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From YouTube: CQC Board Meeting - December 2022
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A
Okay
well
good
afternoon,
colleagues
and
good
afternoon
to
anybody
watching
this
live
web
stream
of
the
public
board
meeting
of
the
Care
Quality
commission
for
those
on
the
recording.
This
is
the
14th
of
December
and
it's
shortly
after
1
30
in
the
afternoon
as
a
consequence
of
the
rmt
industrial
action.
We're
having
to
do
this
as
a
virtual
meeting,
I'm
afraid,
rather
than
the
planned
physical
meeting.
A
The
technology,
as
you
know,
now,
works
very
much
better,
but
inevitably
a
lot
of
people
are
dotting
it
from
home,
and
we
have
found
we
get
occasional
issues
of
of
freezing.
So
there's
nothing.
We
can
do
about
that.
A
A
I
have
no
apologies
from
my
colleagues
I
believe
we
are
a
full
house
here.
If
I
could
mention
a
few
people
who
are
joining
us
today.
As
regular
listeners
will
know,
we
do
always
have
a
representative
from
our
big
quality
networks
today.
We're
pleased
to
welcome
Paul
Kirby
who's,
the
quality
representative
of
this
month
and
a
couple
of
names
I
should
mention.
I
will
return
to
this
at
the
end
of
the
meeting,
but
this
is
Sally
cheshire's
last
board.
A
Meeting
I
think
we
announced
previously,
but
for
everyone
stood
out.
Sally
was
appointed
as
the
chair
of
NHS
resolution
a
few
months
ago,
and
that
is
a
two
to
three
day
a
week
commitment.
So
we've
agreed
that,
sadly,
for
us,
we'll
release
Sally
earlier
from
the
board
and
she
stands
down
at
the
end
of
this
year
and
then
also
picking
upon
me,
Rebecca
Lloyd
Jones
has
been
a
Stallworth
of
the
organization.
A
I
believe
you
know
we'll
come
back
to
that
later
on
as
well,
but
she
is
retiring
from
CQC,
and
so
this
will
be
the
last
meeting
that
she
will
attend.
It's
probably
also
worth
mentioning
that.
Last
time
we
had
a
board
meeting
I
believe
Jorah
was
still
on
the
board
as
a
non-executive
director.
His
term
expired
if
it
is
very
kindly
agreed
to
accept
appointment
as
an
associate,
not
executive
director,
so
you're
still
joining
us
today.
So
these
were
able
to
organize
that.
A
Can
I
just
confirm
that
there
are
no
new
conflicts
of
interest.
I
don't
seem
to
be
any.
We
have
no
additional
urgent
business.
That's
been
notified
to
us,
so
we'll
stick
with
the
agenda.
It
is
quite
a
crowded
agenda
and
there
are
a
number
of
things
on
it
that
are
put
down
as
to
note,
but
in
practice
we
would
expect
that
the
board
will
be
in
agreement
with
or
if
not
commenting
on,
the
proposals
put
forward
to
us.
A
A
It
was
suggested
it
might
be
helpful
just
to
get
a
very
brief
update
on
board
appointments,
but
in
fact
there
isn't
much
I
can
say
I've
already
referenced.
The
fact
that
Jorah
has
stood
down
will
be
back
into
different
guys.
That
Sally
goes
at
the
end
of
this
month,
and
Mark
Saxton's
term
will
come
to
an
end
at
the
end
of
February,
so
that
we
have
been
doing
a
recruitment
exercise.
A
One
of
those
is
to
replace
Robert
Francis.
As
the
chair
of
healthwatch
England
I,
say
we
sorry
that
would
make
it
clear.
This
is
all
run
by
the
Department
of
Health
and
Social
care,
only
all
for
ministers,
so
seeking
replacement
for
Robert
Francis
as
chair
of
HW.
We
and
his
role
is
ex-officio
a
member
of
this
board
and
then
also
to
replace
others
who
are
leaving
when
we
set
off
on
that
exercise.
A
Sally
hadn't
been
appointed
to
NHS
resolution,
so
we
weren't
looking
for
an
audit
committee
chair
at
the
stage.
So
basically
an
exercise
is
being
run.
We've
completed
interviews
for
the
hwe
chair
and
two
other
LEDs
that
is
in
process
I'm,
not
able
to
give
any
more
information.
A
The
department
obviously
will
put
up
submissions
to
ministers
in
a
normal
way,
and
then
we
have
agreed
a
job
description
for
a
replacement
for
Sally
as
the
our
actor,
and
that
is
likely
to
go
live
I
doubt
it
will
happen
now
before
Christmas,
but
the
certainly
the
bulk
of
the
vertical
period
will
be
in
the
new
year
and
we
hope
to
make
an
appointment
sometime
in
the
first
half
of
New
Year.
But
that
will
leave
us
as
Sally
stands
down
with
a
temporary
position
to
fill
as
chair
of
the
audit
committee.
A
So
we
have
agreed
that
we'll
have
a
joint
committee
joints
here.
Sorry
over
the
committee,
one
is
Mark
Saxton
who's
already
a
member
of
the
committee
and
the
longest.
Only
member
of
our
board
and
the
other
Jeremy
boats
who's
the
an
independent
member
but
very
experienced
audit
Committee
Member,
and
he
will
take
over
as
the
The
Joint
chair.
So
between
the
two
of
them
they
will
oversee
the
effect
of
running
of
the
audit
and
risk
Assurance
committee
until
salah's
replacement
is
in
place.
A
So
that's
all
I'm
able
to
say
at
the
present
time,
but
we
thought
it
might
be
helpful
to
update
those
of
you
on
this
call
and
also
anybody
listening
so
I
think
that's
by
way
of
the
introductions
and
welcomes.
So,
let's
get
straight
on
with
the
main
agenda.
The
first
is
we're
going
to
consider
the
pulse
survey,
or
this
is
the
survey
that
was
carried
out
of
our
staff
a
couple
of
months
ago
now
I'm
going
to
ask
Kate
turoni
Kate.
A
If
you
could
introduce
this
item
and
then
introduce
your
colleagues
as
usual,
we
have
read
the
papers,
but
I'm
sure
there
are
points
you'd
want
to
highlight
before
we
go
into
discussions.
Thank
you.
Thanks.
B
Ian
and
good
afternoon
all
so,
you
would
have
seen
our
pulse
baby
results.
This
whole
survey
occurred
during
September
and
October
of
this
year.
I
think
it
would
be
fair
to
say
it
makes
for
quite
tough
reading
for
us
in
the
leadership
roles
at
CQC.
Our
colleagues
have
very
clearly
given
us
some
strong
messages
about
how
they
feel
we
deliver
change
around
here,
how
they
feel
about
working
in
the
organization
how
they
feel
about
how
we
focus
on
well-being
of
staff
and
I.
B
Think
it's
really
important
that
we,
we
don't
label
this
as
just
just
a
reaction
to
significant
management,
a
change
that
a
large
number
of
our
colleagues
have
gone
through.
I
think
there
are
wider
messages
in
there
for
us
as
well.
B
It's
worth
flagging
that
engagement
continues
to
be
really
high,
so
staff
continue
to
engage
with
us
to
tell
us
what
they
think
we
need
to
be
doing
better
as
an
organization,
so
we've
got
79
engagement,
scores
which
I
know
for
many
other
organizations.
That's
a
that's
a
thing
to
Aspire
to.
There
is
also
some
good
news
in
there
around
how
Staff
feel
empowered
to
do
their
job
to
make
decisions
to
deliver
their
role
effectively.
So
so,
there's
good
engagement
scores
some
good
messages
around
our
colleagues
feeling
empowered
to
do
their
role.
B
However,
there
are
some
very
strong
messages
about
how
they
feel
at
the
moment
in
the
organization
I
think,
particularly
around
change.
So
so
we
as
an
exec
team,
were
really
Keen
that
we
didn't
leap
into
action,
but
that
we
we
take
a
different
approach
to
how
we
respond
to
this
people
survey
and
really
use
the
expertise
of
our
our
colleagues
to
help
shape.
B
What
other
you
know,
top
five
actions
we
might
need
to
take
going
forward,
for
example,
so
Jackie
Jackson
is
our
infant
people
director
who's
joining
this
session
today,
as
is
Paul
bunham,
who
is
our
head
of
organizational
development,
who's
helped
with
the
pulse
survey,
so
I'm
just
going
to
ask
Jackie
and
then
Paul
to
talk
about
the
action
and
the
next
steps
and
then
we'll
hand
back
to
you,
chair
for
comments.
B
C
Thanks
Kate
I'm
actually
going
to
ask
Paul
to
lead
off
on
this
conversation
because
he's
been
very
close
to
the
activity
and
then
I
can
contribute,
as
well
as
the
conversation
progresses.
Thank
you
thank.
D
You
Jackie
thank
you
Kate,
so
you'll
note
from
the
paper
that
our
plan
is
to
put
in
place
a
pulse
survey,
Advisory
Group
and
just
by
way
of
an
update
on
that,
we
have
recruited
all
30
members
to
the
Past
survey.
Advisory
Group.
We
actually
had
over
100
applications
to
take
part
in
the
group,
which
I
think
is
quite
positive.
Sign
that
people
are
wanting
to
engage
with
this
conversation.
D
Give
you
an
idea
of
the
makeup
of
the
group.
It
will
be
30
colleagues
drawn
from
all
the
key
areas
of
the
business
and
the
cross-section
of
grades
within
that
group.
There'll
also
be
representation
from
our
staff,
equality
networks
and
from
trade
unions.
D
Give
you
a
sense
of
what
the
group
will
be
doing
and
the
timeline
in
in
January
will
be
supporting
members
of
the
group
to
have
conversations
within
their
own
local
area
of
the
organization
to
review.
The
survey
results
for
that
area
of
cgc
and
the
aim
will
be
that
by
the
end
of
January
directorates
will
have
identified
three
priority
areas
around
which
they
can
form
an
action
plan
and
the
the
group
will
also
come
together
in
February
to
identify
five
areas
of
priority
for
a
corporate
level.
D
And
the
aim
is
the
action
plans
for
directors
will
be
in
place
in
February.
The
action
plan
at
corporate
level
will
go
to
executive
team
in
February
and
will
be
in
place
by
March
and
then
we'll
be
further
supporting
colleagues
to
work
with
leaders
and
areas
of
the
business
that
are
particularly
implicated
in
in
the
Improvement
actions
to
deliver
those
action
fans.
E
Should
I
speak
in
yeah,
so
I
I,
just
just
just
to
reinforce
some
of
the
things
that
Kate
said
I
think
there
was
a
very
big
theme
around
listening
in
the
survey
and
also
having
having
gone
through
a
lot
of
the
free
text.
Comments
I
think
there
was.
There
was
definitely
a
theme
around
a
changing
relationship
between
between
the
people
working
in
organization
and
organization,
I.
E
Think
as
we
come
out
of
covid,
this
sort
of
work-life
balance,
question
is
becoming
much
more
blurred
and
and
much
much
more
nuanced
than
perhaps
it
has
has
been
in
previous
years.
So
this
is
why
this
this
this
Advisory
Group,
is
so
important
because
it
enables
us
to
get
into
the
quite
sophisticated
conversations
that
we
need
to
have
I
think
I
think
there's
a
real
risk
for
us
as
a
senior
team.
E
If
we
just
do
one
or
two
headline
things
and
think
that's
done,
that
would
be
the
wrong
answer
and
that's
why
I
think
this?
This
quite
sophisticated,
that's
quite
sophisticated
point
about
about
the
advisor
group
is
important.
We
are
also
doing
a
number
of
other
things,
a
number
of
of
specific
things
around
continuing
with
the
the
big
calls
that
we've
had
on
on
these
in
these
virtual
settings,
but
I
think
it's
also
clear
to
me
that
we
wanted.
We
need
to
do
more
face-to-face
activity
as
well.
E
E
There's
a
there's
a
lot
of
sophistication
in
this
and
and
on
top
of
that,
I
think
at
this
point
that
different
directors
of
different
teams
are
are
in
different
places
and
I
think
that
the
variation
in
across
the
different
that
across
the
different
teams
is
also
is
also
quite
Stark
and
I.
Think
there's
definitely
a
there's.
Definitely
some
some
positives
around
some
of
the
things
that
some
of
the
teams
that
are
off
further
along
the
change
Journey
have
experienced.
E
But
that
said,
I
think
even
those
teams
have
got
some
have
got
some
things
they're
concerned
about
so
hence
the
the
approach
to
listening.
So
thanks.
A
Okay,
well,
thank
you.
Thanks
for
chipping
it
I
was
unable
to
unmute
my
microphone.
Apologies
for
that
we
do
have
a
number
of
questions.
Mark
Chambers!
Thank
you!
Well,.
F
I
I
think
you
have
a
huge
opportunity
with
79
participation
rate
I.
Think
that's
the
you
know,
that's
the
most
gratifying
part
of
of
this
and
it
and
and
it's
a
tremendous
credit
to
everyone
in
the
organization
that
they
have
taken
the
time
to
to
share
their
views.
This
truly
reflects
the
results,
reflect
the
the
views
of
the
organization
and
they
are-
and
you
know,
they're
so
much
more
actionable
as
a
result.
F
I
think
the
responses
is
is
is
is:
is
right,
you're
avoiding
a
lot
of
the
dangers
from
from
results
which
are
a
disappointment
of
of
trying
to
rationalize
them
away
as
a
as
as
a
moment
of
time
or
jump
to
conclusions
as
to
the
root
cause
you
know
or
to
sort
of
declare
instant,
Victory
and
and
say:
well,
yes,
but
what
we've
done
since
has
has
completely
changed
the
the
game.
I
I
think
it's
a
it's
a
measured
and
entirely
appropriate
response
to
take
time
to
listen
and
properly
understand
the
results.
F
I'm
glad
you
mentioned
the
free
text
comments
in
because
those
are
those
are
always
take
you
to
an
understanding
that
the
raw
scores
can't
aren't
do
I.
You
know,
I
I,
think
it's
key,
that
the
action
plan
really
does
focus
on
the
small
number
of
key
actions
that
the
small
number
of
of
key
insights
that
are
going
to
then
drive
actions
for
improvement.
F
I
think
that
you
know
the
danger
is
with
with
a
lot
of
in
input
that
you
end
up
with
a
with
a
laundry
list
of
things
to
do
and
I
think
that
would
be
a
mistake.
I
think
the
you
know.
The
answer
here
is
to
focus
on
the
four
or
five
things
that
are
really
going
to
move
move
the
needle
on
this,
but
like
I
commend
the
team.
F
I
think
this
is
I
think
the
response
to
this
has
been
has
been
very
appropriate
and
it
feels
very
different
to
the
the
you
know
and
and
a
a
quality
response
to
you
know
compared
to
you
know,
I
I
think
but
respectfully
say
some
of
the
approaches
that
that
in
in
the
past,
not
that
those
were
wrong.
But
I
think
you
know
this
is
there's
a
quality
of
insight
here
and
there's
no
and
there's
a
commitment
to
understand
and
listen
actively,
which
I
think
will
land
very
well.
G
Yeah,
thank
you.
I
agree
with
Mark
and
I
just
wanted
to
go
back
to
the
Nuance
that
Ian
trenhorn
talked
about
before,
so
we
have
talked
about
having
a
Workforce
who
feel
they
are
trusted,
empowered
and
confident
and
I.
Think
within
those
three
values.
G
There
is
quite
a
lot
to
be
positive
about
people
clearly
feel
they
have
autonomy
in
their
jobs.
They
have
flexibility
to
do
that.
They
are
empowered
to
do
what's
a
very
serious
role,
inspecting
Health
and
Social
care
providers.
G
There
are
some
things
around
them,
perhaps
not
feeling
in
control
of
their
own
situation,
which
is
somewhat
inevitable
in
a
time
of
change,
but
that
they
don't
feel
they've
got
the
power
to
either
effect
change
or,
in
some
cases,
potentially
control
their
workload.
G
The
bit
that
I
think
we
can
help
them
with
as
they
go
through
this
process
of
change,
because
clearly
some
people,
for
example,
in
data
and
insights,
have
come
out
of
the
other
side
of
a
difficult
process
is
to
concentrate
on
how
our
employees
feel
valued,
because
I
think
that
was
one
of
the
things
that
came
out
so
I
wondered,
if
there's
anything
more
to
say
on
that,
or
just
that.
As
part
of
the
listening
exercise,
you
will
ask
people
how
we
can
do
more
to
make
them
feel
valued.
A
So,
let's
take
there,
aren't
there's
only
one
more
so
answer
that
one
now
and
we'll
take
the
next
one.
C
C
So
that
is
plotted
into
store
in
January
to
you
know,
kick
off
the
work
that
we
had
to
pause
in
order
to
make
the
the
pay
award
at
the
end
of
the
year.
Also
looking
at
how
we
can
do
you,
peer-to-peer
recognition
and
reward
and
and
be
able
to
think
about.
You
know
out
of
the
box
what
is
out
there
in
the
marketplace,
what
is
really
Innovative?
C
What's
new
and
what's
up
and
coming
and
I
think
will
probably
have
been
a
bit
slow
to
do
that.
So
certainly,
Paul
and
I
have
been
having
discussions
around
looking
to
Benchmark
with
other
organizations
where
it's
not
all
around
the
the
monetary
value.
C
A
Okay,
thanks
Jackie
a
number
of
other
comments,
so
let's
keep
going
Stephen
Marston.
H
Thank
you,
Ian,
and,
and
thank
you
very
much
for
the
paper
like,
like
others,
I
happy
to
endorse
the
the
approach
proposed,
particularly
welcome
the
setting
up
of
the
focus
group.
H
I
do
think
that's
an
important
initiative
and
an
important
signal
to
the
organization,
because
one
of
the
aspects
to
this
seems
to
me
the
need
to
sort
of
keep
thinking
hard
about
how
effective
communication
is
handled
throughout
the
organization-
and
this
is
a
I
guess-
maybe
a
source
of
a
bit
of
frustration,
because
I
know
the
leadership
team
has
worked
incredibly
hard
to
communicate
actively
regularly
and
well,
particularly
about
the
transformation
program
and
the
whole
strategy.
H
But
it
is
also
one
of
the
areas
of
of
biggest
all
in
the
results.
People
still
saying
that
they
don't
feel
particularly
well
informed.
So
there's
a
there's,
a
mismatch
that
you
see
in
many
organizations
between
a
really
a
genuine
attempt
to
communicate,
but
with
large
numbers
of
Staff
still
feeling
yeah,
but
I
still
don't
feel
fully
informed
or
engaged
or
part
of
developing.
This
whole
story,
so
I'm
just
kind
of
interested
in
in
any
any
thinking
about.
What
is
this
telling
us
about
future
approaches
to
communication?
A
number
of
colleagues
have
already
noted.
H
Well,
actually,
it's
really
important
to
listen
well
to
show
that
we're
listening
carefully,
because
that's
part
of
a
genuine
two-way
communication
too
and
I'm
just
sort
of
putting
a
bit
of
emphasis
on
trying
to
understand.
Well
where,
where
might
we
go
in
terms
of
more
effective
communication
of
the
whole
change
program?
That's
going
on
in
the
organization?
Thank
you.
B
If
I
could
kick
off
and
I
think
Ian
and
Chris
want
to
come
in
on
this
same
item
as
well,
if
that
that's
okay
and
so
Stephen
I
think
when
I
look
back
about
how
we've
communicated
the
changes
to
date,
I
think
there
has
been
quite
a
strong
emphasis
on
us
giving
a
message
into
the
organization.
So
we've
made
a
commitment
to
Endeavor
to
always
brief
senior
to
kind
of
cascade
our
messages,
so
that
managers
can
support
their
teams
when
they
when
they
hear
that
news.
B
So
the
consequence
of
that
is,
there
have
been
a
number
of
kind
of
you
know.
Maybe
monthly
broadcasts
where
Ian
or
I
or
other
colleagues
will
will
jump
on
a
call
with
after
large
numbers
of
people
and
deliver
the
message,
and
the
benefit
of
that
is
that
everyone
hears
the
same.
B
You
know
broadly
the
same
message
at
the
same
time
and
we
know
what's
being
delivered,
I
think
on
the
flip
side,
it
doesn't
enable
those
kind
of
small
groups
to
come
together
and
ask
questions,
and
so
I
I
and
then
Chris
will
come
in
now
we
are.
We
are
currently
actively
looking
at
how
we
take
a
different
approach
going
forward,
which
is
much
more
around
empowering
and
Tyson's
been
doing
it
in
his
networks,
where
there
is
more
or
ownership
and
those
messages
coming
out
more
from
within
you
know.
B
The
operations
group
within
the
network
directors,
rather
than
kind
of
all
colleague,
broadcasts
that
we've
done
today,
I
think
there
was
I
still
feel
I
still
support
our
rationale
as
to
how
we've
done
it
at
the
start
of
the
transformation,
because
it's
really
important
that
people
heard
the
same
kind
of
messages
but
I,
but
we
need
to
adapt
our
style
going
forward.
I
One
is
a
general
point
about
making
sure
that,
as
we
as
we
continue
the
communication
engagement
internally
and,
in
fact,
externally
we're
making
a
strong
link
back
to
what
is
changing
and
the
and
the
benefit
that
goes
back
to
our
purpose,
so
it
sorts
of
goats
so
we're
linking
the
changes,
the
the
the
implications
of
the
changes
and
how
that
delivers
on
the
strategy
and
back
to
our
purpose
and
then,
as
Kate
said,
I
think
sometimes
we've
we've
wanted
to
make
sure
everybody
gets
so
message
at
the
same
time.
I
I
think
that's
there's
logic
to
that,
but
I
think
equally
it's
important
that
people
who
manage
people
feel
able
to
and
responsible
for
the
engagement
with
their
team,
so
they
can
make
it
come
to
life
for
the
people
that
they
they
look
after
and
I
think
often
we've.
We
treat
everybody
as
a
as
a
as
an
important
colleague
and
we've
and
we've
We've
engaged
everybody
at
the
same
time.
