if
you,
if
you
go
into
the
individual
directorates,
there's
lots
of
work
going
on
and
lots
of
regular
updates
in
terms
of
you've
told
us.
We've
done
this,
and
so
there's
constants
of
feedback
happening,
and
I
think,
when
you're
looking
at
staff
survey
results
that
there
are,
if
you
look
across
it's
quite
a
mixed
picture
across
various
directorates
and
some
bits
need.
Some
directors
have
different
feedback
to
others
and
so
trying
to
have
us
a
blanket
approach
to
staff
said
it
probably
isn't,
isn't
the
right
way.
L
So
this
the
way
that
we've
done
it
in
terms
of
sort
of
individual
directorate
responses
have
been
quite
successful
and
I
think
some
of
the
the
feedback
and
the
communication
at
that
local
level
has
been
really
really
productive
in
terms
of
driving
driving
change
and
and
responding
to
what
people
see,
and
I
think
a
lot
of
the
work
around
our
well-being
agenda
and
some
of
the
really
positive
work
we've
been
have
done
around
that.
A
J
Thank
you
peter.
So
this
issue
of
insight
is
focused
on
medication,
safety.
It's
interesting!
It's
it's
a
common
fact,
but
but
probably
not
commonly
discussed
that
there
are
over
200
million
medication
errors
in
the
nhs
every
year.
J
What
this
report
tries
to
do
is
to
sort
of
talk
a
little
bit
about
what
we
know
from
our
role
and
from
our
team's
work
around
what
is
working
well,
particularly
the
team
approach,
how
incidents
are
reported?
What
we
can
learn
from
that,
and
also
where
we
still
feel
there
are
there
are
concerns.
J
What
I
think
has
worked
particularly
well
is
a
clear
role
for
medication:
safety
in
a
medication
safety
officer's
role
in
nhs
trust
has
undoubtedly
been
a
benefit,
and
that
was
proposed
and
implemented
some
time
ago,
but
the
issues
around
medications
reporting
and
how
they're
reviewed,
particularly
by
multidisciplinary
teams,
is
variable
in
in
organizations
and
in
some
cases
the
focus
on
improvement
and
local
actions
are
not
always
routinely
followed
to
start
with.
J
What's
working
well
in
some
trustees,
we
definitely
found
an
excellent
multi-disciplinary
approach
to
encouraging
and
engaging
all
members
of
staff,
junior
members
of
staff,
pharmacy
teams,
doctors,
nurses,
in
the
conversation
about
medication
and
medication
errors.
I
think
there's
a
way.
You
saw
a
more
holistic
approach
to
medicines.
You
saw
a
better
response.
This
translated
across
to
incident
reporting
and
learning
when
a
medication
safety
officer
was
able
to
and
be
part
of
the
system
of
reporting
and
monitoring.
J
J
We
also
saw
a
number
of
trust,
introduce
and
embrace
human
factors,
training
to
try
and
improve
their
the
human
element
of
of
of
medication
errors,
lassie
I'll
just
say
that
there's
some
really
good
examples
of
local
networks
working
well
to
understand
the
relationship
between
different
services,
around
medication
errors.
But
again
this
was
variable.
So
the
relationship
between
nhs,
adult
social
care
and
primary
care
is
very
important
in
driving
that
change.
J
The
report
is
designed
to
be
both
a
tool
for
organizations
to
understand
what
they
need
to
do
and
also
a
reminder
to
those
organizations,
both
national
and
local,
that
this
still
remains
a
significant
problem.
Today
I
don't
know
if
colleagues,
ted
or
rosie
wanted
to
say
any
more
about
it,
rosie
and
then.
I
I
think
this
is
a
really
important
area
and
we
know
that
a
lot
of
harm
can
come
to
people
if
medication
is
not
prescribed
correctly,
if
people
aren't
informed
about
the
how
to
take
their
medication
properly
or
the
the
risks
and
the
side
effects,
and-
and
I
really
welcome
the
focus
here-
on
learning-
from
incidents
around
medication
and
just
a
flag.
I
think
this
is
going
to
be
a
very
important
area,
as
we
start
to
look
at
integrated
care
systems
and
the
development
of
them.
I
We
know,
as
you've
said
chris,
that
it's
really
important
that
all
aspects
of
the
system
work
together
around
medication
safety.