I
I
think
that
the
part
of
the
change
that
we're
trying
to
make
is
how
do
we
equip
people
who
manage
people
so
that
they
understand
what
we're
trying
to
do
as
a
as
a
as
a
group
and
that
they
feel
able
to
have
conversations
with
their
team,
so
they
can
bring
to
life
the
changes
for
their
team
I.
Think
part
of
this
is
about
how
we
make
it.
I
You
know
come
to
life
if
you're
working,
our
national
call
center
or
if
you
work
in
our
registration
team
or
if
you
work
in
finance,
because
it
will
it'll
be
it'll,
mean
different
things
to
different
people
alongside
obviously
our
our
inspection
and
other
regulation.
Colleagues,
so
I
think
part
of
the
challenge
is
making
sure
we
can
link
back
to
purpose
and
strategy
and
making
sure
that
managers
or
people
that
manage
people
our
confidence
in
the
conversations
that
they
need
to
have
with
their
team.
A
E
To
other
questions,
same
same
sort
of
answers,
I
think
I
think
we
will.
We
will
continue
to
need
to
make
I
feel
like
Mass
broadcast
announcements
on
some
things
in
order
to
make
sure
the
people
that
everyone
knows
the
same
thing
at
the
same
time,
but
it's
this
also
worth
worth
remembering
that
just
under
half
of
our
Workforce
for
inspectors
and
the
other
half
of
our
Workforce
do
other
things
as
Chris
was
describing
so
sometimes
what
we're.
E
What
some
of
these
some
of
the
mass
communications
are
talking
about
are
only
of
interest
to
one
particular
community
of
people.
E
And
and
some
of
the
times
when
we're
making
mass
communications,
we
are
we're
only
talking
to
we're
we're
talking
something
which
is
only
by
definition,
going
to
be
of
major
interest
to
one
community
of
people
or
or
another
I.
Think
there's
also
something
about
about
this.
This
takes
a
long
time,
I
think
when
we
started
out
with
the
out
with
this
with
the
transformation
program,
we
talked
about,
transforming
the
whole
organization
and
I
think
there's
a
slight
glibness.
E
Sometimes
when
people
talk
about
transformation,
whereas
actually,
when
I
talk
to
other
people
outside
the
organization
around
what
we
are
engaged
in,
they
are
sort
of
utterly
utterly
incredulous
about
the
amount
of
change
that
we
are
undertaking,
we're
changing
our
methodology.
E
Our
technology
stack
we're
moving
people
massively
around
between
between
teams
and
keeping
everybody
up
to
speed
on
all
of
that
and
being
able
to
reflect
back
everybody's
voices
as
we
are
changing
the
entire
organization
over
an
extended
period
of
time
is,
is
a
challenge
and-
and
you
know,
I
think
we-
we
need
to
keep
looking
looking
hard
at
how
we
can
how
we
can
improve
what
we
do
and,
of
course,
overlaying.
E
All
of
that
with
the
fact
that
that
we
haven't
got
as
much
face-to-face
contact
as
as
would
be
ideal
and
I.
Think
that
would
that
would
be
helpful
so
again,
I'm
hoping
that,
in
terms
of
going
forward,
we
we
can.
We
can
build
on
some
of
the
messages
that
this
survey,
this
survey
is
giving
us
because
I
think
there's
a
lot
of
important
work
here,
but
I
do
think.
We
also
need
to
think
about
how
this
plots
into
the
length
of
time
it
it
will
inevitably
take
to
transform.
Thank
you
thank.
A
You
last
couple
of
questions
mark
Saxton,.
J
Thank
you
chairman
and
Paul
and
Jackie
thanks
for
bringing
this
report
to
us
and
some
of
the
top-line
information
that
that
you've
given
us
for
for
this
meeting
I
guess
there
are
two
areas
that
really
struck
me
in
the
data
that
you
provided.
One
was
the
big
fall
off
in
health
and
well-being,
which
was
a
a
major
reduction
versus
our
last
survey,
and
you
know
I
know
that
I
know
that
it's
been
a
positive
response
in
some
areas,
but
it's
a
very
significant
fall
off
and
I.
J
Just
wonder
whether
you
you
could
comment
on
that.
The
second
area
that
I'd
like
to
just
look,
you
know
get
your
comments
on
is
recommended
as
a
place
to
work,
and
that's
very
interesting.
Isn't
it
is
it
not
in
that?
You
know
on
page
to
lean
forward
to
read
29
of
of
our
pack.
J
We've
seemed
to
have
had
a
dramatic
shift
in
this
between
this
survey
and
the
last
survey
from
strongly
agree
and
agree
as
recommending
CQC
as
a
good
place
to
work
to
shifting
to
strongly
disagree
and
disagree,
and
just
you
know
wonder
if
you
could
give
some
comment
on
that
and
finally
I
think
the
survey
Advisory
Group
is
great.
I.
Think
it's
terrific,
that
is,
you,
you've
been
able
to
get
a
good
representation
across
the
business
for
that
I.
J
Just
wonder:
Paul
whether
and
I'm
sure
you're
not
giving
too
much
of
a
steer,
because
the
the
advantage
of
the
survey
group
is
that
people
come
to
you
with
what
they
think
needs
to
be
done.
But
I
wonder
whether
there's
going
to
be
any
sort
of
suggestion
are.
Are
there
any
other
areas
that
people
feel
in
this
survey
group
that
we
should
be
asking
about.
A
Paul,
do
you
want
to
have
a
first
go
out
of
that
and
I
see
Tyson's
got
his
stand
up
so
I
might
ask
him
to
comment
before
we
come
back
to
Jorah,
but
Paul
yeah.
D
No,
so
thank
you
Mark,
so
yeah
I
think
on
the
the
recommend.
Cqc
is
a
good
place
to
work.
We
did
hit
as
quite
a
lot
of
organizations
did
during
the
pandemic.
We
hit
quite
a
high
and-
and
it
has
plateaued-
probably
a
more
stable
level,
which
is
probably
more
realistic
in
terms
of
our
expectations
for
a
number
of
months,
but
a
number
of
surveys
at
this
one
it
has
dropped,
which
I
think
is
a
reflection
of
some
of
the
the
scores
in
other
items.
D
So
if
there's
a
combined
effect
of
of
the
other
messages
that
people
are
giving
us
I,
think
you're
right,
I
think
we
we
do
need
to
be
cautious
about
directing
the
group,
but
I
think
we're
in
the
past.
Perhaps
we
haven't
made
a
strong
enough
connection
is
that
there
have
been
quite
a
range
of
improvements
put
in
place
in
the
organization
that
have
launched
from
survey
feedback
and
what
we
potentially
haven't
done
is
close
the
loop
in
making
sure
people
understand
that
activity
started
as
a
consequence
of
their
feedback
and
I.
D
Think
we
I
think
people
plan
was
on
the
on
the
agenda
earlier
on
and
that's
that's
a
good
example.
A
lot
of
what
we
do
in
the
people
directorate
is
is
in
response
to
what
people
tell
us
about
the
way
they
feel
about
the
organization,
so
I
think
when
we
for
when
we
bring
the
group
together.
D
One
of
the
things
that
we
will
be
able
to
do
is
to
have
an
open
conversation
about
things
that
are
already
in
frame
and
and
and
seek
their
feedback
into
how
we
can
build
on
that
I
think
in
terms
of
themes,
I
think
there
are
some
fairly
clear
demand
signals
from
the
organization
around
communication
around
change.
J
J
A
Tyson,
do
you
wish
to
add
anything
if
you
could
be
brief,
if
you
could,
because
we're
running
over
that
of.
K
K
I
think
it
was
partly
because
of
the
pace
at
which
we
were
working
and
I
think
also
partly
because
they
felt
this
links
back
to
the
not
being
listened
to
comment
they
didn't
feel
empowered
to
or
have
they
ever
have
any
license
in
order
to
make
change,
I
think
there's
a
number
of
things
we
can
do
going
forward.
K
We
need
to
promote
the
the
tools,
the
the
well-being
tools
that
are
out
there
already,
and
we
probably
should
have
done
more
of
that
if
we
went
along
but
also
I,
think
people
had
also
had
to
deal
with
things
that
were
going
on
in
their
private
life,
but
also
very
busy
workload
fields
and
increasingly,
particularly
our
Inspection
Team,
for
managing
more
risk.
We're
managing
more
enforcement
and
I.
Think
all
of
that
together
was
a
com,
was
a
combination
of
factors.
A
But
thanks
so
much
Tyson
joro
I
make
this
last
comment.
If
I
could
yeah.
L
We'll
Tyson
and
Mark
covered
the
point
around
mental
well-being.
I
think
people
have
been
through
a
lot
over
the
last
few
years,
not
only
the
covert,
but
now
we
find
ourselves
in
the
cost
of
living
situation,
so
I
think
all
those
external
factors
and
then
a
massive
change
internal.
It
seems
that
you
know,
although
we
don't
see
it,
but
maybe
people
are
getting
it
to
that
change
fatigue
because
their
lives
are
changing
constantly,
so
so
I
so
I
think
Tyson
made
that
point
sort
of
really
well.
L
It
was
interesting
to
see
the
tech
and
data
side
of
things
really
be
quite
positive,
but
then
I
was
thinking
technology
and
data.
They
live
for
Change
and
that's
what
their
their
lives
are
all
about,
but
also
I,
think
they're.
Also
part
of
the
change
so
they're,
actually
determining
the
change
and
and
I
think
it
would
be
interesting.
L
A
But
there's
probably
more
a
comment
than
the
question:
unless
there's
anything
the
expects
want
to
to
say
well,
look
the
let's
sort
of
wrap
this
discussion
up.
I
had
a
comments,
but
my
colleagues
will
made
them.
I
I
would
just
emphasize
a
couple
of
things
myself.
I
mean
this
clearly,
you
know
nobody
would
return
this
as
a
great
set
of
results,
but
I
do
think
the
organization
and
the
culture,
the
the
executive
leadership
deserve
credit.
A
It
would
have
been
very
easy
to
propose
that
we
deferred
the
survey
because
it
was
done
at
the
the
height
of
period
of
uncertainty,
I
suppose.
But
you
know
there
was
no
proposal
to
do
that.
A
A
That
said,
obviously,
you
know
there
is
quite
a
lot
to
be
done.
Just
the
example
of
openness,
I
would
say,
but
also
other
points
made,
that
I've
had
a
couple
of
direct
approaches
from
staff.
You
know,
as
the
chair
could
could
something
be
done.
A
The
most
recent
one,
the
very
way
the
questions
were
phrased,
showed
that
there
was
a
misunderstanding
of
what
was
proposed,
but
I
mean
there's
been
no
hesitation,
I
passed
it
on
to
Tyson
and
he's
going
to
to
meet,
to
explain
in
more
detail
what's
happening
so,
but
there
is
that
degree
of
responsiveness,
so
I
think
management
deserve
credit
for
that
I
I,
just
from
a
personal
perspective
and
experience
I
I'm
emphasized
as
well.
The
point
Ian
made
that
I
think
trying
to
do
this
in
a
virtual
environment
is
incredibly
difficult.
A
Not
many
organizations
have
done
such
a
relatively
major
transformation,
since
we
all
had
to
turn
to
much
more
homework
and
doing
it
virtually
so
I'm
sure.
There's
lessons
to
be
learned
there
for
both
Us
and
other
organizations.
There's
clearly
more
to
to
look
at
so
I
expect.
This
would
come
back
what
probably
in
March
Kate.
Would
that
be
right.
B
And
come
back
in
springtime
and
provide
an
update,
so
we
want
The
Advisory
Group
to
get
established,
deliver
a
set
of
recommendations
and
for
us
to
have
some
of
those
in
training
so
that
we
can
give
you
kind
of
a
concrete
update
on
the
actions
we've
taken
as
a
result
of
that.
Okay,.
A
Well,
thanks
very
much
Paul
I,
don't
think
of
your
contribution,
I'm,
not
sure.
If
you're
saying
I
know
Jackie
is
we've
now
got
the
quarterly
progress
update
on
the
people
plan
I
mean
we've
probably
covered
some
of
the
themes
in
that,
but
cater
and
Jackie
refer
over
to
you
use
your
rules.
We
have
read
the
papers
so
pick
up
high
spots
and
then
we'll
deal
with
any
questions.
Thanks.
C
You
so
I've
just
pulled
out
some
verbal
updates
that
I
think
chairman
board
would
be
interested
in.
So
if
I
can
start
off
with
diversity
and
inclusion,
we
welcomed
a
new
diversity,
inclusion
manager
in
November,
and
she
has
quickly
hit
the
ground
with
some
really
good
conversations.
C
Colleagues
on
this
call,
Mark
Chambers,
Scott
and
Paul
started
good
conversations
with
good
insight
into
helping
our
thought
process
and
shaping
our
plans
as
we're
going
to
next
year.
C
The
the
plans
that
were
that
we're
going
to
put
together
from
January
onwards
are
in
conjunction
with
the
resin
Des
plans
that
already
exist,
but
actually
by
bringing
them
to
life
and
how
we
integrate,
how
we
approach
inclusive
and
diversity
into
everything
we
do
I
think
at
the
minute.
It
feels
thought
sits
a
little
bit
alongside
our
activity
and
it's
about
how
working
together
we
can
bring
that
to
be
an
integral
part
of
activity
across
CQC.
C
We
currently
have
the
count
me
in
program
that
was
launched
to
include
to
increase
Declarations
of
the
protected
characteristics,
and
the
executive
grades
have
now
closed
waste.
The
rates
have
yet
to
be
verified.
C
The
target
was
95
percent
and
the
race
range
from
93
and
a
half
to
96.,
so
like
I,
say
unverified,
but
that
was
a
really
great
take
up
by
executive
colleagues
in
terms
of
completing
the
Declarations
TDI
now
have
had
the
rule
out
of
the
company
in
and
that
will
run
for
the
next
few
weeks
and
again
we'll
be
monitoring
completion
with
the
view
to
ruin
this
out
throughout
the
rest
of
the
directorates
as
we
go
into
January
stroke
February
next
year.
C
So
I
think
that
was
some
additional
information
regarding
diversity
line
manager
capability
that
continues
to
be
worked
on
and
rolled
out.
There
was
a
short
session
for
Ops
colleagues
in
terms
of
increasing
capability
in
late
of
the
transformation
that
has
had
some
really
good
feedback,
so
we'll
be
continued
to
build
on
that
and
the
inclusive
leadership
program
as
well.
That
was
launched
last
year
last
month
for
colleagues,
E3
and
Bandy.
C
There's
two
programs
E3
and
Bandy,
and
then
Grade
B
downwards,
and
this
is
recognizing
colleagues
in
our
diverse
colleagues
with
diversity
to
encourage
development
and
courage.
Opportunity
encourage
succession
planning,
so
we're
already
starting
to
think
about
stretch
projects
to
think
about
opportunities
for
colleagues
who
are
going
through
that
program
and
how
we
can
support
and
develop
throughout
the
program
and
Beyond.
C
C
So,
unless
there's
any
other
specific
questions,
I
think
that
was
all
of
what
I
want
of
the
points
I
wanted
to
bring
to
the
board
today.
J
You
chairman,
thank
you,
Jackie
I,
think
all
the
colleagues
on
this
call
now
have
always
been
very
supportive
of
the
people
plan
and
I'm
pleased
to
see
good
progress
within
the
plan,
but
could
I
just
pick
up
on
two
points
that
I
gleaned
from
this
report?
Firstly,
the
Working
World
project
I,
think
that's
great,
but
can
I
really
encourage
you
to
look
outside
the
organization
and
glean
some
best
practice
from
other
organizations?
I
think
we
really
need
to
see
how
other
organizations
have
responded
to
the
post-pandemic
world.
J
You
know
how
we
communicate
develop,
recognize
behave,
inclusively
with
a
distributed,
Workforce
and
I
think
that's
worthy
of
of
of
some
intention,
some
attention
and,
secondly,
can
I
just
say
in
terms
of
capability
building.
Obviously
the
dni
team
have
done
some
really
great
work
there
and
again
it's
back
to
that
transfer
of
best
practice,
and
you
know
you
could
see
that
good
work
being
come.
The
outcome
of
that
is
in
their
survey
results.
So,
let's
build
on
that
and
transfer
that
learning
across
the
whole
organization.
Yeah.
C
Thank
you,
I
should
just
add
one
more
point.
There
is
an
active
project
as
well,
which
I've
undertaken
on
reasonable
adjustment,
which
will
obviously
thread
in
to
the
area
the
areas
I've
covered
and
will
follow
the
same
patterns
we're
taking
full.
You
know
the
diversity
element
as
well
and
about
how
we
make
that
an
integral
part
of
everything
we
do
and
we
are
linking
in
with
external
Charities
and
external
best
practice
companies
regarding
the
support
to
colleagues
requiring
reasonable
adjustments
and
and
and
how
we
achieve
those
really
excellent
standards.
There.
A
Thanks
Jackie
I
have
a
couple
of
other
questions
for
Linda.
M
Higher
jacket,
I
would
just
come,
find
and
remember
a
part
about
reverse
mentoring.
I
know,
that's
something
we
talked
about
in
the
last
people
plan
and
I
just
wondered
as
it
dropped
off
the
plan,
or
is
it
just
not
mentioned
in
this
particular
report?.
C
I'm
going
to
be
totally
honest,
Belinda
having
sort
of
just
come
into
the
role
relatively
soon,
that
is
something
I
haven't,
had
the
hands
to
sort
of
like
reach
out
to
at
the
minute
and
certainly
take
it
away
and
have
a
look
at
it.
But
I
am
not
in
a
position
to
respond
to
that
on.
This
call.
B
Okay,
if
I
have
a
if
I
ever
go
and
then
other
so
so,
Belinda
you're
remember
that
some
some
Neds
and
some
of
the
exact
team
were
involved
with
this
as
well,
and
it
was
evaluated.
We
did
it
in
partnership
with
the
university.
It
was
evaluated
and
my
my
understanding
was
there
were
varying
degrees
of
views
about
how
successful
it
was,
but
I
think
one
of
the
main
messages
was:
did
it
actually
lead
to
different
career
opportunities
for
people
and
I?
B
But
it's
looking
to
have
a
much
more
of
a
concrete
outcome
for
colleagues
who
are
in
that
inclusive
leadership
and
terms
of
opportunities
to
apply
for
jobs
and
stuff,
so
I
think
it's
not
saying
parking,
reverse
mentoring,
I
think
it's
taking
the
learning
from
that
into
the
the
inclusive
leadership
program
which
is
about
you
know,
successes,
seeing
increased
diversity
through
the
senior
levels
of
the
organization,
as
one
of
the
you
know,
success
outcomes
as
well.
B
But
let
us
let
me
just
loop
back
with
Jackie
and
and
and
or
unless
any
other
colleagues
want
to
correct
me.
That's
my
that's
my
understanding
of
where
that
got
to
thank
you.
Okay,.
G
Thanks
Ian
and
thank
you
for
the
update,
I'm,
also
supported
with
the
people
plan
and
I
think
we're
showing
real
progress.
Just
had
a
couple
of
questions
on
the
specific
bits
in
this
paper,
so
the
first
one
is
that
we
we
talk
a
lot
about
data
and
skills
and
capability
and
I
wonder
if
there's
more
room
to
talk
about
some
of
the
softer
issues
which
relates
back
to
my
point
before
about
our
employees
being
valued
and
just.
Secondly,
on
leadership
and
change.
G
We
talk
a
lot
about
equipping
our
line
managers
with
training
or
capability,
which
is
definitely
something
I'd
support.
What
we
don't
talk
about
are
exec
or
senior
people
and
how
they're
going
to
lead
change,
which
I
think
also
kind
of
relates
back
to
the
previous
discussion
around
the
pulse
survey.
Thanks,
any
comments
welcomed.
B
K
If
I
can
just
pick
up
on
one
point,
Sally
as
you
may,
as
you
will
have
seen
in
the
in
some
earlier
papers,
we
we're
now
recruiting
to
deputy
director
roles
which
are
of
the
E3,
so
the
so
the
the
third
layer
of
executive
grade
that
all
of
those
colleagues
will
be
going
through
an
induction
program
and
also
some
targeted,
some
targeted
learning
as
well,
so
we're
starting
instead
of
starting
at
the
top
and
rolling
down
we're
sort
of
starting
lower
down
and
rolling
that
type
of
intervention
up
and
the
operations
manager,
training,
intervention
that
Jackie
talked
about.
K
E
I
was
going
to
say
broadly
the
same
thing,
I
think
I
think
in
terms
of
Sally's
question,
I,
think
the
the
coaching
support
and
the
and
the
work
that
we
do
as
lead
as
groups
of
leaders
has
has
has
offered
some
dividends
but
I
the
area
that
that,
though,
the
group
that
of
leaders
who
didn't
have
a
particularly
strong
leadership
development
offer
was,
was
the
those
first-line
leaders
that
Tyson
was
describing
so
I.
E
Think
that's
where
the
that's,
where
the
focus
is
right
now,
but
I
think
the
broader
if
a
click
up
a
level,
the
broader,
the
broader
Pro,
the
broader
problem
that
we
have
is
we
don't
currently
have
an
HR
System
that
is
capable
of
tracking
tracking
skills
and
capabilities
right
across
the
organization,
in
the
way
that
we
would
probably
like,
which
would
give
us
I.
Think
a
more
insightful
and
consistent
set
of
offers.
E
A
Thanks
here,
no
no
more
questions,
so,
let's
draw
that
to
a
a
whole
Jackie
thanks
very
much
indeed
for
joining
us
I
think
you've
got
broad
agreement
to
the
to
the
planet
approach.
A
lot
of
support
for
that
we've
already
agreed
in
the
previous
session
that
we'd
have
a
report
back
on
the
pulse
survey.
What
management
are
doing
in
March
and
stating
the
obvious,
maybe
it'd
be
useful
to
just
see
whether
or
not
there
are
modifications
regard
to
this
plan.
A
In
the
light
of
what
comes
out
of
the
the
work
on
that
pulse
survey-
and
you
know
we
note
here
at
your
point
that
our
existing
systems
are
not
perfect
in
this
area,
so
there's
no
no
media
fix
on
there,
but
it's
on
the
subject
to
funding
agreement
from
the
Department,
something
we
would
like
to
get
done.