We
know
that
there
are
potential
for
harm
as
people
transfer
between
one
part
of
the
system
and
another,
for
example,
on
discharge
from
hospital,
and
this
is
going
to
be
very
important
for
integrated
care
systems.
I
To
look
at
to
really
understand
those
transfers
of
care
to
make
sure
systems
and
processes
are
in
place
to
ensure
safe
medication
transfer
and
and,
most
importantly,
to
learn,
cross-system
about
things
that
have
gone
wrong
and
think
about
how
they
can
put
in
place
processes
that
reduce
the
the
risk
of
harm.
Again.
G
Ted,
thank
you.
I
agree
with
rosie.
This
is
a
really
important
report.
The
the
problems
of
medication
safety
are
very
clear
from
the
from
the
figures
you're,
quoting
it,
and
and
we
recognize
that
it
is
one
of
the
key
safety
areas
in
nhs
trust.
G
But
this
is
not
just
about
nhs
trust,
it
is
about
whole
systems,
and
one
of
the
key
risks
for
patients
is
often
when
they
transfer
from
one
part
of
the
system
to
another
and
the
medication
safety
is
not
carried
through
with
them,
which
leads
to
polypharmacy
and
and
conflicts
in
the
prescriptions
they're
getting
and
med
scenarios.
I
think
this
report
pays
tribute
to
the
work
of
medication,
safety
officers,
energies,
trust.
That
is
a
great
initiative
and
there's
learning
here
for
all
nhs
trust,
but
we
should
come
back
to
our
strategy
on
safety.
G
This
is
about
learning
when
things
go
wrong,
it
is
also
about
involving
patients
in
their
own
safety,
and
no
way
is
that
more
true
than
in
medication.
Safety
patients
need
to
understand
the
medicines
they're
on
and
why
they're
on
them,
but
they
also
need
to
understand
how
they
can
protect
their
safety
on
them,
and
I
think
too
often,
medicines
are
prescribed
in
a
passive
way
to
patients
and
they're,
not
if
you
like
treated
as
equal
partners
in
the
treatment
they're
getting,
and
I
think
that
could
really
drive
forward
improvements
in
safety.
G
F
Just
if
I
could
just
endorse
what
ted
has
just
said,
one
of
them.
I
thought
this
was
really
helpful
report.
But
one
of
the
concerning
points
seemed
to
me
was
that,
while
it's
good
practice
to
have
a
patient
representative
on
the
safety
committee,
very
few
trusts
do
that.
I
know.
F
To
my
mind,
patient
representative
is
important,
but
of
course
it's
only
the
beginning
of
under
an
understanding
of
what
what
you
need
to
do
to
enable
patients
to
understand
their
medication
and
to
comply
with
whatever's
needed,
and
I
wondered
what
we
as
a
care
quality
commission
can
do
not
only
to
ensure
there's
a
patient
representative
on
a
committee
but
there's
some
meaningful
understanding
being
developed
within
providers
about
their
relationship
with
their
patients,
which
requires
a
rather.
I
think
that
would
suggest
broader
engagement
with
patients
than
lumping
it
all
onto
one.
G
G
One
of
the
one
of
the
key
figures
in
in
this
report
is
the
237
million
patient
errors
every
year
in
the
nhs,
which
is
a
phenomenal
number,
and
many
of
those
will
cause
harm,
but
it
is
surprising
how
many
of
them
don't
cause
harm,
and
that
must
raise
the
question
about
whether
those
medicines
were
necessary
in
the
first
place
and
and
initiate
this
patient,
understand
the
risks
and
benefits
of
medicines
and
why
they're
on
individual
medicines?
They
will
never
be
true
partners
in
their
own
care
and
true
partners
in
their
own
safety.
A
A
J
J
Peter,
I
think,
there's
that
there's
start
there
is
just
a
slightly
depress
you
less.
If
that's
that's,
there
are
some
good
examples,
emerging
of
the
use
of
technology
to
exactly
to
to
ted
and
rosie's
point
about
how
organizations
work
together
and
also
how
they
work
with
to
give
people
using
those
services
a
a
lead
role
in
how
they
care
for
themselves,
and
there
are
some
really
good
examples
there.
J
There
are
not
enough
of
them,
but
those
that
exist,
I
think,
are
worth
we're,
we're
talking
to
and
tracking
those
examples
as
they
as
they
appear
in
each
in
each
local
area,
and
I
think
there
is
something
about
how
we
understand
why
they,
why
those
examples
work,
what
were
the
environmental
ingredients
that
made
that
made
it
possible
to
do
that?
It's
about
how
we
share
data
information,
it's
about
how
evolved
people
use
services,
it's
about
how
how
organizations
talk
across
their
organizational
boundaries
and
people
talk
across
their
organizational
boundaries.
J
I
Yes,
and
just
to
emphasize
what
chris
was
saying,
I
just
want
to
highlight
a
little
bit
of
best
practice.
I
saw
a
couple
over
the
last
couple
of
weeks,
which
involved
lots
of
different
parts
of
the
system
working
together,
who
were
going
into
people's
homes
and
something
very
simple.
A
complex
care
gp
was
was
leading
down
this.
I
This
work
and
saying
show
us
your
medication
and
asking
people
who
went
into
the
homes
to
show
them
medication
and
they
were
sadly
bringing
back
bag
fulls
of
medication
that
wasn't
taken
clearly,
that's
a
huge
risk
for
error,
there's
also
sustainability
factors
in
terms
of
all
of
that
waste
and
and
cost
factors
as
well
in
terms
of
medication.
I
That
is
not
taken
as
prescribed
and
very
often
that's,
because
people
either
don't
understand
why
they're
on
the
medication,
they
don't
understand
what
they're
taking
it
for
or
or
they're
confused
about
their
medication,
and
I
think
we
this
is
something
we
really
need
to
get
that
focus
on.
But,
as
chris
says,
it
requires
everyone
in
the
system
to
be
working
together
to
tackle
this.
A
And
if
anybody's
interested,
since
we
started
this
discussion,
there
have
been
four
and
a
half
thousand
medicines
errors
in
the
last
10
minutes
on
average.
So
it's
a
big
subject.
We
need
to
come
back
to
it,
but
thank
you
chris
for
the
the
work
are
we
happy
to
move
on
and
mary
you're
extremely
welcome.
We've
been
having
problems
with
the
light,
so
if
the
lights
suddenly
go
out,
mary,
don't
don't
don't
be
concerned
just
carry
on,
but
hopefully
now
you're
here
it
will
all
be
light
and
sweetness.
D
So
peter,
if
I
can
just
say
one
one
intro
before
I
hand
over
to
mary,
so
I'm
really
pleased
to
have
mary
here
today
she
is
our
senior
responsible
officer
for
the
closed
cultures
program
of
work
of
which
surveillance
sits
within
it.
So
we
are
coming
to
board
today
for
a
decision
and
I
will
hand
over
to
mary
now
to
give
you
a
flavor
what's
in
the
paper
and
hopefully
get
a
conversation
going.
Thank
you.
O
Thank
you,
kate
and
good
afternoon,
everyone.
So
this
is
the
arena
about
enhancing
our
approach
and
our
effectiveness
as
a
regulator
for
the
purposes
of
protecting
people
using
services.
O
O
O
This
is
not
about
replacing
what
the
police
do.
We
would
continue
to
work
with
them.
In
those
circumstances,
the
use
of
these
powers
is
itself
subject
to
regulation,
which
is
important
to
note,
and
also
I
wanted
to
stress
that
the
position
I'm
bringing
to
you
today
is
as
the
end
product
of
16
months,
of
both
internal
and
external
engagement
and
discussion,
and
that
includes
discussion
with
other
regulators
about
how
they
use
their
ripper
powers.
O
It
would
enhance
our
ability
to
collect
and
use
evidence
in
the
world
of
unregistered
providers
and
also
increasingly
digital
services,
and
in
very
very
exceptional
circumstances.
Might
we
deploy
a
covert
resource
actually
into
a
service?
O
If
you
say
yesterday,
the
next
stage
would
be
to
develop
a
detailed
business
case
that
would
look
at
the
detailed
requirements,
both
in
terms
of
the
personnel
skill
set
and
digital
resources
and
management
of
the
information
that
would
be
required
to
run
a
rip.
These
powers
to
the
high
standards
that
are
required
also
further
recommending
that
the
board
remit
to
the
detailed
decisions
on
implementation
to
the
exec
team
and,
of
course
we
would
keep
you
closely
informed
at
all
stages.
O
It
is
highly
specialist,
highly
controlled,
highly
regulated
and
that's
important,
because
it
is
a
balance
between
the
collection
of
evidence
and
human
rights
if
we
agree
the
recommendation
today
that
will
meet
the
recommendations
that
glynis
murphy
made
in
her
reports
and
will
enhance
our
ability
in
the
areas
I've
described,
of
unregistered
services,
digital
services
and
exceptionally,
in
those
high-risk
cases
where
we
have
no
other
route
and
that
that
is
the
decision.