I
guess
over
the
next
couple
of
years,
probably
yeah,
okay,
Jackie
thanks
very
much
for
that
appreciate
you
joining
us.
A
So
Ian
over
to
you
and
your
team,
we've
got
a
report
on
Regulatory
and
organizational
Matters
from
you.
So
it's
to
note
read
the
papers
highlight
what
you
want
and
then
we'll
take
questions.
E
Thanks
Ian,
just
just
just
to
remind
colleagues,
this
is
a
new
format
of
report.
We
normally
have
a
single
report
that
covers
the
whole
gamut
of
both
Regulatory
and
operational
matters.
We've
split
the
reports
into
into
two
halves
now,
so
to
probably
better
reflect
the
way
the
organization
is
now
operating
with
regulatory
leadership
as
one
component
and
operations
as
as
another
component
I'm,
going
to
ask
Sean's
talking
in
a
moment
about
what's
going
on
in
in
the
healthcare
environment,
but
because
I
want
to
make
a
couple
of
comments.
E
One
is
since
the
last
board
we
published
our
state
of
care
report
and
I
want
you
to
say
a
big.
Thank
you
to
the
teams
that
that
help
put
that
together,
that
that
is
our
annual
report
to
Parliament,
and
it
reflects
the
perspective
that
we
have
and
it
brings
the
voices
of
of
three
thousand
people,
three
thousand
of
our
colleagues
together
to
to
talk
about.
E
What's
going
on
in
in
the
Health
and
Social
care
system,
our
core
message
this
year
was
that
the
system
is
gridlocked
and
that
and
that
people
are
stuck
in
in
the
wrong
place
and
I'm
really
pleased
that
that
that
that
message
really
resonated
I
think
with
the
people
that
worked
in
in
Health
and
Social
care,
as
well
as
the
wider
public
and
and
our
our
report
has
been
widely
quoted
and
widely
reported,
and
it
continues
to
be
cited
extensively
by
journalists
and
by
politicians,
and
we've
also
produced
a
number
of
other
reports
recently,
including
our
annual
Mental
Health
Services
report
and
report
on
services
for
people
with
a
learning
disability
and
autistic
people
and
again
I.
E
Think.
Whilst
there
are
some
points
of
detail
in
those
reports,
this
this
whole
issue
of
of
of
Workforce
shortages
comes
up
again
and
again
again
and
again,
as
a
recurring
theme,
we
achieved
a
really
important
milestone
in
the
submission
of
our
draft
methodology
on
integrated
Care,
Systems
and
local
Authority
Assurance,
by
submitting
our
methodology
to
the
Secretary
of
State,
and
we
await
feedback
from
from
the
Secretary
of
State
in
due
course,
and
alongside
that,
we
have
been
taught.
E
We've
begun
conversations
with
Patricia
Hewitt
and
her
team
as
part
of
her
rapid
review
into
integrated
care.
So
I
think
it'd
be
fair
to
say
that
we
are.
We
are
in
good
shape
in
terms
of
of
just
starting
to
go,
live
with
integrated
care
system
assurance
and
local
area,
local
Authority
Assurance
in
at
the
beginning
of
April,
just
one
final
thing
beforehand
out
to
Sean.
E
It's
just
just
to
make
a
point
about
strike
action,
I'm,
conscious
that
in
all
likelihood,
nurses
will
be
on
strike
tomorrow
and
again
on
another
day
before
Christmas
and
that
that
and
there's
there's
a
number
of
other
strikes.
I
think
what
we've
said
as
a
regulator
is
that
we
will
we're
in
in
terms
of
reflecting
that
context,
we
will
only
be
carrying
out
inspection
activity
where
we
have
concerns
around
serious
harm
and
we'll
be.
E
We
have
asked
providers
to
contact
us
proactively
if
they're
worried
about
their
their
abilities
to
to
to
to
offer
safe
care
so
that
we
can.
We
can
talk
to
them
about
it
beforehand.
So
that's
all
I
wanted
to
say
Ian
just
for
in
terms
of
in
terms
of
highlights
and
I'm
going
to
hand
over
to
Sean
now
just
to
talk
about
the
some
of
the
current
issues
in
healthcare.
Sure
thank.
N
You
thank
you
and
I'll,
just
I'll
Focus,
really
mainly
on
the
Urgent,
an
emergency
care
pathway
of
that,
as
the
gridlock
issue
we
describe
in
the
recent
state
of
care
report
remains
a
significant
concern
with
difficulties
in
achieving
discharge
for
patients
with
a
social
or
domiciliary
care
need
still
impacting
on
Hospital
capacity,
with
knock-on
effects
felt
through
the
whole
urgent
and
Emergency
Care
Service,
resulting
in
delays
with
internal
patient
transfers,
delays
with
admission
and,
consequently,
delays
with
ambulance
handovers
at
emergency
departments.
N
It's
important
to
say,
though,
that
we
recognize
how
NHS
staff
can
continue
to
work
exceptionally
hard
to
provide
safe
and
Compassionate
Care.
In
the
face
of
this
increased
demand.
N
I've
seen
this
commitment
and
dedication
myself
on
a
number
of
recent
visits
to
hospitals,
and
it's
also
important
to
say
that
we're
working
with
others
to
ensure
that
we
give
the
support
we
can
to
the
implementation
of
the
NHS
winter
plan
and
we're
also
seeking
to
support
Innovative
approaches
in
the
service
by
developing
some
new
internal
mechanisms
that
will
help
us
identify,
spread
and
disseminate
learning
regarding
safe
and
effective,
best
practice
more
more
widely
and
more
quickly.
So
I
think
that's
that's.
All
I
was
going
to
say
in.
A
A
Okay,
well
a
couple
from
from
me:
if
I
could
firstly
Sean,
for
you
be
helpful,
if
you
just
say
a
couple
of
words
about
the
acute
maternity
Services
review
and
my
understanding
is,
we
hope
to
have
that
work
completed
finally
completed
roundabout
May.
Is
that
correct.
N
That's
that
is
my
understanding,
as
you
know,
there's
a
big
program
where
we
are
inspecting
all
services
that
were
haven't
been
inspected
since
April
21.
N
As
part
of
that
program,
we
are
listening
to
listening
to
service
users
to
Partners
to
all
those
involved
and
will
be
producing
reports,
hopefully
with
additional
new
insights
into
how
maternity
Services
can
be
can
be
supported
to
improve,
but
we
hope
that
work
will
be
finished.
Yes
in
the
spring
of
next
year.
Okay,.
A
I
mean
it's
interesting
just
to
highlight
again
I
suppose
doing
it
for
your
agreement,
but
this
is
the
first
time
we've
done.
One
of
these
sort
of
major
themed
reviews,
I
think
by
looking
at
post,
April
21
spectrums.
We
are
capturing
about
75
percent
of
all
maternity
units
was
my
understanding,
but
this
is
important
at
its
own
right,
but
I
think
also
if
we
can
demonstrate
the
benefits
of
this
sort
of
thing
and
actually
getting
some
change
working
with
with
others,
then
it'll
be
potentially
a
template
for
other
ways
of
working.
A
And
then
I
see
Sally
you've
got
your
hand
down.
Let
me
be
just
I
said
there
were
a
couple
of
things
one
for
you
Ian,
you
did
mention.
We've
submitted
a
letter
to
the
Secretary
of
State
on
on
our
proposed
approach
with
Care
Systems.
We
didn't
specifically
mention
funding,
so
I
wonder
if
you
just
heard
a
bit
more
about
when
we
might
expect
a
response
from
the
Secretary
of
State
and
where
on
the
critical
path.
E
My
understanding
at
the
moment
in
Chris
Usher
will
be
able
to
be
out
off
the
very
latest
position.
But
my
understanding
is
that
we've
had
assurances
from
the
Department
that
we
will
receive
funding,
support
for
the
work
we're
doing
this
year
to
prepare
for
the
first
of
April.
E
But
we
have
not
yet
had
a
confirmation
of
funding
for
the
operational
service
from
the
first
of
April
and
there
are
one
or
two
other
points
of
detail
around
things
like
commencement
orders,
which
which
also
need
to
be
in
place
before
we
can
formally
go
live
on
the
first
first
of
April,
but
from
a
CQC
point
of
view.
I
think.
E
We
think
that
we
will
be
able
to
start
work
on
the
1st
of
April,
but
we
do
need
confirmation
or
formal
confirmation
of
Life
funding
for
for
next
next
financial
Year
from
the
first
of
April.
E
L
A
Okay,
so
so
just
to
be
clear,
I
think
on
the
last
probably
board
meeting.
We
know
to
the
fact
that
we
there
was
uncertainty
on
funding
and
we
did
say
we
would
get
the
stage
where
by
December,
if
we
hadn't
got
that
sorted
out,
we
would
have
to
at
this
meeting
gives
us
consideration
to
slowing
downward,
deferring
or
even
potentially
starting
some
of
our
work.
A
E
I
think
I'm
content
I'm
content
to
proceed
based
on
where
we
are
at
the
moment,
but
but
I
think
that
there
will
come
at
other
points
before
the
first
of
April,
where
we'll
need
confirmation
of
of
live
running
funding
for
for
next
year,
which
we
haven't
yet
gone.
They.
O
Are
active
conversations
at
the
minute,
though,
with
the
Department
around
next
year.
A
I'm
passing
back
to
ask
if
we
could
explicitly
report
back
on
those
by
the
next
meeting
in
February,
because
by
then
I
think
all
of
those
issues
will
be
on
the
critical
path
if
they're
not
resolved
yeah.
G
Thank
you
and
you
asked
my
old
chairs
question
about
money,
but
your
your
comment
about
maternity
Services
just
triggered
an
extra
thought
that
I
think
it's
worth
saying
in
public,
so
because
of
all
the
focus
on
maternity,
quite
rightly,
a
lot
of
different
arms
length,
bodies
or
organizations
are
thinking
about
maternity,
Improvement
and
I'm.
Aware
of
some
really
good
work,
that's
happening
between
CQC
h-sib,
so
safety,
investigation,
branch
and
NHS
resolution
pooling
their
information
and
data
around
potential
concerns
ahead
of
inquiries
and
I.
G
Think
that's
a
really
important
piece
of
work
working
together.
If
we
can
ensure
that
that
continues
a
CQC
and
that
you
know
we
come
back
to
talk
about
it
at
a
more
strategic
level
to
support
our
employees
in
the
Endeavor
I.
Think
that
would
be
really
worthwhile
thanks.
E
E
There
are
a
lot
that
there's
a
lot
of
joint
working,
which
I
think
is
a
real
positive
and
we
are
looking
to
share
and
pull
our
work,
whether
it's
ourselves,
a
to
the
you
know
the
nursing
of
Midwifery,
Council,
General,
Medical,
Council,
and
so
on.
So
we're
trying
to
get
as
many
of
the
players
who
can
influence
this
agenda
to
come
together
and
and
that
you
know
people
are,
are
definitely
moving
in
the
right
direction.
So
it's
it's
a
good.
It's
a
good
thing
to
reinforce.
Thank
you.
E
You
if
you're
content,
I'll
move
on
to
the
organizational
matters
report
so
I'm
on
page
46,
now
of
of
our
of
our
board
pack
I
think
first.
Firstly,
I
I
just
want
to
welcome
some
some
new
new
Jonas,
one
of
whom
is
here
Scott's
our
new
director
of
integrated
care
inequalities
and
Improvement.
E
Although
he's
he's
in
a
particular
particular
project
for
us
which
he'll
come
on
to
on
on
the
agenda,
next
I'd
like
to
welcome
Chris
as
akiti
our
new
director
of
mental
health
and
Lorraine
tedashini,
director
of
operations
in
the
Midlands
and
that
and
they
they
join
a
number
of
of
internal,
promotes
and
a
number
of
of
colleagues
who've
who
who've
been
remained
in
post
to
produce
I
think
what
is
going
to
be
a
very
effective
director
team
and
I'm
really
excited
about
about
some
of
the
the
work
that's
already
started
and
I
I
think
it
gives
us
a
really
good
leadership
platform
to
to
to
do
really
well
on
for
the
future.
E
I
just
want
to
also
take
take
the
opportunity
to
publicly
thank
Rebecca,
Lloyd
Jones,
who,
who
I
know
is,
is
will
be
leaving
us
very
shortly.
This
will
be
her
last
meeting.
I
know
you'll
want
to
say
a
few
words
at
the
end
of
the
meet
again
but
but
I
think
just
worth
saying
from
from
my
point
of
view,
I
to
Rebecca's
been
with
us
for
since
2013
and
she's
made
a
a
really
big
difference.
E
I
think
to
the
board
and
to
The
Wider,
wider
organization
and
she's
been
I
think,
firstly,
the
legal
architect
behind
a
lot
of
the
ways
that
that
we
work
and
she's
always
that
that
quiet
considered
voice
that
that
comes
up
with
answers
to
and
ancestor
problems.
She
is
definitely
the
the
person
that
looks
for
answers
which,
which
I
think
we've
all
really
appreciated,
but
also
I.
E
Think
it's
also
it's
just
fair
to
say
that
Rebecca
has
a
real
lifetime
of
of
public
service,
and
it's
been
has
been
the
lawyer
in
the
room
for
some
recent,
quite
significant
historical
events
and
and-
and
although
she
probably
would
never
admit
it
could
probably
take
credit
for
some
for
some
really
important
legal
decisions
which
which
have
have
led
to
some
really
positive
outcomes.
E
For
many,
hundreds
of
thousands
I'll
give
you
millions
of
people
in
this
kind
country,
so
I
think
it's
it's
a
real
tribute
to
Rebecca
that
that
she's
she's
done
that
I
think
we'll
miss
you,
Rebecca
I,
think
on
a
personal
level,
we'll
miss
you
exactly
we'll
miss
you
and
I'm
sure.
All
of
the
board
members
here
will
miss
you
and
I
think
the
public
will
be
the
poorer
as
a
result
of
your
retirement.
E
So
I
I
wanted
to
wish
you
the
very
best
of
luck
for
the
future
and
then
final
thing
before
before
I
just
opened
it
up
to
to
other
colleagues
is
I
just
want
to
just
just
pay
tribute
to
our
wider
operations.
Group
colleagues,
in
particular
who've,
had
a
really
strong
operational
performance
this
month.
I
know
Tyson
can
talk
to
that
in
a
moment
if,
if
necessary,
but
I
I
think
it
given
the
fact
we
just
have
had
an
important
conversation
about
the
employee
survey
and
some
of
the
real
challenges.
E
Despite
that
people
have
done
some
done,
some
really
good
work
and
I
think
I
think
that's
a
real
Real
Testament
to
our
colleagues.
So
I
want
to
say
a
public
thank
you
to
them
for
the
work
that
they've
done
to
without
further
Ado
I.
Think
Ian,
I'm,
I'm
I
think
I'll
stop
there
and
call
colleagues
in
if
they
want
to
add
to
anything
I've
said
or
of
course
answer.
Questions.
Thanks
is.
E
Oh
yes,
of
course,
we
have.
We
have
spoken
to
spoken
to
the
Patricia
Hewitt
review,
sorry
to
Patricia
Europe
personally,
but
also
We've
made
make
contact
with
the
review
we've
just
seen.
E
The
I
think
it
was
this
morning
the
the
call
for
evidence
came
out
and
we
will
be
submitting
evidence
and
supporting
the
review
in
a
range
of
different
ways,
because
that
we
think
it's
entirely
consistent
with
the
work
that
we're
we're
aiming
to
do
and
the
approach
that
that
which
would
aim
to
take
with
its
and
La
Assurance.
Thank
you.
Okay,.
K
Okay,
thank
you
Ian.
Just
just
very
briefly,
can
I
reiterate
the
other
Ian
thanks
to
the
operational
teams,
for
what
was
a
really
strong
performance
Acro
across
the
month
of
November,
given
everything
else
is
going
on
and
the
complexity
of
their
workload
at
the
moment.
K
Just
for
the
record,
the
final
tally
of
inspections
for
November
has
now
come
in,
and
it's
actually
at
962,
which
is
exactly
100
more
than
we
managed
in
October
and
is
our
strongest
performance
since
May,
rather
than
June
as
it
was
before,
and
I'd
also
call
out
the
95
to
whistleblowing
alerts
which
we're
now
meeting
for
the
first
time
in
in
the
financial
year.
So
we're
meeting
the
kpi
for
the
first
time
in
the
financial
year,
so
really
really
grateful
very
strong
performance
and
and
we'll
look
to
keep
going.
A
Yeah
I
think
it's
particularly
impressive
in
a
way
that
that
we've
already
heard
through
the
pulse
survey
that
a
number
of
people
have
some
problems
or
concerns,
but
but
they're
not
allowing
that
to
impact
the
work
that
they're
doing
so
I
think
well
done.
Everybody
involved
absolutely
other
questions
for
Ian
or
the
executive
team.
A
No
all
very
quiet
this
time
around.
Well,
we
have
plenty
of
other
things
on
the
agenda,
so
we
can
probably
use
the
the
extra
time
Ian,
the
colleagues.
Thank
you
very
much
indeed,
for
that.
Should
we
move
on
to
the
item
3.2,
which
is
the
independent
review
again
down
to
note,
but
this
is
one
of
these
where
there's
things
to
be
told,
but
also
we
need
to
agree
and
set
out
how
we're
going
to
agree
some
things
that
are
relevant
to
this.
A
We
agreed
at
the
outset
that,
although
this
is
is
clearly
an
executive
responsibility
that
we
would
ask
Ali
Hassan
one
of
our
associate
nads
just
to
provide
some
some
more
direct
Hands-On
oversight
on
on
behalf
of
the
board,
so
Ali
I
don't
know
whether
I
perhaps
just
turn
to
you
see
whether
you
have
any
introductory
remarks
and
then
perhaps
I
could
ask
Scott
durai
Raj
who's
been
patiently
sitting
on
your
screens
to
introduce
himself
and
then
say
a
little
bit
more
about
his
approach
to
these
reviews,
and
then
we
could
open
it
up
for
questions
from
colleagues.
Q
Thank
you
and
I'll
keep
it
brief.
We
recognize
that
there
are
areas
in
which
we
can
do
better
and,
of
course,
how
we
listened,
learn
from
and
respond
to
concerns,
whereas
inside
and
outside
the
organization,
and
for
us
this
review
that
we're
undertaking,
Which
Scott
will
talk
a
bit
more
about
in
detail,
is
about
making
sure
that
we
understand
the
right
diagnosis,
the
challenges
that
we
have
find
the
right
ways
forward
and
embed
them
in
the
organization.
Q
We
see
an
importance
of
getting
us
done
and
getting
this
done
right
and
we're
undertaking
two
work
streams,
one
fully
independent
mate
and
one
the
plus
five
options
within
our
organization
to
really
help
understand
how
we
make
things
better.
So,
let's
go
over
to
you.
R
Thank
you
Ali
and
thank
you
Ian
yeah.
So,
from
my
perspective
and
the
way
we're
approaching,
this
is
really
following
on
from
all
the
conversations
we've
had
is
connecting
with
the
human
impact
and
the
challenges
that
arose
during
the
summer
and
how
they
affected
those
individuals
primarily
and
then
how
they
impacted
on
the
core
purpose
and
the
values
of
the
CQC
I.
R
So
the
review
has
been
structurally
designed
to
really
directly
respond
to
the
challenges
that
arose
during
the
summer,
connect
with
that
human
impact,
but
to
really
acknowledge
and
address
the
issues
of
credibility
and
confidence
that
had
felt
like
it
started
to
be
eroded,
and
that
is
really
important
that
we
as
a
as
a
leadership
and
ourselves
as
a
review
team
I,
feel
deal
with
issues
of
inequality
or
racism
and
the
review
in
a
way
that
had
on
that's
competent,
that's
confident
but
looks
for
really
meaningful
transformation
at
the
end
of
this.
R
So
we're
not
listening
just
to
respond,
but
we
are
hearing
in
almost
a
sense
of
feeling
as
well
to
actually
make
sure
that
we
deliver
the
improvements
at
the
end
of
this
and
that's
really
critical
and
the
reason
why
it
was
felt
really
important
that
we
we
looked
at
moving
to
a
level
of
Independence
having
an
independent
membership
on
the
on
the
review
board,
was
because
again
getting
that
voice
and
getting
that
Honesty
meets
our
values
in
the
CQC,
about
being
honest
and
transparent
and
open,
but
also
really
committed
to
deliver
the
change
that
this
review
made
May
report
against.
R
So
again,
the
the
review
is
in
two
phases.
As
Alice
said
phase
one
is
the
Zoe
11th
I'll
case,
which
is
fully
independent
and
then
there's
five,
where
experience
under
phase
two
and
to
assure
colleagues
and
people
who
are
watching
those
work,
streams
will
cut
across
some
things.
You
just
heard
talk
about
from
the
staff
survey
to
other
inclusive
leadership
practices,
but
we're
not
duplicating
we've.
We've
acknowledged
those,
but
we
are
also
building
in
evaluation
to
every
recommendation
and
the
evaluation
and
again
listening
to
people
externally.
R
The
key
stakeholders
has
been
in
important
part
of
that
process
that
the
evaluation
of
those
recommendations
and
the
delivery
of
those
recommendations
are
actually
almost
more
important
than
everything
else
to
make
sure
we
make
those
improvements.
So
again,
that's
also
in
train
and
kind
of
being
acted
on.
R
We've
got
primary
stakeholders
who
have
been
engaged
all
the
way
through
and
are
happy
where
the
timelines
and
the
changes
we
may
have
had
to
make
during
this
to
make
sure
this
review
is
robust,
is
credible
and
builds
confidence
and
I
think
that's
really
important
to
say
that
the
value
of
this
review
is
in
meeting
the
values
of
the
CQC
and
recognizing
the
human
impact
in
the
first
place,
and
that's
the
core
process
really
that
we're
doing
the
review
has
to
be
done
right
and
it
has
to
be
done
correct
and
proper,
and
the
end
up
is
really
important
for
me
that,
as
that,
as
a
review
comes
out
that
there's
a
level
and
a
secure
level
of
Handover
monitoring
and
tracking
and
I
know,
the
board
are
really
keen
on
Ensure.
R
A
Thanks
Scott
Kate
I'd
rather
skip
to
you,
but
you're,
the
and
ultimately
the
executive
overseeing
this.
Do
you
want
to
add
anything
to
what
Scott
and
Ali
have
said
before
we
moved
to
questions.
B
The
only
thing
I
would
add
is
that
this
is
incredibly
important
for
us
as
an
organization,
so
you
will
see
from
the
papers.
This
is
comprehensive.
This
is
going
wherever
we
need
to
go
to
in
the
organization
to
make
sure
that
we're
responding
to
whistleblowing
we're
doing
speak
up.
Well,
we've
got
the
right
culture,
so
I
I.
The
only
thing
I
would
want
to
add.
B
Is
this
really
matters
to
us
and
and
I
know
it
does
to
the
board,
and
that's
why
we
have
put
in
place
such
a
robust
plan
that
will
come
out
with
a
set
of
recommendations
that
we
will
track
track
through
and
ensure
they
are.
They
are
implemented
as
well.
That's
it
thanks.
A
Thanks
Kate
I
have
some
comments
and
questions
again.
Should
let
colleagues
go
first
Mark
Saxon.
J
Thank
you
chairman
and
Scott
hello
again,
and
thanks
for
presenting
such
a
a
good
paper,
I
mean
I'm
completely
in
agreement
with
you
about
the
importance
of
external
validation
of
the
findings.
This
is
absolutely
a
critical
part
of
of
what
you're
doing,
but
for
the
HR
the
work
stream
for
HR
you
know
can
I
especially
ask
that
this
review
looks
at
best
practice
in
other
organizations.
J
R
Yeah,
if
I
can
come
back,
thank
you,
Mark
and
actually
I
should
have
mentioned.
We,
because
this
is
a
fast
movement
program.
R
Since
the
paper
we
have
now
appointed
a
web
stream
lead
for
work
stream,
four,
who
is
independent
and
got
20
years,
history
working
across
numerous
organizations,
as
well
as
a
employment
tribunal
panel
member
and
is
certainly
I'm
most
certainly
looking
at
best
practice
within
these
areas
and
within
Workforce,
and
when
we
come
into
inclusion
from
a
global
best
practice,
actually
because
I
think
our
Workforce
and
the
people
we
are
here
for
deserve
a
world-class
service
and
that's
what
our
ambition
is
from
this
piece
of
work
to
really
move
forward
on
that.
A
Scott,
do
you
want
a
bit
more
about
your
contacts
with
other
stakeholders,
I
suppose
I'm,
specifically
thinking
of
well
Zoe's,
not
exactly
a
stakeholder
but
there's
a
key
player
in
doing
phase
one,
but
we
have
mentioned
publicly
before
we'd
engaged
her
in
its
reference
in
the
paper
that
I
don't
know
if
you'd
like
to
say
a
little
bit
more
about
her
work
and
how
that
will
feed
into
what
you're
doing
so
that
that
small
question
and
then
the
other
is.
A
My
understanding
is
that
you
have
also
been
in
touch
with
Mr
Kumar
I.
Don't
know
whether
it's
appropriate
say
anything
about
that.
R
Yeah
so
I'll
start
with
with
Zoe
and
I,
probably
should
have
made
really
clear
earlier
that,
of
course,
Zoe
Leventhal
is
an
independent
review.
So
as
per
that,
the
CQC
have
very
limited
responsibility
over
that,
because
it
is
an
independent
review.
So
we
have
no
editing
powers
and
we
will
have
no
editing
powers
from
that.
So,
although
there
is
governance
there,
it's
governance
about
the
delivery
and
the
oversight
and
they're
going
to
make
some
comment
to
that.
R
So
I
think
I
just
should
have
probably
made
that
really
clear,
yeah
I'm
engaged
with
with
Zoe,
and
it's
really
important
again,
because
we've
had
ambition
and
recognition
that
these
reviews
are
the
healthiest
for
all
when
they
are
timely.
R
I
think
that's
fair
to
say,
however,
some
of
those
Ambitions
were
established
before
the
independent
reviewer
Zoe
was
in
place
and
before
those
terms
of
reference
were
agreed,
and
so
obviously,
as
that
come
in
and
as
we
are
doing
this
robustly
and
correctly
and
values
LED,
it
has
meant
that
the
sampling,
as
I've
talked
about
the
paper
has
needed
to
change
and
I
have
engaged
with
Cheyenne
Kumar.
R
Who,
who
you
know
we
have
now
a
a
regular
update,
a
regular
brief
and
I,
provide
a
direct
contact
and
that
we
have
got
plans
for
Ali
and
Kate
and
myself
to
meet
with
him
and
he
spent
some
time
with
Zoe
I
think
that's
all
I
will
stay
at
this
space
because
that's
Mr,
Kumar's
information
but
I
have
briefed
him
and
he
has
seen
the
papers
before
today,
for
instance.
So
from
for
respect,
we've
got
well.
R
I
would
say,
is
a
very
positive
and
productive
working
relationship
focused
on
the
quality
and
the
depth
and
The
credibility
of
this
review
and
my
commitment
to
him
on
making
sure
that
is
done
in
a
robust
Manner,
and
it
does
mean
obviously
some
of
these
timelines
May
shift,
but
if
they
do
they're
they're
shifting
because
of
a
robust
methodology
and
Mr
Kumar
is
has
been
and
as
discussed
with
a
level
of
contempt
with
that,
because
it's
important
to
get
this
done
right
as
I
mentioned
earlier.
Okay,
like.
E
Thanks
I
think
just
really
to
build
build
on
what
Kate
was
saying
around
how
important
this
this
piece
of
work
is
I
think
it
is
important
that
that
we
do
this
piece
of
work,
but
I
think
it's
important.
This
piece
of
work
delivers
an
outcome
that
we
can
stand
behind
and
that
we
can
deliver
to
all
parts
of
the
organization
because
in
some
respects
it
you
know,
we
sometimes
find
that
when,
when
reviews
are
done
in
a
very
externalized
kind
of
way,
they
they
produce
a
report.
E
But
then
it
doesn't
really
get
into
the
detail
into
the
Tactical
detail
in
the
organization.
For
this,
the
the
way
we're
doing
this
review
I
think
is
quite
unusual
in
some
respects.
There's
a
there's,
a
big
internal
component,
but
there's
a
there's,
a
very
big
external
components
and
we're
also
drawing
in
expertise
from
expert
practitioners
as
well
as
I'm,
really
grateful
to
Mr
Kumar
for
the
way
in
which
he's
engaging
with
the
with
the
review
as
well.
E
So
I
think
it
does
give
us
an
opportunity
to
produce
an
outcome
which
is
which
is
which
has
allowance
of
Independence
to
it,
but
also
so
we
have
Pace
to
it,
but
also
it
gives
us
that
real
insight
that
really
detailed
Insight
that
we
can.
We
can
deploy
those
insights
really
quickly,
and
it's
also
from
a
timing
point
of
view.
It's
a
relatively
short
period
of
time,
but
I
think
I'm,
hoping
it'll
make
a
really
big
difference
over
that
over
that
really
short
period
of
time.
A
I
was
going
to
ask
you
a
question
about
Pace.
I
might
still
come
back
on
the
point,
but
thanks
for
just
volunteering,
that
any
the
other
questions
or
comments
from
colleagues.
A
Although
one
comment
for
me
and
then
by
way
of
of
summary,
firstly,
a
comment
aimed
more
at
the
public
listening
I
don't
want
to
read
the
papers.
We
did
say
in
there
that
the
terms
of
reference
were
of
these
reviews
were
appended
underneath
or
short,
while
they
were,
but
I
think
we
got
a
bit
ahead
of
ourselves
and
what
was
supposed
to
have
hadn't
actually
been
formally
approved
internally.
A
So
we
will
get
these
finalized.
We've
we're
not
going
to
go
through
the
detail
now,
but
but
there
will
be
a
Steering
group
that
have
already
mentioned
that
Ali
will
represent
as
an
independent
non-exec
to
the
board
as
a
whole.
A
Kate
is
the
executive
response
for
Scott
is
leading
order,
phase
two,
and
so
he
has
he's
emphasized,
and
it
is
important
as
the
independent
KC
leading
on
on
phase
one,
which
was
clearly
an
important
input
the
since
so
what
I
would
like
to
suggest
is
that,
probably,
if
Ali
and
I
in
particular
representing
the
board,
we
could
review
and
sign
off
on
those
in
terms
of
reference
and
we'll
aim
to
get
those
in
the
public
domain
in
probably
on
the
website.
A
A
We
don't
buy
about
now
this
month,
but
we've
as
understanding
we've
extended
the
scope
of
her
work
a
little
bit
and
the
pace
at
which
she
can
move
is,
to
some
extent
determined
by
the
ability
to
retrieve
information
and
then
go
talk
to
people
and
the
people
on
holiday.
That's
a
constraint,
so
we
can't
I
think
we'd
like
to
move
faster
at
times,
but
but
if
you're
committed
to
work
with
others,
you
can't
then
bypass
them
because
they're
not
around.
A
So
my
understanding
is
that
we
in
an
Ideal,
World
we'd,
like
Zoe's,
work
to
be
finished
by
the
time
in
the
next
board
meeting.
That's
an
aspiration.
A
It
may
not
happen,
but
the
we
are
should
be
in
a
position
to
say
that
all
of
this
so
phase,
one
and
phase
two
will
all
be
completed
by
the
end
of
March,
am
I,
correcting
that
understanding
from
the
paper
yeah
yeah,
okay,
so
published
terms
of
reference
in
January
will
report
back
in
February
what
we
can
but
commit
to
getting
it
on
by
the
end
of
March,
which
Ian
I
think
plays
back
to
your
point.
A
We
need
to
you
know
we
need
to
do
this
thoroughly,
but
equally
we
can't
spend
a
year
putting
the
findings
together
and
never
acting
unless
there
are
any
comments
from
colleagues,
but
just
one
other
observation
for
me
without
laboring
this,
but
I
I
think
there's
a
common
link
between
this
and
the
response
to
the
staff's
pulse
survey
that
neither
of
them
make
great
reading,
but
I
do
think.
A
It
says
something
from
the
organization
that
it's
taking
these
head
on
and
trying
to
deal
with
them
in
the
best
possible
way
difficult
anyway,
but
but
we're
doing
it
on
the
glare
of
the
public
eye.
So
I
think
that's
us
the
the
transparency
with
which
that's
being
done,
I
think
is
it
both
a
testament
to
the
approach
of
the
executive
and
the
culture
of
the
organization.
So
thank
you
very
much
indeed
for
that
Ian.
R
Could
I
just
say
one
thing
to
to
Fat
fanish
I'd
like
to
thank
the
Jade
unions
actually
on
our
disability
staff.
Network
specifically
who've
helped
us
recruit
the
network,
their
working
lead
at
independent.
We
extreme
lead
for
work
stream.
Four,
there
was
two
colleagues
sues
Andy
who
helped
from
the
Trade
Union
at
a
very
short
notice
and
both
Paul
who's
on
the
call
today
and
his
colleague,
who
helped
again
at
short
notice
for
Cruz
and
I.
R
Think
this
is
that
commitment
from
our
colleagues
who
may
have
faced
a
human
impact
from
some
of
this
work
and
have
engaged
to
help
me
with
part
of
the
solution
as
well.
So
I
just
wanted
to
thank
them
publicly
for
their
commitments.
A
A
Let's
move
on
to
the
corporate
performance
report
which
and
then
we've
one
other
item
before
we
take
a
short
Comfort
break
so
Kate
once
again,
I
seem
to
be
handing
to
you.
This
is
more
of
a
to
note,
but
you
may
want
to
bring
Chris
in
I'm
sure,
but
can
I
ask
you
just
to
to
take
us
through
this
usual
rules?
We
have
read
the
paper,
but
what
do
you
want
to
highlight.
B
Yeah,
so
thank
you
I'm
going
to
do
a
fast
Handover
to
Chris.
So
this
is
our
delivery.
Through
quarter,
two
against
our
business
plan.
I
suspect
we
might
want
to
spend
a
bit
of
time
discussing
risk.
But
let's
see
where
the
conversation
goes.
Chris
over
to
you.
O
Thanks
Kate
thanks
Ian,
so
I'll
just
obviously
report
is:
is
there
for
board
to
to
note
and
comment
on
I'll
just
pull
out
a
few
areas
as
for
info,
so
as
Tyson
taught
before
just
about
operational
performance,
we
are
starting
to
see
some
good
good
figures
within
within
operations.
Nearly
20
locations
of
either
been
inspected
or
the
dma
call
to
the
end
of
November,
which
is
on
track
to
exceed
last
year,
manufacturing
our
public
statements.
That
means
55
have
had
a
regulatory
activity.
O
That's
on
slide
two
of
the
deck.
Similarly,
in
registrations,
Timeless
is
reducing
so
I'm.
Sorry,
our
average
time
to
to
handle
registrations
is
reducing
across
all
three
categories
that
we
deal
with
complex
is
25
down
normal
four
percent
and
simple
four
percent.
So
that's
that's,
meaning
that
we're
turning.
There
is
around
quicker
than
we've
done
before,
and
all
that's
against
a
Target
reduction
of
15
percent
in
terms
of
whistleblowing,
we
are
95
of
whistleblown
have
been
actioned
within
five
days,
which
is
in
line
with
our
Target.
O
This
is
on
racing
through
it's
on
slide
nine
of
the
the
deck
that's
an
increasing
Trend
and
you
can
see
in
August
in
September.
This
was
98
and
99
respectively,
so
close
to
100.
It's
worth
noting.
This
obviously
focuses
on
Timeless
and
and
the
work
that
Scott's
just
talked
about
in
terms
of
the
llr
review
will
obviously
focus
on
more
on
impact
and
outcomes
of
those
whistleblowing.
O
O
Just
one
obvious
note
lag
in
terms
of
people
deck.
We
we've
just
talked
about
the
pull
survey
earlier
in
this
board
meeting.
We
haven't
timing
was
slightly
against
us
in
terms
of
publishing
that
in
this
report,
so
there's
a
gap
in
this
deck
around
the
pulse
service
finders,
but
we'll
include
that
as
a
as
a
baseline
in
future
reports
and
and
Mark
Saxton.
Just
as
my
apology
to
yourself,
you've
asked
for
information
on
diversity
comments.
We
haven't
managed
to
get
that
into
this
pack
in
time,
but
I
know
people.
O
Colleagues
are
working
on
that,
so
apologies
I
know,
you've
asked
that
previously
and
I've
assured
you
it
would
be,
and
we
will
get
that
in
for
the
next,
the
next
report
and
then
just
to
close
in
terms
of
the
a
financial
position
we're
under
spent
year
to
date
largely
due
to
the
profile
of
income
received,
but
we're
Focus
forecasting
that
I'll
be
close
to
budget
by
the
end
of
the
year,
with
a
0.1
million
surplus
previously
as
well
about
the
the.
How
are
activities
funded.
O
I'll
include
this
in
the
report
going
forward,
but
just
for
for
reference
we
have
10
of
our
activity
as
well.
10
9
10
is.
L
O
Not
financed
through
all
the
fees
that
we
charge
to
Providers
and
it's
activity
that
is
funded
by
the
department
through
granting
Aid
and
the
last
bit.
For
me
before
open
a
note
is
just
on
Capital.
We
are
forecast
to
overspend
we're
currently
overspend
to
forecast
or
spend
about
four
and
a
half
million
for
the
year.
We
are
monitoring
that
very
closely
and
in
conversation
with
the
Department
about
any
options
there
are
to
mitigate
that
pressure
for
the
year,
so
I'll
close
that.
A
L
A
M
Hi
hi
Chris
on
the
business
plan
over
there.
One
of
the
points
is
improved
percentage
of
inspections
to
learn
disciples
and
Autism
Services
out
of
hours.
Do
you
think
that
we
should
include
other
services
in
that,
such
as
the
mental
health
services,
secure
services
and
other
areas
at
risk
of
close
cultures?
B
Yeah
yeah
I
am
I,
am
but
really
I
really
believe
that
believe
that
there
should
be
a
strong
component
of
ours,
a
lot
of
our
work,
because
it's
absolutely
critical
that
we
get
out
and
and
observe
care
at
all
points
of
the
the
week
be
evening:
Saturday
Sundays
Etc,
so
we
we
kicked
off
this
this
out
of
hours
as
focus
and
learning,
disability
and
autism
Services.
We
now
need
to
absolutely
have
it
for
other
settings
where
people
live
often
that
that
does
happen.
B
You
know
inspectors
run
over
or
they
start
early,
but
I'm,
quite
Keen
that
we
we
in
regulatory
leadership
in
partnership
with
Tyson
and
the
Ops
group,
are
clear
on
what
our
ambition
is.
You
know
what
what
does
good
look
like?
Would
we
expect
that,
for
example,
30
or
40
of
any
service
where
someone
lives
would
have
an
out
of
hours
component
of
an
inspection
just
as
a
for
example?
So
that
is
a
conversation
we
will
be
having
going
into
23
where
between
us.
B
We
need
to
think
about
what
the
ask
is
and
then,
between
Tyson
and
the
people
team,
we
just
need
to
check
out
that.
That's
an
okay
thing
to
ask
for
are
our
colleagues
and
and
to
make
sure
that
that's
that's
all
that
can
be
handled
in
a
way,
that's
safe
and
and
there's
an
acceptable
will
ask.
But
if
it's
okay,
if
I,
can
just
check
with
the
Titan,
where
Tyson
has
a
different
view
to
what
I've
just
said
that
before.
A
K
I
couldn't
have
put
any
better
myself,
but
just
just
to
reiterate,
Belinda
as
well
and
I.
K
Think
I've
mentioned
this
to
you
before
we're
doing
a
piece
of
work
about
how
we
can
I
guess
have
proper
to
proper
terms
and
conditions
for
our
people
when
we're
expecting
them
to
work
in
the
middle
of
the
night,
for
example,
so
not
not
out
of
hours
in
terms
of
just
before
the
start
of
the
working
day
or
just
after,
but
real
real
out
of
hours
work
and
we
need
to
make
sure,
there's
access
to
supervision
and
and
that
we
keep
keep
our
people
safe.
But
I
completely
agree.
We
should
we
should
be.
A
A
Add
that
to
your
list,
Chris
Mark,
Chambers,.
F
It's
an
improvement
on
the
on
the
previous
reports
and
it's
great
to
to
to
see
this
just
sort
of
one
question:
if
I
might
on
page
83
on
the
publication
data,
you
know
it's
great
to
see
average
days
to
publish
coming
down,
but
the
the
numbers
of
things
that
we're
getting
out
of
the
door
that
have
come
down
as
well.
K
Missing
something
Charlotte
should
I
come
in
again
Chris
I
I
think
the
lead
indicated
for
me.
Mark
is
if
the
timeliness
of
the
reports,
and
so
what
what
are
the
oldest
reports
in
the
system
and
we've
been
trying
to
as
I,
would
call
it
Britain
the
tail
in
for
some
time
now.
F
I
I,
that's
very
helpful.
You
know
variance
is
what
kills
you
here,
and
so
yes,
it's
good
that
you're
tracking
the
tail
thanks.
Thank.
K
F
G
Oh
yeah,
thanks
here
and
thanks
Chris
and
colleagues
for
a
very
comprehensive
report.
It
definitely
does
get
better.
I
had
one
General
point
about
impact,
so
other
colleagues
have
already
mentioned,
but
it's
my
last
meeting
so
I'm
going
to
make
most
of
it
we
have
to.
G
We
do
have
to
count
things,
but
we
do
have
to
think
about
the
impact
and
I
think
this
report
is
still
in
a
bit
of
a
counting
phase
and
I.
Think
if
we
can
start
to
think
about
how
we
show
the
impact
that
we
are
definitely
having
in
this
type
of
report.
G
That
would
be
really
helpful
and
I'm
I
welcome
the
bit
about
risk,
which
says
we
will
be
reporting
in
a
new
type
of
way
around
risk
next
time,
which
is
also
a
positive
step
forward
and
we'll
relate
back
to
our
strategy
and
can
think
about
impact.
So,
first
of
all,
Impact
had
two
small
points.
G
I
think
I've
read
somewhere
and
I
can't
find
it
now
that
we
were
pausing
some
of
our
direct
monitoring
activity
I
think
it's
to
transfer
resources,
but
I
just
wanted
to
check
that
with
Tyson.
That
was
a
question
and
the
second
bit
was
that
we've
seen
an
increasing
give
feedback
on
care
and,
if
I'm
understanding
the
slide
right,
we've
had
a
lot
more
positive
responses
about
the
quality
of
care.
So
I
just
wondered.
If
someone
could
comment
on
that
and
whether
I've
got
that
right
or
not
thanks.
D
A
K
Shall
I
pick
up
on
the
on
the
on
the
dma
point?
No,
no!
We're
not
poor
thing,
GMA
activity!
What
what
we
have!
We
have
a
a
bit
of
a
smaller
team
than
we've
had
for
a
while,
partly
because
the
bank
inspectors
are
now
working
on
our
registration
priorities
and
and
where
people
have
left
the
team.
Naturally,
we've
not
replaced
them
from
within
the
inspection
director.
It's
because
of
the
the
pressures
that
they're
under
at
the
moment,
but
the
team
are
still
are
still
working
on
dmas
and
that's
the
plan.
K
The
the
dma
inspectors
will
move
into
the
integrated
teams
when
we
move
into
the
integrated
teams
in
March,
but
they
will
continue
to
work
on
dma's
with
some
national
oversight
until
until
we
adopt
the
regulatory
platform
later
on
in
2023,
so
we're
still
using
the
we're
still
using
the
dma
and
and
on
the
good,
give
feedback
on
care
points.
Ali
I
think
one
point
I
would
make.
K
Is
that
actually
I
think
the
the
dma
activity
might
well
be
driving
up
some
of
the
more
positive
feedback,
because
a
part
of
the
preparation
for
the
dma
is
asking
providers
to
seek
feedback
about
their
performance
and
so
I
think
we're
getting
more
performance?