I
am
looking
for
and
happy
to
take
any
questions.
A
So
mary,
thank
you,
and
I
think
it's
just
worth
saying
that
this
is
this
is
the
end
of
what's
been
a
lot
of
work,
I
know
there's
another
phase
that
you
go
into
assuming
we
we.
We
agree
your
recommendation,
but
this
isn't
the
first
time
the
board
have
discussed
this
and
got
our
minds
around
it.
You
said
earlier,
you
you've
been
many
times
to
the
board
on
this
and
other
other
related
subjects.
So
I
just
made
that
point
because
I
I
hope
we're
at
a
point.
A
A
F
F
An
extremely
important
subject,
obviously
so
far,
there's
been
a
lot
of
engagement,
not
only
with
the
board
but
lots
of
other
people.
F
A
Chris,
I
think
we
probably
have
done
that.
What
have
we
done,
or
at
least.
J
List
of
things
that's
going
wrong
with
the
technology
today.
Let's
add
this
to
the
list
yeah,
I
think
so.
I
think
what
mary
was
saying
is
that
this
these
are
powers
that
that
we
are
using
the
full
extent
of
our
current
powers
that
we
have
under
under
the
act.
So
there
isn't.
These
are
granted
to
us
by
parliament
so
that
we
we
we're
just
in
a
sense
exercising
our
ability
to,
but
we
have
had
a
number
a
wide
engagement
on
this
topic
over
and
over.
J
I
think,
probably
as
mary's
tone
of
her
her
conversation
with
us
said.
We've
had
a
long
conversation
with
this.
I
think
the
key
thing
to
remember
is
we're
using
the
powers
that
we
have
available
to
us
through
through
the
act
through
to
parliament
and
we've
used
them
in
the
way
that
we
think
is
the
most
beneficial
to
us
as
a
regulator,
but
mary,
you
might
want
to
say
more.
O
A
Thanks
anybody
want
to
raise
anything
else.
So
are
we?
Are
we
happy
to
to
support
the
recommendation?
That's
in
front
of
us
good
all
agreed
excellent
mary.
Thank
you
very
much.
I
know
you've
done
a
lot
of
work
in
this
and
and
we're
really
grateful
it's
an
important
thing
to
have
decided
this
morning
and
and
and
then
obviously,
as
you
say
in
your
paper,
there's
the
next
stage
to
get
to,
but
thanks
very
much.
Thank
you.
A
So
if
we
are
then
happy,
let's
move
on
to
our
provider
mental
health
collaborative
review,
rosie
you're
gonna
introduce
both
the
the
paper
and
and
your
support
team.
I
Yes,
certainly,
and
can
I
welcome
vicky
donner,
who
has
been
leading
the
workcon
provider
collaboration
reviews
for
us,
welcome,
vicky
to
the
board
and
just
I'll
say
a
few
words
and
then
vicki's
going
to
just
outline
the
paper
in
a
little
bit
more
detail.
So
this
is
the
last
of
our
provider,
collaboration
reviews.
I
This
is
really
important
in
terms
of
our
development
and
we
will
be.
We
are
learning
from
all
of
our
provider
collaborative
reviews
and
that
learning
is
going
to
feed
into
the
work
we're
going
to
be
doing
around
integrated
care
systems
going
forward.
So
we
have
been
having
have
been
learning
ourselves
as
we've
been
going
through
this
work
with
relation
to
this
particular
provider.
I
Collaboration
review,
I
think,
we've
all
been
incredibly
concerned
about
the
mental
health
of
children
and
young
people
and
how
it's
been
impacted
during
the
last
18
months
or
during
the
pandemic,
and
so
this
is
a
very
important
area
of
work.
So
I'm
really
pleased
that
we've
been
able
to
have
this
focus
on
this
area
of
work.
With
this
review,
I'm
now
going
to
hand
over
to
vicky
just
to
say
a
few
more
words
and
then
we'll
open
the
floor
up
to
questions.
Thank
you.
P
We
have
also
seen
significant
challenges,
in
particular
around
health
inequalities,
and
there
really
does
need
to
be
improvements
in
health
inequalities,
with
a
much
bigger
focus,
and
there
is
still
a
need
to
reduce
the
silo
working
and
services
providers
working
together,
much
more
collaboratively
to
ensure
better
services
and
care
for
young
people,
and
then
the
final
area
is
around
digital.