And
you
may
well
more
feedback,
and
some
of
that
may
actually
be
the
more
positive
feedback
that
people
wouldn't
normally
surrender
if,
if
they
hadn't
been
prompted
for
it.
J
I
O
On
the
your
point
about
outcome,
Sally
just
to
say,
I
couldn't
agree
with
you
more.
You
know
we
had
conversations
with
each
board,
member
of
our
future
planning
future
measures,
and
that
was
resounding
feedback
to
us
which
we
completely
endorse.
So
that's
what
we're
aiming
for
for
the
future.
Our
ability
to
capture
those
outcomes
is
is
what
we're
trying
to
deliver
on,
which
is
why
the
balance
is
probably
out
of
the
minute,
but
it's
definitely
something
we
are
working
towards.
I
Just
to
build
on
on
Tyson's
Point
around
give
feedback
on
care,
also
as
part
of
the
Thematic
work.
We
are
looking
for
examples
of
innovation
and
good
practice,
so
we're
in
a
sense
we're
looking
for
some
of
those
people's
experience
of
how
Services
have
improved
and
changed
I
think
to
further
aside,
there's
still
more
that
were
that
were
seen
that
comes
from
people's
concerns
about
care,
but
it,
but
that
I
think
it's
important
that
we
can.
I
We
can
look
for
both
and
and
certainly
in
terms
of
driving
improvement.
It's
important.
We
can
see
why
and
how
Services
change
and
improve
and
how
they
bring
people
who
use
them
with
them.
A
Thanks
Chris
Mark
Saxton.
J
Thank
you
chairman
and
thank
you
Chris
for
preempting
my
question
and
knowing
that
I
would
go
to
chart
88
on
in
your
pack,
but
I
I'm
to
Sally's
Point.
You
know
it
might
look
as
if
I'm
looking
just
to
count
things
and
actually
the
things
I
want
to
count
do
have
an
impact
as
well.
So
that's
why
I've
asked
you
to
go
after
the
promotions
and
the
acting
apps
and
in
in
terms
of
ethnicity
and
and
disability.
J
So
you
know
so
that
we
can
measure
what
we're
doing
and
may
I
also
say
and
I'm
sorry
Chris
said.
Another
chart
is
missing:
that's
normally
in
this
pack,
and
that
is
our
recruitment
performance
across
ethnicity
and
disability,
and
that
has
an
impact
on
us
as
an
employer
as
well.
So
I,
yeah
I
think
it's.
It's
really
good.
If
we
keep
those
that
chart
coming
back
into
this
pack
so
that
we
can
monitor
that
performance,
but
thanks
it's
as
always,
Chris
a
very
thorough
report.
So
thank
you.
A
Of
course,
there
are
a
few.
The
ultra
marks
comment
needed
an
answer
as
such,
but
I
we
have
talked
about
other
changes
on
reporting,
it'd,
probably
be
helpful
to
make
sure
we
do
have
a
suitably
standardized
pack
so
that
we
make
sure
we're
reporting
it.
A
So
we
want
to
report
against
not
just
what
somebody
might
just
put
together
we're
making
changes
in
any
event
to
our
risk
framework,
so
that
will
probably
impact
some
of
this
reporting
in
any
event,
so
not
trying
to
put
words
in
your
mouth,
but
am
I
right
in
thinking
that
that
maybe
the
beginning
of
next
financial
year
that
some
of
this
will
look
a
bit
different.
O
Yeah,
that's
the
plan.
I
mean
it's
constantly
evolving,
so
we're
trying
to
enhance
the
reporting
through
this
year
and
the
look
and
feel
of
it,
but
I
think
coming
back
to
the
heart
of
the
measures
that
still
work,
that
we're
building
in
on
going
in
and
we'll
have
a
new
performance
framework
and
Reporting
on
this
against
a
new
business
plan
for
next
year.
O
Hopefully,
focus
on
more
outcome
measures
and,
as
I
said,
against
a
risk
framework
as
well
in
terms
of
Mark's
Point
around
the
people's
side
will
take
that
away,
an
apologies
that
was
and
obviously
I,
think
we
need
to
get
into
a
better
Rhythm
around.
What
do
we
report
through
a
corporate
performance
pack
and
what
do
we
do
as
part
of
a
people
Plan
update
of
both
of
which
kind
of
regularly
come
into
the
board?
O
A
Okay,
thanks
Chris
Stephen
Marston,
anything.
H
Two
points
the
first
one
may
be
just
a
kind
of
different
reflection
on
on
the
the
Sally
Chris
discussion,
I
suppose,
just
looking
at
page
71
in
the
pack,
it's
very
green
and
for
me,
that's
kind
of
setting
up
a
bit
of
a
disjunction
about
what
we
know
about
the
stresses
and
strains
on
the
services
that
we're
dealing
with
now.
H
The
other
point
I
just
wanted
to
raise
is
Page
73,
which
got
me
interested
because
of
the
regional
difference
in
percentage
of
services,
rated
good
or
outstanding
Northeast,
91,
West,
Midlands
83.5,
quite
a
big
gap,
and
that
got
me
sort
of
thinking.
Well,
where
does
where
does
that?
Where
does
that
go?
Where
do
we
take
that
in
terms
of
trying
to
work
out
what's
going
on
in
those
different
regions
that
we
or
ics's
or
anybody
else
could
could
learn
from
because
for
me,
that's
really
quite
an
interesting
element.
H
B
So
so
Stephanie
Steph
you'll
know
from
Chris's
team
has
been
bitterly
working
away
at
what
a
map
looks
like
across
the
country.
When
you
look
at
provider
ratings
within
ics's,
so
with
an
integrated
care
system
to
draw
out
that
very
Point
Stephen
around
variation-
and
you
can
cut
it
a
number
of
different
ways,
you
can
look
at
variation
across
adult
social
care
services
across
hospitals
Etc,
so
that
that
data
is
available
already
I.
Think
where
I
get
excited
is
when
I
think
about
our
new
powers
from
April
23
onwards.
B
It's
how
we
might
use
that
data
and
insight.
We
have
about
quality
of
providers
at
presented
at
an
ICS
or
a
local
Authority
level
to
invite
those
ics's
to
do
that
to
you
know
to
either
get
involved.
If
there's
areas
that
need
Improvement
to
learn
from
best
practice
from
from
other
ics's,
so
I
think
it's
critical
that
we
always
use
the
Insight
that
we
have
because
of
our
unique
position
to
then
make
that
as
accessible
for
organizations.
B
I
We
need
to
understand
both
the
underlying
health
inequalities
in
an
area,
how
the
organize,
how
the
individual
organizations
are
performing
and
how
the
ICS
and
local
Authority
plans
support
the
Improvement
of
an
area
taking
into
account
the
health
inequalities
that
exist
and
I.
Think
what
we've
got
at
the
moment
is
some
of
the
information
around
how
services
are
performing
and
I
think
we're
getting
an
improving
picture
of
the
underlying
health
equalities
in
an
area.
I
So,
for
example,
I
want
to
say
that
West
Midlands
has
a
has
proportionately
a
lower
or
sorry
higher
health,
health
inequalities
and
elements
of
the
Northeast,
even
though
you
might
think
they're
actually
quite
similar
and
and
if
you
think,
if
you
add
into
that
the
fact
that
it
has
a
poorer
performing
and
more
reductions
in
elements
of
adult
social
care
than
the
Northeast,
you
can
begin
to
see
why
there
may
be
differences
that
exist
there.
I
But
I
think
the
real
opportunity
here
and
the
real
excitement
is
to
pull
these
in
essentially
quite
disparate
pieces
of
information
that
sit
across
different
organizations
together
to
form
a
common
understanding
of
how
areas
are
performing
N1
line.
I
think
in
that
way
we
can
provide
the
best
guide
to
ics's
and
local
authorities
and
enable
them
to
provide
the
best
service
for
people
in
their
local
areas.
A
A
Chris
I
had
a
number
of
detailed
questions
and
most
of
them
are
being
covered
by
my
colleague.
So
we
also
look
for
some
of
the
same
things.
Can
I
just
ask
two
more?
What
I
think
is
a
viewer?
One
might
be
for
python.
On
page
74,
it's
headed
up.
The
the
rating
does
not
match
the
predicted
risk.
Do
you
mean
predicted
or
previous,
so
his
previous
that's
factual?
If
it's
predicted,
how
are
we
going
about
making
that
prediction?
O
So
it
is
predicted
it's
based
on
I
mean
Mark
might
want
to
talk
to
this
better
than
me,
but
it's
based
on
the
algorithms
I
think
that
would
determine
what
what
a
risk
profile
is.
The
the
the
three
bondings
that
we're
operating
with
so
it's
based
on
that
algorithm
coming
through
in
terms
of
predicted
risk.
O
It's
so
it's
we.
We
have
kind
of
algorithms
telling
us
three
bandings
of
of
profiling,
our
our
Services
over
three
bands,
high
medium
low
It's,
a
Wonderful
better
word.
We
are
doing
sample
inspections
of
the,
so
in
a
band
one
you
wouldn't
inspect.
You
would
do
a
published
statement
which
would
go
onto
our
website.
O
We
are
sampling
some
of
those
band
One
Services,
to
see
what
we
find
on
inspection
to
test,
whether
what
we
are,
how
we
are
our
algorithm
and
how
we're
assessing
that
risk
is,
is
correct
or
not
so,
we'll
sample
some
of
those
inspections
and
similar
to
band
two.
Where
we
do
a
dma
call,
we
again
we'll
be
sampling,
some
of
them
by
doing
an
inspection.
A
Okay,
perhaps
misunderstood
the
the
chart.
Okay
thanks,
I
I
was
also
intrigued
by
the
the
big
increase
in
positive
outcomes
on
page
76,
but
as
being
mentioned,
and
then
my
last
one
on
page
79
in
the
pack.
This
is
percentages
of
action
taken
to
mitigate
risk.
I
mean
it's
great
that
the
percentage
has
increased,
really
quite
markedly.
A
I
wondered
if
Tyson,
neither
you
or
one
of
your
colleagues
could
say
a
bit
more
about
why
that
significant,
Improvement
and
and
what
do
we
Define
as
action
for
the
purposes
of
this
presentation?.
K
I
mean
I,
think
I.
Think
the
performance
on
this
measure
is
is
strong,
because
I
think
there's
been
a
particular
focus
on
it
over
the
last
few
months
and
I
mean
there's
been
a
lot
of,
there's
been
a
lot
of
focus
on
one
whistleblowing
across
the
board
in
in
the
commission
and
I.
K
Think
that
that's
a
good
sign
of
that
in
terms
of
what
the
actions
are
I
think
there
are
a
number
of
categories
in
terms
of,
in
some
cases,
alert
alerting
the
provider
so
that
they're
they're
aware
and
they
can
they
can
address.
They
can
address
what
the
what
the
problem
is,
and
there
will
be
other
actions
that
we
will
take.
K
But
I
think
this
is.
This
is
one
of
those
measures
that
doesn't
measure
outcome
and
I
think
there
is
some
work
that
we're
now
doing.
There's
a
new
colleague
Haley
Moore
who's
working
for
Kate
in
regulatory
leadership,
on
safeguarding
who's.
Looking
at
what
we
do
as
a
result
of
the
actions
that
are
taken,
it's
not
just
good
enough
to
do
something
within
five
days.
We
want
to
make
sure
that
the
quality
of
our
overall
contribution
to
safety
is
right
and
so
that
that's
the
qualitative
element.
A
Well,
obviously,
it
was
behind
my
question
as
to
if
you
there
could
be
many
reasons
for
an
increase
in
of
ability
to
to
respond.
It
depends
on
the
quality
of
response
yeah,
okay
website
you
want
to
come
in
as.
B
Well,
yeah,
if
I
could
just
linked
to
the
Scots
update
earlier
at
one
of
the
worships,
is
around
whistleblowing
and
it
is
doing
study.
Is
your
outcomes
point
so
this
counts
the
numbers
so
check?
Are
we
taking
in
action
within
five
days
the
work
that
sits
under
this
whistlebling?
What
extreme
is
interviewing
whistleblowers?
How
did
they
experience
their
dealings
with
us?
It's
really
testing
ourselves.
B
That
says
you
know
in
an
X
number
of
cases,
you
ask
you
invite
a
provider
to
investigate
is
that
is
that
the
right
thing
does
that
get
the
best
outcome,
so
we
are
doing
that
really
detailed
piece
of
work
to
really
challenge
ourselves
around
the
actions
we
are
taking,
because
this
statistic
looks
great
and
it's
fabulous
that
our
teams
are
getting
on
and
taking
action
and
it's
being
recorded
as
such.
The
the
work
in
the
review
that
Scott
was
talking
about.
B
Is
us
really
scrutinizing
our
approach
to
how
we,
how
we
action
whistleblers
to
make
sure
that
we're
getting
the
best
outcomes
for
them
and
for
the
services
they're
often
raising
concerns
about.
A
And
I
guess:
there's
also
a
link
here
to
the
work
that
Scott
was
talking
about
earlier
on,
there's
a
lot
of
potential
with
that.
Okay,
thank
you.
No
more
questions.
Let's
conclude
that.
Thank
you
very
much
indeed.
One
last
thing
before
we
take
a
short
Comfort
break.
We
have
a
transformation
and
people
update
so
Kate
and
Mark
you're
on
the
line.
I
think
Amy
Pritchard
was
going
to
join
us.
I
can't
immediately
see
here.
P
S
B
So,
quite
rightly,
we
often
hone
in
on
what
we
need
to
do
better
and
what
is
slipping
but
I.
Think
it's
important
in
these
kind
of
quarterly
updates
that
we
also
celebrate
some
significant
achievements
that
have
been
delivered
over
the
last
quarter.
So
I'm
gonna
invite
Amy
to
kind
of
shine
a
spotlight
on
a
couple
of
those
and
I.
B
Imagine
Mark
will
come
and
want
to
come
in
also,
but
we'll
also
flag,
some
areas
that
we're
doing
some
more
work
on
and
when
we'll
be
able
to
talk
about
that,
a
bit
more
in
the
kind
of
coming
weeks
and
months
so
over
to
you,
Amy.
S
S
So
we've
been
really
grateful
to
the
support
of
colleagues
providers
and
other
partners
who
have
all
given
us
feedback
over
this
period.
That's
really
enabled
us
to
strengthen
our
approach
to
this
rollout,
we're
particularly
grateful
to
colleagues
in
ics's
and
local
authorities,
who
have
been
helping
us
to
shape
our
approach
to
assessment
in
this
space
and
we're
really
starting
to
now
think
about
what
we
can
do
by
the
start
of
April
next
year
to
apply
some
of
this
thinking
internally.
S
Our
work
to
transition
colleagues
into
integrated
teams
is
on
track
to
happen
in
March,
and
all
colleagues
now
know
what
their
new
roles
are
in
those
teams.
S
This
represents
the
first
phase
of
the
journey
for
people
in
moving
towards
that
new
regulatory
approach,
and
there
will
be
subsequent
phases
over
the
course
of
the
next
year
and,
as
I
said
in
my
opening
remarks,
we've
taken
an
enormous
amount
of
time
over
the
last
quarter
to
really
reflect
on
how
well
the
transformation
program
has
worked
to
date
and,
as
a
consequence,
we've
really
strengthened
our
practice
and
adapted
our
approach
to
roll
out,
making
it
more
sensitive
to
the
load
that
we
are
placing
on
providers
and
people
and
also
really
deliver
a
much
improved
user
experience.
S
So,
in
summary,
we'll
be
looking
to
talk
about
our
revised
timings
with
the
organization
providers
and
others
over
the
course
of
the
next
month.
So
I'll
just
invite
Mark
in
to
see
if
there's
anything
you'd
like
to
add,
and
then
we
can
take
questions.
T
T
We
can
learn
from
that
experience
and
that's
exactly
what
we've
done
and
that
work
will
allow
us
to,
to
course
correct
and
deliver
new
Services
which
are
really
fully
incorporating
of
that
feedback
from
providers
and
from
external
parties.
The
important
thing
to
note
is
that
the
the
foundation
of
what
we've
built
is
really
secure.
T
We've
got
a
number
of
live
services
that
were
already
running
on
this
Dynamics
365,
this
regulator,
platform
environment,
that
that
is
facilitated
by
that
that
foundational
work,
the
the
environments,
the
data
structures,
the
migration
of
data
from
our
Legacy
systems,
and
that
includes
products
that
people
will
be
familiar
with
and
direct
monitoring
activity
and
new
maternity
safety
assessments
and
we're
continuing
to
build
on
those
we're
building.
T
That's
been
done
on
our
transforming
data
Insight
program
that
has
been
about
building
a
a
new
capability
made
of
a
new
capability
of
of
people
and
the
technology
that
supports
that
and
throughout
this
year
we've
delivered
a
a
new,
a
new
structure.
We
have
new
heads
up
in
place
in
our
in
our
data
and
insight
capability.
T
We've
got
a
new
Enterprise
data
platform
which
we've
We've
delivered
and
we're
making
a
really
significant
progress
in
migrating
from
our
Legacy
Insight
reports
into
our
new
Microsoft
Azure
and
power
bi
environments,
all
of
our
new
services
are
now
being
built
in
that
environment
and
that
transition
is
making
really
good
progress
and
will
be
completed
by
the
end
of
this
financial
year.
E
Nice,
just
just
to
reinforce
the
point
that
Mark
was,
was
making
about
the
the
importance
of
things
like
data
taxonomy,
but
all
that
that
database
management
activity
that
that
Mark
talked
about
it's,
it's
quite
easy
to
say,
but
the
the
practicalities
of
doing
this
and
maintaining
the
Integrity
of
data
as
you
go
from
old
system
to
new
system.
It's
really
important
foundational
work
and
the
work
we're
doing
with
the
maternity
program,
for
example,
are
testing
that
end-to-end
integration.
So
I
think
that's
a
that's
a
really
important
message
and
I
I
think.
E
Sometimes
we
we
probably
just
see
that
as
being
quite
simple
work,
but
actually
there's
a
there's
an
awful
lot
to
it.
When
we've
got
some
billions
of
documents
that
that
from
our
regulatory
history
that
we
need
to
carry
forward
and
we
need
to
carry
forward
the
cat
care
for
the
the
the
the
codification
and
systematization
of
this
in
a
way
that
we
can
then
start
to
form
these.
These
long-term
views
and
long-term
National
views
of
what's
going
on
as
because
we
are
we're
doing
two
things
here.
Really.
E
We
are
making
sure
that
we
can
continue
to
to
run
our
our
day-to-day.
Let's
look
at
a
provider,
let's
rate,
let's,
let's
regulate
and
rate
a
provider,
but
we're
also
starting
to
think
about
what
how
we
can
start
to
aggregate
that
information
together
and
also
report
that
things
like
ICS
level,
at
Regional
level
and
and
at
National
level
and.
O
E
Of
that
will
be
possible
without
some
of
this
really
really
hard-end
data
management
activity
and,
of
course,
the
the
group
of
people
that
work
work
for
Mark
in
in
the
in
in
the
data
and
insights
team
that
are
that
are
starting
to
bring
this
together
and
we
have
to
process
this
information
that
the
group
we
don't
often
talk
about,
but
I
think
a
huge
tribute
to
the
work
that
they've
done.
A
Well,
I
guess
this
means
going
into
next
financial
year
when
we
come
to
look
at
the
business
plan
that
will
include
now
quite
a
bit
of
the
the
back
end
of
completing
this
and
turning
it
into
business
as
usual
by
you
know,
orders
of
magnitude,
probably
halfway
through
the
exponential
year,
is
that
right.
U
A
Okay,
any
other
questions
from
colleagues,
okay,
well,
Amy.
We
let
you
off
very
lightly.
Thank
you
very
much
indeed,.
S
A
Bye-Bye,
so
why
don't
I
think
we'd
only
allowed
about
a
five
minute,
Comfort
break?
That's
probably
a
bit
mean
the
risk
of
running
is
behind
schedule.
Why
don't
we
try
to
recommence
absolutely
if
I
say
at
22
no
later
than
people
could
be
back.
It
gives
you
a
chance
to
go
warm
up
thanks
very
much.
A
Welcome
back
for
anyone
listening
to
the
live,
webcast
welcome
back
to
you
as
well.
A
The
next
session
is
an
update
from
Louise
Ansari
who's.
The
director
of
healthwatch
England,
just
for
a
hand
over
to
her
I
thought.
I
might
just
mention
that,
as
we've
already
touched
on,
Robert
Francis,
of
course,
retired
from
his
role
as
chair
of
healthwatch
England
in
the
middle
of
November
I
also
mentioned
earlier.
The
department
is
in
the
process
of
recruiting
a
successor
just
to
provide
the
right
links
to
between
health
and
poacher
England
and
the
board.
A
We've
asked
for
Linda
black
one
of
our
existing
non-executive
directors
to
act
in
a
an
interim
chair
role.
Until
such
times
they
have
a
full-time
appointment,
so
she
is
actively
engaged
Belinda.
If
you
want
to
say
anything
later,
please
do
but
I
won't
ask
you
to
say
anything
at
this
stage,
I'll
just
hand
straight
over
to
Louise
so
Louise.
The
floor
is
yours.
V
Thank
you,
chair
and
good
afternoon
everybody
a
pleasure
to
be
here
online
to
talk
to
you
today,
I'm
not
going
to
go
through
the
report,
which
I'm
sure
you've
read
but
I'll
be
happy
to
answer
any
questions.
What
I'm
going
to
do
very
briefly,
because
I
know
that
you
are
very
interested
in
the
impact
that
that
healthwatch
has
is
talk
about
one
example
of
the
significant
impact
that
a
local
Health
watch
has
had.
V
We
had
our
housewatch
week
and
our
housewatch
Awards
recently,
and
we
had
some
just
phenomenal
examples
of
the
of
the
difference.
People
can
make
so
I'll
be
very
briefed.
So
it's
a
really
interesting
example.
The
health
watch
Sunderland
have
got
regular
sessions
with
an
organization
called
Sunderland
people
first,
and
they
heard
from
Sharon
who's
got
a
learning
disability
after
she
received
a
mammogram.