So
what
we
do
know
is
that
digital
advancements
has
really
sped
up
during
the
pandemic
period.
It
has
really
benefited
and
brought
multi-disciplinary
team
working
together
better
to
provide
services.
P
We
do
know
that
it
has
enabled
quicker
access
for
young
people
and
children,
but
what
we
do
know
is
that
it
does
not
fit
for
everybody,
and
particularly
when
we
look
at
the
health
inequalities,
young
people
that
are
living
in
more
deprived
areas.
So
again,
that's
something
that
really
needs
to
have
a
much
bigger
focus
and,
as
rosie
touched
upon.
A
Vicky,
I
thought
it
was
a
great
report
and
and
and
yeah
I
I
really
like
that.
The
the
comments
and
the
stories
I
mean
it
brings
the
whole
thing
to
life,
the
good,
the
bad
and
the
ugly
and
it's
it's
it's
a
great
report.
Thank
you
very
much
ted.
G
Yes,
thank
you.
Can
I
just
second
that
it
is
a
great
report
and-
and
can
I
just
congratulate
the
team
on
them-
the
way
that
the
provider
collaboration
review
methodology
has
matured
over
the
last
few
few
times?
I
think
we've
learned
an
awful
lot
from
this
and
I
think
it's
learning
we
can
take
forward
into
our
future
regulatory
approach.
G
I
think
about
a
year
ago
we
published
an
update,
saying
there'd
been
some
commitment,
but
very
little
action
had
had
taken
place
and
I
think
this
report
really
highlights
the
problems
that
that
that
the
the
services
have
faced
undercoved,
but
they
are
not
new
problems.
G
I
should
say
I
was
turkey
talking
earlier
on
about
pressures
on
urgent
emergency
care
and
I
think
one
of
the
more
distressing
parts
of
that
is
the
number
of
children
and
young
people
turning
up
at
a
e
in
mental
health
crises,
and
sometimes
they
spend
long
periods
in
the
accident
emergency
department,
because
no
inpatient
facility
can
be
found
for
them,
and
you
know
patients,
sometimes
young.
These
young
people
are
sometimes
spending
several
days
in
an
a
e
department
waiting
for
an
inpatient
accommodation.
G
E
Mark,
thank
you
chairman,
and
thanks
vicky,
just
echo
what
a
great
report
this
is
just
on
page
82,
on
on
in
our
diligent
pack
it
you
know
you
talk
about
inequalities
and
there's
again
features
this
issue.
E
That's
we
we
hear
quite
a
lot
of,
which
is
that
the
reporting
is
not
done
properly
when
we
heard
this
quite
a
lot
on
the
dna
cpr
work
that
we
did
so
just
wonder
whether
there
is
in
your
view,
something
that
we
can
do
to
shine
a
light
on
the
importance
of
reporting
effectively,
especially
when
we
talk
about
the
importance
of
care,
coordination
and
collaboration
across
care
providers.
I
E
It's
the
third
paragraph
under
equalities
monitoring
data.
We
say
that
recording
of
children
and
young
people's
protected
characteristics
wasn't
properly
completed.
Shall
I
start
with
that?
Mark
and.
I
As
well,
so
I
think
I
think
it
is
vital
that
we
we
do
improve
the
recording
of
a
whole
range
of
protected
characteristics,
so
both
with
children
and
young
people,
but
actually
more
generally
with
all
of
our
populations,
because
I
think
there
is
that
there
are
specific
issues
related
to
ethnicity
or
related
to
sexuality
or
a
whole
range
of
other
issues
that
actually
really
impact
on
the
services
that
people
need
and
the
services.
And
we
really
need
to
understand
that.
I
How
providers,
but
also
systems
and
primary
care
networks
are
looking
at
really
understanding
their
populations
and
delivering
services
that
meet
the
needs
of
the
populations.
That's
going
to
be
very
difficult
if
people
don't
understand
what
their
population
in
the
first
place.
So
I
think
it
is
going
to
be
important
for
us
to
really
think
about
how
we
encourage
better
recording
of
of
protected
characteristics
and
how
we
make
sure
that
going
forward
that
services
provide
both
at
provider
level
and
system
level
really
use
that
data
to
to
really
consider
how
their
services
are
set
up.