She
had
a
recall
letter
and
she
couldn't
understand
the
letter.
V
It
was
in
the
complicated
jargon
that
the
NHS
sometimes
sends
its
Letters
Out
in,
and
she
felt
that
she
had
to
ask
somebody
else
to
explain
the
letter
to
her,
which
meant
that
she
felt
her
independence
had
been
taken
away
effectively.
V
So
in
response,
healthwatch
Sunderland
worked
with
several
NHS
teams,
those
at
the
local
Breast
Care
Clinic
and
the
PHD
screening
services
and
discovered
that
there
are
actually
three
standardized
recall
letters
after
a
mammogram,
none
of
which
were
in
easy,
read
format,
and
so
what
the
team
did,
along
with
with
Sharon,
is
actually
support.
Sharon,
to
explain
to
the
people
who
who
create
easy,
read
and
who
create
callback,
letters
that
she
couldn't
understand
them
and
she
helped
the
teams.
Sharon
helped
the
teams.
V
Draft
easy,
read,
recall
letters,
so
it
this
actually
took
a
couple
of
years
to
do,
and
it
was
the
Persistence
of
Sharon
and
healthwatch
Sunderland
that
have
that
have
brought
about
this
change,
which
means
that
easy
read
letters
are
now
available
to
be
sent
out
to
to
women
who
have
mammograms,
and
that
means
that
all
people
with
learning
disabilities
can
Now
understand.
What's
actually
what's
actually
happened.
V
And
there
are
hundreds
of
examples
of
this
up
and
down
the
country
if
any
members
of
this
board
would
like
to
visit
a
local
Health
watch
and
hear
about
some
of
those
examples
would
be
very
happy
to
facilitate
that,
but
just
after
after
my
first
year
in
in
post,
I'm,
always
very
inspired
by
these
kinds
of
stories,
so
I
thought
I'd
share
one
with
you
today,
but
as
I
say
very
very
happy
to
answer
any
questions
about
the
Fuller
report,
chat.
A
So
anyways
I've
had
problems
sometimes
unmuting
myself
today
at
least
I
realized
today
before
I
smoke.
So
thank
you
very
much
for
for
that
story
and
other
things.
So
we
have
your
report
comments
from
colleagues.
L
Q
Thank
you
Louise
for
a
great
update.
As
always,
and
it's
good
to
hear
about
the
work.
That's
being
done.
They
noted
that
when
we
looked
at
the
section
that
talk
about
supporting
the
healthwatch
network
and
improving
data
collection,
there's
noted
that
many
Health
watches
are
unable
to
afford
paper
systems,
and
certainly
we
know
that
Health
Watchers
do
excellent
work
for
very
constrained
budgets
and
deliver
a
great
return
on
them
too.
A
V
Could
so
that's
one
of
the
things
that
keeps
me
awake
at
night
is:
is
financial
sustainability
for
the
healthwatch
network
and
it's
not
just
being
able
to
finance
a
good
data
collection
systems
and
we're
working
hard
to
support
them
on
on
on
cost-free
ways
of
doing
that,
as
well
as
providing
them
with
other
kind
of
data
platforms.
V
Some
health
watch,
some
of
the
smallest
Health
watch,
are
running
on
around
about
60
000
a
year
which
barely
covers
their
ability
to
actually
have
a.
You
know,
fully
functioning
organization,
and
then
others
are
on
three
or
four
hundred
thousand
and
the
variation
is
staggering.
I
find
it
and
it
doesn't
particularly
it
doesn't
particularly
match
deprivation
or
the
populations
they're
serving.
V
So
some
of
the
things
that
we're
trying
to
do
in
that
space
are
talking
to
commissioners
of
local
Health
watch,
who
are,
of
course,
local
authorities
and
to
the
Department
of
Health
to
escalate
con,
where
we
have
concerns
about
commissioning
at
to
lower
level
and
what
the
Department
of
Health
can
do
to
go
back
to
the
Commissioners
and
provide
clear
guidance
about
the
level
of
commissioning.
V
We
also
produce
an
annual
report
called
the
state
of
support
which
gives
a
huge
amount
of
detail
around
the
country
about
how
much
funding
every
single
Health
watch
has
and
most
of
them
use
that
the
lower
the
lower
funded
ones
use
that
to
provide
comparative
information
with
their
local
authorities.
We
also
support
them
in
other
fundraising
activities.
Many
of
them
are
Charities,
and
many
of
them
do
get
funds
from
other
sources,
including
some
funds
on
Project
work
from
the
CQC.
A
And
thanks
Maurice
Belinda.
M
Thanks
for
that
story,
Louise
it,
it
really
shows
the
impact
that
local
Health
Watchers
have
when
they've
got
some
resources
to
do
the
job
properly,
and
it
was
really
nice
to
hear
that
story.
But
my
questions
I
can
relate
to
you
apart.
Really,
it's
related
to
the
upcoming
nurse
strikes
and
I.
Wonder
if
the
local
Health
Watchers
have
said
anything
back
to
you
are
you've
had
Direct
concerns
yourselves
from
members
of
the
public.
V
Linda
and
we've
actually
being
very
tried
to
be
very
careful
and
evidence-based
in
what
we
say.
So
we've
been
very
careful
in
terms
of
ensuring
that
our
position
is
based
on
what
we
know
at
the
moment.
V
However,
today
we
wrote
to
Pat
Cullen
General
Secretary
of
the
RCN,
with
some
concerns
about
the
possible
variation
in
the
provision
of
Life,
protecting
care
in
hospitals
around
the
country,
and
also
about
the
confusion
that
that
might
that
and
anxiety
that
people
are
going
to
be
experiencing
when
they're
not
entirely
sure
whether
or
not
they're
going
to
get
chemotherapy
or
or
what's
available
on
a
bank
holidays
they've
been
describing
it.
V
So,
following
the
letter
we've
sent
to
pacqueline
this
morning,
I
had
a
meeting
with
Nicola
Ranger
who's,
the
deputy
chief
executive
of
the
RCN,
and
she
committed
to
both
national
and
local
strike
committee
level,
further
Communications
to
patients
and
the
public
about
what
they
could
expect.
So
we
we
may
say
more
about
this
as
as,
if
the
strikes
happen-
and
we
understand
the
impact
more
but
at
the
moment
we're
happy
that
the
RCN
has
been
open
to
our
approach
and
is
committing
to
try
and
improve
Communications.
V
We
have
been
in
Fairly
constant
contact
with
NHS
England,
who
have
who
have
put
now
at
our
request
and
requests
of
H,
UK
and
others
a
q
a
on
their
website
to
explain
what
the
exact
state
of
play
is
at
the
moment
and
we're
continuing
to
talk
to
them
about
their
requests
to
trusts
in
terms
of
local
Communications,
foreign.
A
J
Saxton
thanks
chairman
and
hi
Louise
good,
to
see
you
again
and
very
thorough
report.
Louise
was
really
interested
in
the
work.
You've
been
doing
around
maternity
services
and,
as
you
know,
we
in
CQC
are
very
much
engaged
in
working
with
the
maternity
services
from
a
patient
safety
point
of
view,
and
we've
done
a
lot
of
work
in
terms
of
bringing
maternity
staff
together
and
learning,
and
we
have
a
special
maternity
service
inspection
program.
I
just
wondered:
are
we
connecting
with
each
other
here
because
I'm
sure
we
could
both
learn
off
each
other?
J
V
You
Mark,
yes,
absolutely
and
thinking
about
the
state
of
care.
You
know
the
really
impactful
CQC
sync
reports
where
we
we
all
fed
in
what
we
knew
and
what
we
know
about
maternity
purposes
and
people's
experiences
of
that
into
that
report
as
well.
V
Currently,
what
we're
doing
is
collecting
people's
experiences
of
maternity
and
mental
health,
because
before
my
time,
child's
watch,
England
influenced
NHS
England
to
try
and
ensure
that
people
would
get
a
six-week
check
on
their
mental
health,
even
if
they've
got
pre-existing
mental
health
conditions
or
their
mental
health
was
poor
because
of
anything
to
do
with
maternity
or
or
having
having
a
child,
and
we
don't
believe
that
that's
happening
around
the
country
in
the
way
it
should
be.
V
But
you
know
for
lots
of
reasons,
Workforce
issues
and
a
range
of
reasons,
so
we've
just
we've
been
reaching
out
and
local
healthwatch
have
been
talking
to
individuals
in
a
kind
of
Deep
dive
and
getting
a
kind
of
case
studies
of
people's
experience.
We
are
very
pleased
to
say:
we've
had
we've
actually
had
several
thousand
people
contact
us
with
their
experience
of
maternal
mental
health.
V
So
we're
going
to
be
in
a
position
in
the
new
year
to
give
a
pretty
comprehensive
report
of
the
experience
of
of
new
mothers
and
whether
or
not
their
mental
health
is
being
taken
care
of
and
will
absolutely
work
with.
Chris
and
Jill
Marathon
the
team
to
make
sure
that
we
link
up
with
the
work
that
CQC
is
doing
on
on
maternity
and
and
consider
what
we
can
do
together
going
forward.
V
A
G
W
G
And
hi
Louise
had
the
pleasure
of
your
team
coming
to
our
audit
committee
last
week
to
report
on
risk
and
governance
Assurance.
So,
first
of
all,
I
just
wanted
to
say
thank
you
for
that.
You
always
bring
a
really
good
sense
of
the
risks
you
face
in
a
great
level
of
detail.
It's
always
up
to
date
and
they're
always
very
eloquent.
So
this
is
actually
my
last
meeting
as
a
CQC
board
member,
but
I
just
wanted
to
place.
G
G
Secondly,
I
just
had
a
question
about
social
care
just
to
raise
it
up
here,
really
in
public,
so
I
know
you
are
healthwatch,
but
you've
talked
a
little
bit
about
your
campaign
around
access
to
social
care.
My
councils,
all
the
NHS
and
Kate,
might
want
to
comment
as
well
potentially,
but
it's
really
interesting.
Isn't
it
that
if
there
is
that
unmet
need
where
we
signpost
people
and
whether
we
could
get
a
bit
more
publicity
about
that,
particularly
over
the
winter
period.
Thanks
thank.
V
You
Sally
and
just
to
say
how
much
we've
valued
your
support
as
the
chair
of
the
CQC
audit
committee
and
your
and
your
challenge
and
and
such
a
a
sensitive
but
properly
challenging
way.
I
really
really
appreciate
that,
over
the
years
from
a
social
care
point
of
view,
you're
absolutely
right.
V
The
risks
on
this
level
of
not
understanding
where
to
go
for
social
care,
how
to
ask
for
it,
and
that
also
matches
to
some
extent
with
the
problem
of
what
the
definition
of
need
is
from
coming
up
the
department
and
then
that
being
evenly
applied
across
the
country
by
local
authorities.
So
that
may
well
be
a
direction
we're
going
in
trying
to
determine
what
what
a
clear
definition
of
unmet
need
is,
which
would
then
support
people
receiving
the
proper
level
of
social
care,
so
that
I
mean
there's.
V
There's
yes,
even
though
we're
called
healthwatch
and
various
people
do
say
this
way.
You
know
we
need
to
make
sure
that
we
are
clear
that
we're
here
on
social
care
as
well
and
actually
during
Health
watch
week
and
as
we're
in
as
a
strategy
sort
of
renewal
cycle.
At
the
moment.
A
large
number
of
people
have
said
to
us.
You
also
need
to
focus
on
social
care,
so
make
that
an
important
part
of
what
you
do
in
the
future.
V
So
we're
still
exploring
what
more
we
can
do,
taking
into
account
that
local
healthwatch
do
have
this
power
of
entrant
view
in
Social
care
facilities,
but
also
what
we
can
do
at
a
national
level
and
what
is
a
very
complex
picture
where
nobody
seems
to
quite
have
the
comprehensive
political
will
or
levers
to
pull
to.
V
You
know
make
the
requisite
changes
in
the
in
the
in
the
system
of
you,
know
the
the
market
and
the
and
the
workforce
so
we're
trying
to
sort
of
hone
down
on
where
we
might
actually
be
able
to
make
a
difference.
Information
and
advice
on
where
to
go
is
probably
one
area,
but
a
definition
of
of
of
what
is
need
and
what's
on
that
need
May
well
be
another.
A
B
I
said
just
a
super
quick
remind
us.
Obviously,
when
we
start
doing
local
Authority
Assurance,
then
we
will
have
the
ability
to
consider
how
local
authorities
are
meeting
their
Care
Act
requirements.
So
it's
set
up
really
clearly
in
legislation.
What
is
a,
what
is
a
statutory
need
that
should
be
being
met
and
and
the
kind
of
fresh
insights
we'll
be
able
to
bring
from
April
23
will
hopefully
enhance
the
kind
of
transparency
and
the
understanding
about
what
that
variation
potentially
looks
like
across
the
country
as
well.
Thanks.
A
Thanks
Kate
I
think
it's
the
end
of
the
comments
up
there.
One
last
comment
really
rather
than
question
from
me:
Louise
but
I
mean
obviously
we
talked
before
I.
Certainly
I
talked
to
you
and
I
think
in
this
format
about
the
role
of
healthwatch
England
with
the
new
care
system.
So
I
think
you
will
be
inputting
to
the
Hewitt
review
and
then
a
meeting
we
were
attending
the
other
day
outside
the
board.
A
I
think
we've
agreed
well,
you
know
Chris's
team
and
others
will
just
make
sure
that
or
Joyce
whoever
it
is
I'll
get
to
make
sure
that
we
facilitate
giving
your
feedback
into
that
review.
So
that's
more
of
an
observation.
Unless
you
wish
to
comment
on
it.
V
Thank
you,
chair
guests.
We've
met
with
the
with
the
review
team
and
we're
we're
we're
guessing
our
response
ready,
so
the
team
will
definitely
be
talking
to
CQC
colleagues
about
them.
Okay,
right,
thank.
A
You
all
right
Belize!
Thank
you
very
much
for
joining
us
usual
helpful
report
and
we'll
see
you
in
a
few
outside,
if
not
before.
Thanks.
Thank
you
bye.
For
me,
we
now
have
a
an
update
from
our
CQC
equality
networks.
I
think
Paul
Kirby,
who
I
mentioned
at
the
beginning
of
this
meeting,
is
setting
it
as
a
attending
all
listening
of
representing
all
their
networks.
A
B
Is
indeed
yes
fabulous?
So
thank
you
much
so
much
colleagues
for
joining
us,
so
you're
going
to
hear
a
kind
of
forward
view
from
each
of
the
from
each
of
the
network
chairs
about
what
their
priorities
are
for
2023
and
also
I'm
really
pleased
to
introduce
Nadia.
You
heard
at
our
earlier
people
Plan
update
that
we'd
appointed
a
new
diversity
and
occlusion
manager,
who's
Nadia,
who
has
just
been
called
into
into
the
meeting
now.
B
X
You
Kate
thank
you,
chair,
I've,
introduced
before
the
disability,
equality
networks
chair
before
I,
go
to
the
priority.
It's
been
a
real
tough
year.
The
network
of
change
and
and
from
the
previous
meeting
you've
had
is
the
vice
chair,
Karen
Hill,
at
Express
National
concern
that
some
of
them
are
struggling
and
coping
differently
and
to
adapt
the
den
leadership
team.
X
We
want
to
see
a
change
of
the
way
our
dead
Network
to
be
reformed
differently,
because
you've
got
this
area
of
neurodiversity,
which
is
the
high
population
in
CQC
and
mental
health
group
as
well,
and
long
Health,
positions
and
I
want
to
make
sure
that
the
subgroup
that
I
created
a
few
years
ago
actually
works.
But
the
volume
of
the
network
is
increasing.
X
We've
got
over
300
members
and
to
hear
300
voices
and
I
appreciate
you
hearing
of
the
CEO
3
000
voices
I
only
got
three
years
voices,
but
those
voices
count,
and
we
want
to
make
sure
that
we
hear
them
and
feed
that
back
and
a
filter
system
and
so
on.
The
New
Year
I'm
talking
to
Mark
and
the
OD
and
Jackie
Jackson
to
see
how
can
we
structure
the
den
more
effectively
and
more
responsively?
So
that's
one
of
the
areas
we're
looking
at
next
year.
X
The
support
is
about
how
to
action
things
and
how
to
split
areas
so
we're
going
to
try
and
see
how
we
can
prioritize
quick,
wins
and
things
that
might
take
action
day
over
six
months
a
year,
two
years
that
these
days
take
time.
Unfortunately,
some
members
want
things
happen
now,
but
that's
not
the
reality.
X
Long-Term,
short-term
action
we're
grateful
having
the
the
workforce,
disability,
equality
standard,
which
really
reinforce
all
the
tasks,
projects
of
different
elements
which
Chair
by
Mark
Sutton.
So
we
can
take
advantage
of
those
changes.
I
mean
Jackie
Jackson.
The
interim
way
of
the
new
year
he's
looking
at
how
the
interview
process
going
to
work
and
how
the
reasonable
adjustment
is
going
to
work
and
how
so
the
relationship
with
the
the
exec
team
and
the
OD
has
been
stronger
this
year
than
than
over
the
years.
X
So
I'm
looking
forward
to
the
new
year
to
have
that
stronger
relationship
of
stronger
support
network,
and
so
that's
the
priority
is
changed
to
influence
change.
So
that's
where
the
code
for
the
Dem
would
be
going.
So
that's
my
piece,
I've
passed
you
on
to
my
colleague
from
the
when.
Y
Y
And
I'm
a
race
equality,
Network
called
share
with
my
colleague
blazing
hell.
We
came
into
Post
in
July
2022
hit
the
ground
running
with
the
successful
hosting
of
the
Black
History
Month.
We
have
heard
several
meetings
with
our
network
members
and
based
on
the
feedback.
We
formulated
our
three
priorities
for
the
coming
year:
2022-2023.
Y
Lastly,
one
day
we
have
Future
Leaders
program,
the
mentoring
and
coaching
schemes
our
last
priority,
but
not
the
least
important,
is
ensuring
a
zero
tolerance
to
bullying,
harassing
and
discrimination
against.
Colleagues,
from
an
ethnic
minority
background,
building
a
more
inclusive
culture
where
everyone
feels
included
and
valued,
identifying
microaggression
and
dealing
with
them,
encouraging
staff
to
report
incidences
of
bullying
and
harassment
and,
lastly,
implementing
a
zero
tolerance
approach
to
bullying
and
harassment.
Z
Thank
you
thanks:
I'm
Emily,
Hempstead
I'm,
a
carer's
equality,
Network
co-chair
and
that's
along
with
Andrea
and
Julia
we're
a
recently
re-elected
chair
team,
and
these
are
our
top
priorities
for
the
network.
We've
already
discussed
these
with
Sean
O'kelly
who's,
our
sponsor
so
first
of
all
are
the
stay
well
at
work
plans
which
we
hope
to
incorporate
the
carers
passport.
Z
We
know
the
plan
is
to
roll
these
out
in
April,
but
we'd
really
like
these
to
be
brought
forward
as
they
need
to
be
in
place
before
we
move
into
our
new
teams,
and
that
will
make
sure
managers
are
aware
of
any
additional
considerations.
Our
personal
circumstances
and
any
informal
working
Arrangements
we've
seen
there's
been
a
stay
well
at
work
plan
rolled
out
to
the
operations
group
and,
although
we
weren't
involved
in
the
development,
it
might
be
something
different
or
maybe
we
can
add
two.
Z
Secondly,
we'd
like
some
support
in
achieving
level
two
carers,
confident
accreditation,
that's
with
the
employers
for
carers
and
we're
already
level
one,
and
that
would
make
sure
that
we're
providing
practical
career
support
at
the
moment,
it's
sitting
with
the
diversity,
inclusion
manager,
Nadia,
Rahman,
we've
discussed
it,
but
there's
some
work
that
we
need
to
do.
We
need
some
more
evidence.
We
also
need
to
grow
our
membership.
So
at
the
moment
we've
got
about
140
members
in
our
network,
but
we
know
from
the
staff
survey.
Z
Also
like
managers
to
be
aware,
they
can
use
discretion
when
applying
certain
policies
and
that's
particularly
carer's
leave.
That
would
be
a
massively
positive
step
for
our
members
and
make
sure
we
get
consistent
care
across
the
commission.
We've
also
got
the
carers
bill
going
through
Parliament.
At
the
moment,
it's
going
to
be
a
statutory
requirement
to
have
carers
leave
and,
although
it'll
be
unpaid,
we
still
need
to
consider
how
that's
going
to
affect
our
policies
and
that's
it
from
us
I'm
going
to
hand
over
from
Diane
in
the
gender
equality
Network.
U
Family
excuse
me
so
I'm
Diane
Horsley
I'm,
the
co-chair
of
the
gender
equality
Network
along
with
Hannah
Carson.
We've
got
four
key
priorities
and
they
are
very
much
framed
by
the
first
one.
U
Our
first
aim
is
to
find
another
co-chair,
because
my
position
in
the
organization
is
very
uncertain
and
so
I
could
be
out
of
the
organization
by
March.
If
you
want
to
talk
to
Hannah
about
her
situation,
you
can
ask
her
yourself.
She
didn't
want
me
to
discuss
it
today.
That's
fine,
but
because
of
that
we
do
need
to
find
another
co-chair
and
also
because
if
we
want
to
expand
what
we
do,
we
want
to
make
sure
that
we've
got
the
extra
support
for
that.
U
One
of
our
key
priorities
is
that
we
would
like
some
support
to
develop
menopause
policy
within
CQC.
There
is
a
menopause
group
called
The
Hot
Topic
that
is
sitting
within
well-being.
So
our
aim
is
to
do
more
work
with
those
and
to
investigate
menopause
policies
in
other
organizations,
so
that
we
can
make
sure
that
we
get
the
best
fit
for
CQC
being
is
it's
something
that
affects
so
many
women
within
the
organization,
and
it
affects
men
as
well.
U
So
that
brings
us
to.
Another
point:
is
that
we
want
to
increase
our
membership,
especially
male
members,
because
we're
trying
to
get
not
just
allyship,
but
we
want
to
start
promoting.
The
idea
of
anti-sexism,
which
is
very
similar
to
the
idea
of
anti-racism,
is
not
enough
to
say
that
you're
not
sexist.
U
You
need
to
actually
stand
up
and
call
it
out
where
you
do
see
sexism
happening
in
the
organization
or
anywhere,
and
we
also
want
to
have
more
men,
because
we
want
to
make
sure
that
men
feel
included
and
as
Paul
one
of
our
biggest
Champions
always
says.
Women's
issues
affect
men
as
well
and
if
you've
got
women
in
your
family
who
are
affected
by
certain
things
like
the
menopause
or
fertility
issues
and
stuff
like
that,
men
need
to
know
about
it
in
order
to
be
able
to
help
and
support.
U
And
then
another
might
seem
low
level
at
the
moment.
But
it
was
important
to
us.
U
We
are
working
towards
having
the
loan
working
personal
safety
page
on
the
internet,
updated
because
currently,
the
wording
of
it
is
very
victim
blaming
and
it's
not
focusing
on
the
positives
and
being
very
supportive
of
women,
or
indeed
anyone
in
the
organization
who
might
find
themselves
working
in
either
risky
situations
or
just
having
to
leave
the
office
after
dark
and
feeling
threatened
and
unsafe
and
stuff
like
that,
and
so
now
I'm
going
to
hand
over
to
Becky
Appleby
Dean.
AA
Hello,
I'm
Becky
I'm,
the
chair
of
the
LGBT
Plus
network.
This
is
my
last
week
at
CQC,
so
it
was
really
nice
to
spend
some
time
earlier
this
week
for
his
first
day
thinking
about
what
we've
achieved
as
a
network
and
what
I
hope
to
need
for
other
people
to
do
going
forward.
So
the
first
thing
we
want
to
look
at
is
in
the
staff
survey.
AA
People
who
identify
themselves
as
lesbian
and
female
tend
to
be
really
really
happy
at
CQC,
they're,
far
more
happy
than
the
kind
of
average
colleague
and
we're
really
interested
to
find
out
why
that
is
if
whether
it
is
just
that
we
have
more
female
colleagues
at
CQC
or
is
it
particular
things?
Particular
areas
are
doing
that
we
can
scale?
Are
there
particular
managers
doing
really
good
work,
because
I
think
it'd
be
nice
to
take
that
really
positive
experience
and
hopefully
share
it,
not
just
with
members
of
the
network
but
the
wider
CQC.
AA
The
next
priority
is
to
really
embed
a
lot
of
LGBT
Plus
work
into
the
work.
Cqc.
Do
we
know
when
we
go
out
to
inspect
we'll
look
at
how
LGBT
plus
people
are
treated,
but
sometimes
that
doesn't
carry
into
CQC,
so
more
raising
awareness
of
colleagues
experiences
and
how
that
might
affect
their
management
or
kind
of
other
things?
So
it's
really
it's
up
there
with
when
we
think
about
this
ability
that
it
we're
always
looking
at
those
impacts
and
we
kind
of
improve
and
the
final
one
is
real,
tangible.
AA
This
year,
hopefully
you'll
be
able
to
put
your
pronouns
in
your
display
name
on
teams,
because
we
know
the
main
way
that
staff
meet
each
other.
Most
of
the
time
now
is
via
teams,
and
we
all
encounter
that
awkwardness.
When
you
see
someone's
name
and
press
our
Network
sponsor
has
encountered
it
before,
where
he'll
sometimes
go
to
events
and
get
introduced
to
she,
rather
than
he
and
you
kind
of
have
to
make
that
guess
and
just
giving
colleagues
a
safe
way
to
identify
themselves
and
to
and
to
show
any
changes.
So
yeah,
that's
our
update.
B
P
A
Thank
you.
So
there
was
depending
on
how
you
count
things.
It
was
about
15
or
20
priorities
there.
We
we
clearly
can't
attempt
to
respond
to
them
individually,
but
okay,
Toria.
Do
you
want
to
have
any
high
level
of
comments
about
the
organizations
views
on
a
response
to
that?
And
then,
if
there
are
any
questions
with
time
for
a
couple
before
we
move
on.
B
I
said
if
I
just
go
briefly
and
then
see
if
Ian
must
add
anything,
so
so
I
am
really
Keen
that
we
so
there's
a
lot
of
stuff
here
that
sits
in
the
kind
of
the
people
space.
So
I'm
thinking
about
the
progress
that's
been
made
or
is
starting
to
be
made
around
reasonable
adjustments
between
the
disability,
the
quality,
Network
and
people
I'm.
B
Thinking
about
the
inclusive
leadership
work
and
the
work
that's
starting
around
the
racer
quality
Network
and
the
people
service,
and
then
there's
just
a
long
to-do
list
there,
including
the
loan
worker
policy
that
that
Diane
brought
up
I
just
think
I
just
want
to
you
know
we
as
an
exec
team,
are
really
Keen
that
we
support
these
networks
to
be
as
impactful
as
possible,
and
our
job
is
to
kind
of
break
down
barriers,
but
also
to
get
things
motoring.
So
so
yeah
I,
think
I.
B
Think
a
number
of
us
in
the
exact
team
have
looked
to
Mark,
who
has
done
a
great
job.
Working
with
den
and
I
certainly
know,
I
need
to
step
up
a
bit
more
with
my
gender
Network,
because
I've
not
been
anywhere
near
as
active
as
Mark
as
and
him
and
him
and
the
den
are
really
flying
and
I
know.
All
of
us
on
ET
are
kind
of
keen
to
to
support
in
whatever
way,
and
the
networks
would
find
useful
as
well.
Thanks.
A
Okay,
thanks
Kate
Ian,
you
want
to
comment.
I
see,
marks
come
on
the
screen
as
well,
so
the
impulse
yes.
E
I,
just
I
think
just
to
reinforce
Kate's
points
about
how
important
the
networks
are
from
from
my
point
of
view,
because
it
does,
it
does
mean
that
we
are
hearing
firsthand
the
things
that
that
really
matter
around
around
the
the
different
groups.
I
think
the
area
that
that
I
guess
I'd
be
interested
in
hearing
colleagues
point
of
view
on
is
this
issue
of
intersectionality,
because
my
my
slight
worry
is
that
I
think
every
organization
does
this.
E
It
sees
sees
diversity
in
quite
narrow,
narrow
silos,
almost
and
there's
some
value
in
doing
that,
but
there's
a
there's,
probably
an,
and
rather
than
an
or
here
that
says,
and
what
happens
when
when
people
have
have
multiple
protected
characteristics
and
and
does
that,
does
that
matter
and
I
suspect
it
probably
does
and
and
how
do
we
as
an
employer,
make
sure
we
can?
E
We
can
blend
those
those
those
those
different
protective
characteristics
together
to
give
people
that
that
good
experience,
because
sometimes
we
might
be
we-
they
may
feel
like
they're
well
treated
in
in
terms
of
one
protected
characteristic.
But
you
add
another
one
and
in
some
cases,
the
third
one
on
top
and
that
becomes
a
very
complex
picture.
So
you
know
as
an
employer.
E
We
need
to
be
in
a
position
where
we've
got
a
an
employment
offer
which
is
which,
which
is
is,
is
as
bespoke
as
it
can
be
given,
given
the
fact
that
there's
three
thousand
people
but
but
I
I'd,
love
to
just
get
a
sense
from
people
as
to
whether
we
need
to
do
more
in
that
area
and
and
whether
we
can
we
can,
we
can
bring
things
together
in
a
different
way.
So
I'd
just
be
interested
in
people's
comments
on
that.
E
T
Thanks,
yes,
if
there's
okay,
just
just
a
couple
of
words
on
how
I
mean
how
much
of
a
an
active
network
and
and
breadth
of,
if
you
think
about
the
breadth
of
issues
that
we've
talked
about
in
the
updates
today,
it's
it's
really
significant
covers
a
huge
ground.
My
personal
experiences
with
with
Paul
in
the
disability,
equality,
Network
and
it's
been
a
huge
body
of
activity
that
we
he
talks
about.
T
Priorities
Ian
just
within
the
the
disability
quality
Network
we've
got
a
a
body
of
work
there,
which
involves
nine
separate
work
streams
and
a
significant
amount
of
effort
around
each
one
of
those
there
is.
T
There
is
much
to
do,
but
that
what
I
would
take
away
from
this
is
that
I
think
the
two
really
important
things
that
the
networks
do
one
one
is:
it
is
a
supportive
environment
to
support
colleagues
who
who
may
have
particular
challenges,
but
it's
also
a
body
of
of
action
and
and
a
real
Force
for
change
and
I.
Think
in
each
of
the
networks.
We
have
that
that
Spirit
of
wanting
to
make
this
this
a
better,
better
place
to
work
for
our
colleagues
and
and
we
will
continue
to
do
that.
A
Thanks
Mark
Stephen
Boston.
H
Firstly,
thank
you
all
thank
you
for
really
really
interesting
reports
but,
more
importantly,
thank
you
for
the
work
you're
doing
to
make
the
CTC
an
inclusive,
Affair
and
a
great
place
to
work.
But
my
question
was
about
confidence
in
reporting.
X
Yeah,
yes
and
Stephen
must
have
been
interesting.
We've
been
working
closely
with
speak
up
Guardians
as
well,
so
it's
kind
of
working
with
HR
to
make
sure
that
the
process
from
if
staff
mention
it's
their
line,
manager
and
then
line
managing
to
take
it
to
HR
and
go
we're
trying
to
work
on
because
Ian
said
in
the
the
network
meeting
last
year
and
he
wants
to
make
sure
the
line
managers
and
the
staff
work
together
closely
because
that's
kind
of
like
a
pastoral
care
in
there
they
know
each
other
and
they
work
together.
X
And
then
we
could
work
closely
with
freedom
speak
up,
so
it's
giving
them
more
of
a
pathway
and
the
same
time
is
making
sure
that
the
response
back
from
that
pathway
is
clear
as
well,
because
what
sometimes
did
happen
that
the
pathway
goes
up
and
it
passed
on
passed
on
and
then
it
kind
of
diluted
somewhere.
So
that's
coming
the
the
process,
I
think
the
Regional
Adjustment
area,
where
people
made
that
complaint,
the
feedback
of
that
and
hopefully
that
pattern
working
with
Jackie
Jackson
will
hopefully
continue
with
that.
So
yeah,
it's
a
great
question.
Y
Add
something:
yes,
thank
you
for
the
opportunity.
The
other
one
is
to
mention
that
if
there
is
equality,
Network
we've
had
the
opportunity
of
pulling
in
our
members
together
when
we
have
had
significant
events
happening
like
the
George
Floyd,
and
we've
made
our
submissions
just
like
after
the
Kumar
case
to
say
this
is
how
our
members
feel
and
our
submission
they've
actually
been
received,
and
we
feel
that
they
are
being
considered
in
the
actions
plan
that
has
been
coming
on
board.
Now.
Y
We
feel
that
our
voices
are
being
heard,
so
we
think
that
opportunity,
if
they
in
that
we
see
that
our
rent
sponsor
Tyson,
is
actually
engaging
in
taking
on
board
what
we
have
to
say.
So
we
are
having
vibrant
discussions.
Considerations
of
different
thoughts
within
our
membership,
so
I
think
this
relationship
will
continue
to
build
and
for
us
to
be
heard.
A
Jorah,
you
had
your
hand
up.
Perhaps
one
last
comment
on
this.
L
Yeah
no,
it
was
I
mean
thank
you
all
for
for
sharing
the
initiatives.
I
think
they're,
all
I'm
actually
learned
a
lot
today.
I'm
just
listening
to
to
I
was
putting
it
back
in
my
own
life.
But
how
do
we
measure
progress?
So
we
talked
about
where
we
want
to
go?
How
do
we
know
where
we've
been
and
where
we've
reached
so
far,
I
mean
the
the
equality
Network
you
know
has
been
running
for
a
few
years.
L
No
is
it
where
we
want
it
to
be
right
now
and
are
we
moving
to
the
sort
of
next
tier
or
aren't
we
quite
you
know
we'll
never
get
to
the
end
properly,
hopefully
one
day
but
yeah
we'll
see.
But
how
do
we
measure
the
effectiveness
over
the
past
three
years
say.
X
What's
really
impacted
this
year,
how
The
Voice
network
working
together
closely
and
the
whole
point
of
working
together
closely
that
we
share
the
impact
and
also
share
the
workload
where
the
range
doing
something
we
will
work
with
them
and
let
them
lead
it
and
the
Den's
doing
it
they
let
them
deep,
leave
it
and
on
Monday,
just
gone,
we've
had
a
our
first
effective
training
where
we
joined
in
with
our
sponsors
talking
about
priorities
and
plans
for
the
year.
X
So
the
networking
between
the
the
equality
Network
group
and
the
exec
team
are
stronger,
stronger
link
as
ever
before.
So
it's
taken
those
years
to
get
there
and
it's
now
maintaining
that
so
we're
having
some
CPD.
We
had
a
couple
of
hours
learning
about
communication.
How
can
we
communicate
effectively
with
our
peers
and
how
can
we
help
cope
with
their
impact
if
they
come
up
with
some
grievance
to
say?
Well,
you
haven't
helped
me
as
a
chair,
and
how
can
we
cope
with
that?
X
So
it
kind
of
give
us
some
toolkits
how
to
support
and
also
filter
to
the
exec
team
as
well,
because
over
the
years
I
could
hand
up
being
a
chair
for
a
while.
We
have
been
acting
at
the
buffer,
we've
been
taking
the
blow
and
there's
nobody
behind
just
hold
our
backs
for
this
year,
I'm
sensing
that
I've
got
the
exec
behind
me
as
well
as
Mark,
where
in
Paul
not
your
world
to
take
out.
Let
me
take
that.
A
A
Okay,
Ian
Chatham.
Do
you
want
to
finally.
E
Just
just
just
to
reinforce
what
Paul's
just
said,
I
think
my
my
sort
of
measure
of
success
is
to
for
Paul
to
say
that
sort
of
thing
that
that
he
is
getting
the
support
that
he
meets.
It
feels
like
it's
an
ongoing
dialogue
rather
than
if
you
like,
a
measure
that,
in
terms
of
a
single
thing
that
were
that
we're
aiming
for
I,
think
the
other
thing
I
wanted
to
come
in
on
was
just
this
point
around
the
question
you
asked
in
around.
E
Do
you
feel
like
you
can
speak
up
and,
and
you
feel
that
the
action
is
being
taken
and
I
think
it's
a
really
tough
one
to
demonstrate,
because
I
can
think
of
a
number
of
cases
where
where
action
has
been
taken,
but
that
action
has
been
by
definition
confidential,
because
it's
it
relates
to
to
to
it
to
to
individuals
and
action
has
been
quietly
taken
from
from
issues
that
have
been
raised.
E
But
the
issue
is,
is
you
can't
really
advertise
that?
And,
and
so
that's
an
important
points
in
terms
of
giving
people
confidence
to
raise
issues?
I
want
people
to
have
that
confidence,
but
I'm
in
this
slightly
perverse
position.
I
can't
feed
back
to
what's
been
said
when,
when
issues
have
been
raised
so
that
the
networks
have
an
important
sort
of
intermediary
role,
that
Paul
was
just
sort
of
describing
a
little
bit
there
in.
E
A
Thanks
here,
I
mean
I,
I
would
probably
you've
ever
answered.
My
main
question
before
I
could
answer
a
bit,
but
it's
just
about
the
the
connectivity
between
the
networks.
I
mean
it's.
It
seems
to
me
that
I
mean
we
are
a
product
of
the
society.
We
live
in
over
three
and
a
half
thousand
people
recruit
from
many
jurisdictions.
A
But
but
it
seems
to
me
there's
almost
two
parts
of
this
one
is:
there
are
certain
things
that
are
are
required,
action
that
reflect
the
needs
of
the
individual,
but
actually,
if
you've
got
an
organization
that
is
inclusive
and
suitably
flexible
in
its
natural
culture
than
many
of
the
other,
things
would
get
fixed,
irrespective
of
which
the
protected
area
or
network
you're,
a
member
of
because
you
just
have
a
more
inclusive
organization
that
it
seems
to
me.
I
am
hearing
from
the
executive
team
that
that's
where
they
want
to
go.
A
I'm
not
sure
I'm
looking
for
response
to
that
unless
you
disagree,
but
thanks
very
much
look
Paul
and
colleagues.
Thank
you
very
much
indeed,
for
your
time.
I
hope
that
the
fact
that
the
board
is
interested
in
hearing
what
you
have
to
say
firsthand
and
of
excellent
question
about
how
do
we
actually
measure
whether
it's
making
a
difference
shows
you
how
important
the
board
I
mean.
Ian's
already
made
his
comments
about
the
importance
of
the
executive
and
I
would
Echo
that
from
the
board's
point
of
view
as
well.
A
So
many
of
you
may
not
be
used
to
speaking
in
public
in
this
other
nature,
so
I
particularly
thank
you
for
for
that
and
joining
us.
A
If
we
could
move
on
to
the
the
next
item,
we're
slightly
behind
schedule,
but
I
hope
Jane
won't
mind.
Have
we
got
Jane
joining
us
now?
You.
AB
Have
indeed
thank
you
very
much
Ian.
Thank
you
chair.
Thank
you.
Colleagues,
it's
great
to
be
back
here
and
I
can't
believe
it's
a
whole
year
since
I
actually
started
and
I
came
to
my
first
board,
not
long
enough.
AB
I
started
and
obviously
I
came
in
the
summer
and
where
has
the
year
gone,
it
has
been
as
I
was
reflecting
and
preparing
the
broad
paper,
a
lot
of
water
under
the
bridge,
some
of
which
has
been
really
positive
and
some,
if
you
look
at
some
of
the
high
profile
reports
and
incidents
such
as
occenden
such
as
Bill
kirkup's
report
into
Sri,
free,
I'm,
sorry
into
East
Kent's
maternity
service,
such
as
the
Panorama
program.
AB
There
continue
to
be
high
profile
cases
where
workers
speak
up
and
the
right
thing
doesn't
happen
or
where
workers
don't
speak
up
because
they
don't
feel
psychologically
safe
enough
to
do
so
with
sometimes
drastic
consequences.
So
I
think
my
message
to
you
support
today
is
that
the
work
remains
as
important
as
ever,
and
we
know
why,
because
we
see
the
consequences
where,
where
things
can
go
horribly
wrong,
if
people
don't
feel
empowered
and
safe
to
speak
up,
but
also
there
is
good
progress
as
well.
So
it's
a
mixed
picture.
AB
There
are
some
organizations
that
are
making
great
strides
in
improving
their
speaking
up
culture
and
psychological
safety,
but
our
Guardians
continue
to
tell
us
that
not
all
workers
feel
safe
to
speak
up
and
across
England
and
and
that's
backed
up
by
by
some
of
those
high
profile
reports.
AB
I
talked
about,
so
it
remain
remains,
really
really
important
that
we
stay
working
in
this
space
and
I
say
we
as
ourselves
as
National
Guardians
office
myself
as
the
national
Guardian,
but
yourselves
as
CQC
and
the
board
and
Leadership
of
CQC,
because
you
have
a
key
role
alongside
Us
in
terms
of
the
regulation
of
what
the
providers
are
doing
and
that
important
part
of
the
well-led
inspection
in
terms
of
speak
up
culture
and
its
widest
sense.
Not
just
if
we
can
speak
up
Guardian
route
is
absolutely
key.
AB
So
I
just
wanted
to
to
to
start,
but
that
was
my
preface
you
will
have
read
my
paper.
I,
don't
intend
to
go
through
it
in
terms
of
line
by
line.
I
would
just
like
to
highlight
a
couple
of
things
to
you.
The
first
is
laying
our
annual
report
for
Parliament
I'd.
Obviously
hopes
for
our
annual
report
from
the
office
would
have
come
to
you
as
a
board
long
before
now.
AB
It
was
ready
in
July,
but
due
to
the
ministerial
changes
when
Boris
Johnson
resigned
and
then
the
Queen's
death,
it
was
impossible
to
get
another
grid
slot.
But
I
have
heard
today
from
Department
of
Health
and
Social
care
that
it's
looking
very
likely
for
early
January
and
I'll.
AB
Keep
you
updated
on
that
I
think
it's
really
important
that
we
land
that
report,
because
then
coming
hot
on
its
tails
later
in
January,
will
be
the
first
of
our
speak
up,
reviews
which
is
into
the
10
ambulance
trusts
across
the
country,
and
that's
going
to
be
a
really
important
review
of
the
speaker.
Culture
across
ambulance
trusts.
Speaking
in
a
thematic
way,
there
are
many
reviews
going
on
in
the
amban
sector
at
the
moment
because
of
the
challenges
of
culture
and
and
performance.
AB
Obviously,
ours
is
into
is
interculture,
but
it's
it's
really
important
that
that
lands
well
and
I
think
having
your
team
talk
about
for
each
speaker.
More
generally
before
that
will
be,
will
be
helpful
timing,
at
least
coming
on
the
back
of
the
delays
that
we've
had
I.
AB
Also
just
wanted
to
flag
to
you
that,
in
terms
of
our
governance,
I
went
two
weeks
ago
under
Sally's
chess's
leadership
to
acgc
to
present
annually
regarding
our
governance
and
risk
registers
and
had
a
really
constructive
meeting
and
hopefully,
board
members
who
were
present
at
that
will
feel
assured
around
our
approach
to
governments
and
and
Ian's
accounting
officer
will
take
that
one
of
our
biggest
risks,
which
I'll
just
mention
very
very
briefly
here-
is
our
funding
on
going
our
mou.
AB
That
comes
to
an
end
at
the
end
of
March
and
there's,
there's
negotiations
happening
with
NHS
England
as
the
co-fundder,
with
yourselves
to
sort
out
a
funding
agreement
from
March.
So
at
the
moment
that's
a
risk.
For
me,
because
I
have
a
you,
know:
a
well-developed
business
plan
but
I'm
currently
without
the
the
funding
agreement
in
place,
but
we're
working
with
Department
of
Health
and
very
much
CQC
colleagues
are
helping
me
with
that
Chris
Usher
and
team
in
particular.