J
Just
to
echo
that
point,
there's
some
work
that
the
ons
have
been
doing
around
how
the
regional
variation
between
reporting,
because
it's
a
national
issue-
it's
also
a
regional
and
local
issue
as
well,
and
I
think,
there's
some
work.
We
can
do
with
them,
there's
an
ambition
that
they
have
around,
creating
a
health
and
care
index
for
for
different
areas,
and
it's
built
upon
obviously
data
like
this.
J
But
there
is
a
there's
a
as
rosie
said
there
is
a
and,
as
it
says
in
the
report,
there
is
a
there
are
differences
in
the
way
this
data's
information
is
captured.
I
think
there's
something
we
can
do
working
with
them
to
sort
of
highlight
the
variation
about
how
it's
reported
well
and
where
it
isn't,
and
also
to
guide
ics's
and
other
organizations
responsible
for
regional
health.
To
take
this
into
account
because,
as
ted
said,
these
services
should
be
built
around
people
that
use
them,
and
I
think
the
start
point
of
that
is.
J
A
Okay,
so
I
think
everybody's
spoken
said
what
a
great
report
it
was.
I
therefore
assume
that
the
board
is
happy
that
we
publish
this
report,
which
we
will
do
with
the
board's
agreement
immediately
after
this
meeting
so
vicky.
Thank
you
very
much.
Thank
everybody
else.
That's
been
involved
in
producing
this
and
thanks
to
you,
rosie
as
well.
Thank.
P
A
Great
good,
so
that
is
the
end
of
the
meeting
other
than
if
there
is
any
other
business
anybody
wants
to
raise.
A
A
I
I
think
ted,
and
I
will
do
a
quick
double
act
on
this,
if
that's
okay,
so
just
I
think
we
have
answered
this
question
before,
but
just
in
terms
of
primary
care
and
vaccinations
being
delivered
in
primary
care.
We
continue
with
our
risk-based
approach.
So
we
are,
we
are
looking
out.
We
follow
up
any
concerns
that
are
raised
about
vaccination
in
primary
care.
We
on
our
inspections.
We
look
at
vaccinations
and
systems
in
place
clearly
in
primary
care.
Vaccination
is
not
new
for
years.
I
Primary
care
has
been
running
a
whole
range
of
programs
in
vaccinations
such
as
flu
and
the
childhood
immunisation
program.
So
it
is
something
that
they
are
very
familiar
with
and
something
our
inspectors
are
very
familiar
with
when
they,
when
they
are
inspecting.
So
we
don't
have
a
specific
arrangement
around
covid
vaccination,
but
we
are
following
up
any
concerns
and
using
a
risk-based
approach.
G
We
developed
last
summer
a
structured
assurance
tool
for
the
mass
vaccination
centers
and
we
we
spoke
to
each
of
them
and
continue
to
do
so
to
ensure
that
they
have
the
right
assurance
in
place
to
ensure
safety
in
their
centers.
And,
of
course,
we
follow
up
any
risk,
that's
identified,
so
we
have
an
ongoing
process
of
of
assessing
them,
and
I
I
just
to
pay
real
tribute
to
the
way
the
centers
were
set
up
and
I
think
our
flexible
approach
to
regulation
helped
them
operate
quite
quickly,
which
is
is
to
be,
I
think,
celebrated.
A
I
agree
thanks
ted
and
then
the
the
second
question
from
robin
is
what
can
cqc
do
to
improve
the
subtitles
for
their
public
board
meetings?
Members
of
the
public
with
hearing
disabilities
have
difficulty
following
proceedings
mark.
M
You
and
it's
an
excellent
question.
Accessibility
is
a
very
important
issue.
It's
worth
noting
that
we've
always
had
subtitles
available
on
our
recorded
board
meetings
and
the
live
streaming
is
something
a
recent
service
that
we've
introduced
and
we
have
plans
to
to
to
introduce
subtitles
for
for
the
live
streaming
in
the
very
near
future.
M
It's
worth
noting,
there's
an
awful
lot
of
work
that
we
we
do
focus
on
around
accessibility,
both
internally
and
externally,
and
another
example
of
some
work
that
we've
launched
recently
is
the
new
british
sign
language
only
service
that
we've
launched
for
our
our
contact
center,
which
allows
anybody
who
can
communicate
only
with
pretty
sign
language
to
to
to
communicate
with
us
in
the
through
a
new
kind
of
live,
live
bsl
service.