So
thank
you.
AB
Chris
I
put
in
our
activity
just
sort
of
some
Reflections
on
key
areas.
Of
course
it
doesn't
cover
the
whole
areas
of
our
work.
I've
mentioned
ambulance
trusts,
but
I
do
just
want
to
mention
the
the
work
of
our
team,
but
actually
of
the
Guardians
in
speak
up
month.
So
you
all
would
be
aware
that
long-standing
there's
been
a
month
of
raising
awareness
around
the
importance
of
speaking
up
and
there's.
AB
Some
highlights
in
the
report
here
today
and
I
just
wanted
to
call
out
to
our
comms
team
supporting
the
much
wider
work
that
goes
on
across
the
whole
vnhs
in
England,
relating
to
raising
awareness
of
speaking
up
I
also
wanted
to
speak
to
a
point.
That's
not
in
my
paper
but
I
know
from
the
conversation
that
I've
had
with
with
your
selfie
in
his
chair
recently,
but
one
of
the
things
that
we're
very
aware
of
in
the
National
Guardians
office
and
we've
done
research
on
it
and
actually
listening
to
previous
speakers.
AB
In
terms
of
maybe
that
you
come
from
a
different
culture
and
it's
not
respectful
to
even
speak
to
someone
who's
older
than
you,
let
alone
more
senior
than
you
and
yet
our
expectations,
particularly,
for
example,
for
those
of
us
who
are
on
professional
registers.
There
is
an
expectation
that
is
the
right
thing
to
do
as
part
of
my
code
of
conduct
as
a
nurse
to
speak
up,
but
that
can
be
different
if
you
are
educated
elsewhere
or
brought
up
elsewhere.
So
it's
an
important
part
of
work
for
my
team.
AB
It's
included
in
our
training,
it's
something
that
we
very
much
support,
Guardians
to
be
thinking
about
in
their
own
workplaces,
and
it's
something
that
I'm
working
at
a
national
level
with
the
team
with
the
chief
nursing
officers
advisor
on
the
international
educated
Workforce,
the
nmc
on
on
International
recruits
into
nursing
to
look
at
how
we
can
help
that
understanding
of
what
the
culture
of
the
speak
up
actually
is
here.
AB
So
we're
very
cognizant
of
it,
and
it
is
an
important
issue
not
just
within
nursing
but
across
all
professions
and
non-professions,
to
make
sure
we
get
right
to
reduce
the
barriers.
So
that
everybody
feels
safe
to
speak
up
whatever
their
background,
whatever
barriers,
they
may
feel
they,
they
have
been
speaking
up
so
I'm,
just
gonna
conclude
if
I
may
share
just
by
drawing
attention
to
the
forward
plan.
The
forward
look
I'm,
not
bringing
you
the
business
plan
here
today,
but
concluding
with
some
next
steps
in
terms
of
particular
areas
of
work.
AB
That
will
be
a
priority
for
us,
but
that's
not
set
in
stone
depending
on
what
the
national
pitch
was
looking
like,
and
we
continued
to
to
do
that
work
both
within
organizations
with
guardians
at
a
national
level
and
carrying
out
the
reviews
we're
doing
so.
Thank
you
for
your
support
have
to
take
any
questions
on
any
of
the
detail
in
the
paper.
Thank
you.
Thanks.
A
Jane
we've
already
answered
the
question
that
I
have
so
if
you
preempted
that,
so
thank
you
the
time
for
a
couple
of
questions.
Mark
Chambers
thanks.
F
Very
much
and
and
thanks
again
that
was
enormously
helpful,
just
just
sort
of
one
question
on
detail
in
in
the
report.
You
know
you're
sort
of
tracking
a
a
an
uptick
in
in
in
the
number
of
case,
the
proportion
of
cases
that
relate
to
bad
behavior,
you're,
also
tracking,
an
uptick
in
proportion
of
cases
where
there's
some
evidence
of
of
of
detriment.
F
The
detriment
level
seems
still
well
below
the
actual
experience
levels
of
of
of
detriment.
That
was,
you
know
we
see
from
from
other
surveys,
which
suggested
at
least
in
a
corporate
world
at
some
time
sometimes
around
you
know,
40
percent
of
people
who
speak
up
actually
suffer
some
detriment
for
doing
it,
which
is
a
shocker,
but
it's
reality.
F
Do
you
think
this
reflects
people
just
being
more
comfortable
and
more
aware
and
more
willing
to
come
forward
or
or
are
we
seeing
you
know?
Are
we
are
we
seeing
a
worse
environment
for
for
people
speaking
up
or
do
we
just
not
know.
AB
Thanks
Mark
I
think
I
think
we
don't
know.
Obviously,
Trends
are
what
are
important
about.
Individual
cases
are
important.
Nobody
should
suffer
detriment
for
for
doing
the
right
thing
and
and
speaking
up
in
their
work
environment,
in
a
constructive
in
a
constructive
way.
However,
we
do
see
that
the
the
detriment
figures
that
we
reported
during
the
during
the
previous
year,
that's
the
first
time
they've
sort
of
gone
back
down
and
what's
really
important,
is
that
we
don't
continue
to
see
that
Trend.
AB
Yes,
it
may
be
smaller
than
what
we
see
elsewhere
but
but
for
me
any
detriment
is
wrong
and
obviously
there
are
very
high
profile
cases
of
detriment
that
we
see
that,
because
actually,
this
is
the
reports
of
what's
coming
through
the
guardian
room
and
the
guardian
is
the
additional
valuable
route,
not
people
who
are
reporting
and
speaking
up
through
HR
line
management,
patient
safety
Etc.
What
I
don't
know
is
those
levels
of
detriment
there.
AB
What
strikes
me
is
that
still
not
enough
is
being
done
and
not
all
leadership
teams
across
organizations
across
the
NHS
are
taking
this
as
as
As
a
matter
to
really
look
into
to
track.
Monitor
because
if
people
are
fearing
that
bad
things
will
happen,
we
know
what
happens,
then
people
don't
speak
up,
and
then
we
have
the
terrible
care
failings
that
we've
had
in
the
past.
AB
So
it's
one
to
watch
and
when
I
go
on
my
visits
to
trusts
when
I
speak
with
leadership
teams
or
do
board
development,
I
am
always
asking
what
are
you
doing
to
to
address
that?
To
build
the
confidence
and
the
trust
in
your
organization
that
people
can
speak
up
in
safety
and
won't
suffer
consequence
sit
with
a
negative
consequences
for
doing
so
so
I
think's,
a
great
question
of
I.
AB
Don't
have
the
answers
yet,
but
it's
one
I
will
continue
to
raise
the
profile
of
and
watch
the
data
and
work
with
others
on
and
I
really
hope
that,
through
the
inspection
and
the
regulatory
framework,
that
CQC
will
be
very
much
looking
at
that
as
well.
In
terms
of
part
of
that
well-led,
you
know
so
tell
us
about
how
you
do
manage
that
give
us
examples
of
and
and
that
our
inspectors
will
really
get
under
the
skin.
Of
those
wider
implications
of
the
speak
up
culture,
including
any
perceptions
of
detrimental
actual
detriment
that
workers
have.
L
E
Thanks
I
mean,
as
you
know,
Jen
over
the
next
few
months.
We
are
upgrading
our
our
methodology
to
produce
the
single
assessment
framework
to
look
at
things,
both
that
are
at
an
integrated
care
system
level,
but
also
at
an
individual
provider
level.
I'm
really
interested
in
the
point
you
were
making
about
the
the
speak
up,
Dimension
to
overseas
workers
and
the
work
you're
doing
with
with
other
colleagues
so
I
think
in
in
due
course.
E
It
would
be
really
interesting
to
to
understand
at
a
working
level
what
what
insights
that
you
and
colleagues
are
coming
coming
forward
with
with
the
viewers
trying
to
embed
that
in
our
single
assessment
framework.
So
we
can
start
to
look
at
that
in
more
detail,
because
I
I
am
conscious
of
the
the
understandable
large
increase
in
the
number
of
overseas
workers
in
in
the
NHS
at
the
moment,
and
and
there's
a
lot
of
real
real
positives
to
that.
E
But
I
want
to
make
sure
that
that
the
the
the
welcome
that
they
get
and
the
the
their
ability
to
speak
up
is
also
as
good
as
they
possibly
can
can
be.
We
play
our
part
as
a
regulator
in
in
promoting
that.
Thank
you.
Yeah
thanks.
A
Very
much
it's
interesting.
There's!
Variations
on
this
theme
have
come
up
in
about
four
recent
meetings
I've
had
outside
the
organization,
one
of
which
I
hope
you
were
up
as
well.
I,
don't
see
any
real
question
so
Jane.
Thank
you
very
much
indeed,
for
joining
us
comprehensive
reporters
usual.
We
wish
you
luck
in
the
next.
We
look
forward
to
the
report.
We
wish
you
luck
in
the
next
few
months,
dealing
with
funding.
So
thank
you
very
much
and
you
for
joining
us.
A
Right
we
have
a
few
matters
now
for
board
approval.
Some
are
more
straightforward
than
others.
Probably
the
first
is
the
proposed
modern
slavery
statement,
so
Kate
I
think
you're
gonna
pick
this
up
initially,
but
then
involve
one
or
two
of
your
colleagues,
but
let
me
hand
straight
to
you.
B
That's
refreshed
statement
on
Modern
slavery.
Our
last
one
was
published
in
2018
we
needed
to
to
re-look
at
it
and
make
sure
it
reflected
our
current
position
so
without
further
Ado
Debbie
who's,
the
director
for
people
with
learning
disabilities
and
autism
and
autistic
people
is
also
responsible
for
safeguarding
where
this
work
Falls
and
the
Haley's.
B
Our
deputy
director,
leading
the
work
and
Lucy
is
our
head
of
equality
and
human
rights
issue
so
that
that's
a
team
but
I
hand
over
to
Debbie
to
flag
key
issues
in
the
paper
over
to
you
Debbie.
Thank
you.
W
Thank
you
Debbie
and
yes,
there
are
kind
of
two
aspects
to
this.
So
first
is
we
don't
legally
have
to
produce
a
modern
safety
statement,
unlike
some
organizations,
but
we
do
it
because
it's
actually
helpful
to
us
and
because
it
aligns
with
our
values.
W
So
the
two
aspects
is
the
internal
aspect
which
is
like
around,
for
example,
HR
and
Recruitment
and
procurement,
and
what
we
do
as
a
big
organization
which
we
have
good
processes
for
in
terms
of
in
terms
of
preventing
modern
slavery
and
then
there's
the
regulatory
aspect
for
this,
which
is
kind
of
in
two
parts.
W
The
first
is
that
we've
we've
got
a
contract
with
the
home
office
to
to
inspect
safe
houses
for
for
survivors
of
modern
slavery,
which
we've
had
since
2021,
which
is
up
and
running,
and
we're
about
to
produce
our
first
annual
report
about
that.
And
the
second
is
the
more
complex
issue,
maybe
because
it
cuts
across
our
regulatory
work,
which
is
what
do
we
do
if
we
suspect
modern
slavery
is
occurring
in
in
all
sorts
of
services
that
we
regulate,
for
example,
in
adult
social
care
services.
W
So
that's
the
kind
of
overall
scope
we're
building
on
our
2018
report,
updating
it
and
and
and
adding
more
in
about
the
safe
houses,
but
also
going
forward
as
Debbie
says,
there's
quite
a
lot
to
do
around
the
safeguarding
aspects
which
I'll
hand
over
to
Hayley.
To
talk
about.
W
AD
You
both
and
really
just
here
to
Echo
what
MW
and
Lucy
is
sad
about
this
being
a
really
critical
area
for
us
as
a
as
the
regulator,
and
we
can
use
this
statement
as
a
springboard
to
refresh
and
rescope
out
what
it
is
that
we
can
do
to
continue
to
improve.
We
are
actually
seeing
quite
a
sharp
rise
in
modern
slavery
activity
within
Health
and
Social
Care
at
the
moment,
which
I
would
say
is
making
it
really.
AD
You
know
quite
a
Hot
Topic,
and
this
relates
both
to
Services
regulated
by
us
as
the
regulator,
but
also
those
that
are
falling
out
of
scope,
such
as
recruitment
agencies
and
nursing
agencies
as
well,
and
we
are
in
contact
now
with
a
number
of
external
Partners,
including
the
Department
of
Health
and
Social
care,
who
are
also
reporting
this
growing
Trend.
So
for
rules,
then
we're
going
to
be
focusing
on.
AD
If
we
do
suspect
the
signs
of
modern
slavery,
but
also
actually
looking
externally
to
this
is
a
live
issue,
because,
as
I
mentioned,
recruitment
agencies
with
the
high
gaps
in
Staffing
across
the
sector
and
we're
increasingly
seeing
that
as
a
potential
Gap,
where
people
are
being
exploited
and
providers
needing
to
have
really
good
due
diligence
about
the
checks
that
they
do
as
well
when
they're
using
recruitment
agencies.
Thank
you.
A
H
Quick
question:
if
I
could
just
interested
in
sort
of
how
you're
seeing
the
scope
of
what
you're
trying
to
do
and
what
you're
trying
to
influence
because
clearly
you've
covered
the
chunks
of
well,
where
we've
got
CQC
itself
in
scope.
We
also
have
people
who
are
working
in
Health
and
Care
settings
in
scope,
but
many
Health
settings
particularly
GP
surgeries,
others
May
themselves
be
seeing
service
users,
patients
who
actually
they
begin
to
suspect,
there's
something
wrong
here.
I
I,
you
know
I,
think
this
person
may
be
the
victim
of
modern
slavery.
AD
Actually,
it
does
and
it's
already
covered
and
when
we
inspect
so,
for
example,
when
we
interact
GP
practices,
we
would
expect
them
to
be
meeting
regulation
13
around
safeguarding,
which
would
mean
that,
actually,
you
know
they
should
be
able
to
explain
how
they're
supporting
their
staff
to
be
trained
in
seeing
the
warning
signs,
because
often
GPS,
for
example,
are
going
to
be
one
of
the
first
points
of
coal
who
could
recognize
this,
and
we
have
already
seen
a
couple
of
examples
of
less
than
ideal
practice
coming
through
in
terms
of
the
lack
of
awareness
when
GPS
have,
you
know,
come
across
people
who
are
showing
indications
of
potentially
having
been
trafficked
or
being
exploited
so
again,
I
think
that
goes
down
to
making
sure
our
inspectors
are
very
clear
about
what
they
should
be
looking
for
on
inspection,
but
also
asking
some
of
those
wider
questions
about.
AD
E
Just
I
think
it
was
just
to
build
on
on
Haley's
answer.
I
think
I
think
just
to
be
clear.
This
statement
does
not
apply
to
GPS
directly,
but
it's
about
our
assessment
of
of
their
modern
slavery
position
is,
is
what
we
look
at.
If
that
makes,
if
that
makes
sense,
which
I
think
is
the
subtlety
of
your
question,
Stephen.
A
So
just
to
swipe
here.
To
what
extent
does
this
represent
a
an
updating
of
a
policy
to
reflect
what
we're
doing
or
to
what
extent
is
this
a
statement
of
intent
about
things
we're
going
to
do
differently.
AD
In
in
many
ways,
even
the
statement
is
quite
similar
to
what
we've
had
previously
and
with
some
clarifications,
including
the
inclusion
of
safe
houses
and
that
program
of
work.
So
it's
nothing
that
that's
particularly
different
on
you
for
us,
but
as
I
said,
it
does
give
us
an
opportunity
for
us
to
revisit.
You
know
our
approach
and
our
awareness,
both
internally
and
externally,
but
there
isn't
anything.
You
know
that's
of
any
massive
difference
to
what
we've
had
before.
B
AD
B
Had
a
conversation,
didn't
we
regulated
leadership
board
earlier
in
the
week
about
this
being
a
developing
area
that
we
want
to
have
really
good
visibility
of
in
terms
of
our
data,
in
terms
of
us
having
a
really
good
insight
into
the
prevalence
and
and
issues
so
so
Debbie
Haley
Lucy
there'll
be
a
team
of
people
drawing
up
a
piece
of
work
that
we
will
potentially
look
to
start
in
Spring
so
that
we
can
make
sure
we're
we're
bringing
as
much
information
and
insight
to
this
topic
as
possible
as
well.
W
Yes,
just
just
to
this
really
restate
what
Kate
just
said:
I'm
also
going
to
be
bringing
the
equality
objectives,
deliverables
to
the
board
in
February,
and
one
of
the
one
of
the
things
that
we're
considering
in
the
lead
up
to
that.
This
is
a
bit
of
a
trail
is
what
we
might
do
more
generally
about
internationally
recruited
workers
in
relation
to
our
work
on
Workforce
equality,
because
there
is
obviously
a
lot
of
pressure
to
recruit
internationally
at
the
moment.
W
But
there
are
there
are
where
this
is,
where
this
is
not
done
well
or
where,
where
services
are
under
a
lot
of
pressure,
it
can
lead
into
situations
which
are
akin
to
to
Modern
slavery.
So
so
we
are,
we
are
doing
some
proposals
around
that
we're
also
talking
with
the
dhsc
and
the
NHS
England
about
about
Workforce
equality,
particularly
for
internationally
recruited
low-paid
staff.
W
On
the
back
of
a
report
that
the
equality
and
Human
Rights
Commission
did
about
low
paid
staff,
low-played
ethnic
minority
staff
working
in
Health
and
Social
care.
So
there
are
a
number
of
bits
of
work
that
we
will
join
together
in
a
program
around
around
the
particular
issues
about
staff
and
potential
modern
slavery
issues.
A
A
What
are
we
doing
so
if
I
could
try
to
separate
those
out,
I
mean
if
Haley
is
saying
that
that
this
is
suddenly
becoming
a
much
bigger
issue
for
us,
so
I
think
there's
probably
something
that,
whether
it's
at
the
arak
or
somewhere
else
or
perhaps
the
executive
first
of
all,
just
make
sure
we
understand
what
the
risks
are
to.
What
we
do.
We
don't
want
scope
group.
A
We
can't
you
know
we're
not
here
to
police
the
whole
system,
but
I
think
it'd
be
useful
if
it's
on
the
uptake
just
to
make
sure
we've
understood
what
the
risks
are
to
us
on
our
reputation,
but
as
far
as
the
policy
itself
is
concerned
or
the
statement,
rather
it's
not
a
policy.
Are
we
happy
to
approve
it
here?
Let's
see
what
I
end
up
I'll
come
to
you
in
a
moment,
but
can
I
just
see
whether
we're
happy
to
approve
it
your
hands
going
up,
no
one's
saying
no
sorry.
E
Ian,
this
is
that
first
action
you
were
talking
about
I
think
it's
it's
something
which
is
definitely
on
our
agenda
as
an
exact
team.
So
at
an
appropriate
point,
if
this
does
when
the
when,
when
the
evidence
suggests
that
this
is
something
to
to
Really
worry
about,
then
we
would
of
course
bring
it
here
and
we
would.
We
would
talk
about
what
we
do
about
it
publicly,
but
I
don't
think
at
this
stage
it
needs
to
sort
of
come
back
in
three
months.
E
A
You
yeah
that's
fine,
okay,
Debbie,
Haley
Lucy.
Thank
you
very
much
indeed,
and
I
think
that's
approved
we're
getting
around,
probably
very
slightly
over.
We
always
would
have
done
because
we
had
some
questions
which
I'll
have
to
do
with
after
five,
but
we're
very
close,
I
hope.
No
one
else
to
to
Dash
the
minutes
of
the
previous
meeting.
They
were
circulated
in
advance.
A
I
didn't
have
any
comments
or
people
happy
to
approve
them.
Yes,
thank
you
very
much.
Indeed,
there
is
so
just
looking
at
my.
There
are
some
actions
for
previous
meetings.
Probably
what's
required
stated
here
just
needs
a
bit
of
update.
So
the
first
item,
one
on
here,
the
I'm
not
sure,
we've
been
able
to
get
all
the
data
for
inclusion
report.
So
maybe
we
leave
that
open
if
that's,
okay
and
then
on
the
second
one
Chris
it's
down
for
suggested
for
closure.
Do
you
have
any
comments?
O
A
Can
we
amend
then
that,
rather
than
call
and
close,
both
open
but
we'll
deal
with
them
at
Future
meetings,
the
the
Sally?
Could
you
give
us
a
brief
oral
report
on
your
final
chairmanship
of
arak
meetings.
G
Yeah,
thank
you
Ian
in
the
interest
of
time.
I'll
be
very
brief
because
there's
a
report
that
went
to
our
private
board
with
the
detail
in
it.
So
the
headlines
are
that
our
financial
statement
audit
is
complete,
barring
something
out
of
our
control,
which
is
about
Assurance
around
local
government
pension
schemes,
which
is
a
problem
for
many
public
bodies,
so
CQC
have
done
what
they
need
to,
and
I
would
like
to
thank
the
team
from
Ian
downwards,
for
a
successful
audit
and
hopefully
laying
of
our
accounts
in
due
course.
G
We
continue
to
pursue
a
full
program
of
risk
and
internal
audit,
which
is
progressing
well.
These
things
are
always
backloaded,
but
we've
taken
into
account
all
the
key
risks.
G
I
think
that
CQC
has
and
we've
also
welcomed,
healthwatch
and
National
Guardians
office
to
our
meetings,
so
that
program
continues
I'm
most
proud
of
the
fact
that,
as
evidenced
in
the
wallpapers
today,
we
now
have
a
framework
which
looks
at
our
strategy
key
performance
measures,
our
business
plan
delivery,
our
risk
framework
and
it
feels
like
it's
joined
up
and
that's
been
quite
a
a
piece
of
work
over
the
last
two
years.
G
But
hopefully
a
very
positive
direction
and
I'd
just
like
to
say
that
the
exec
commitment
to
this
audit
committee
far
outweighs
many
others
that
I've
seen
and
I
think
Ian
and
now
Kate
and
Chris
and
everybody
who
comes
along
plus
my
non-exec
colleagues
who've,
been
I.
Think
Jane
used
the
phrase
before
supportive
but
appropriately
challenging
is
a
good
mix,
so
I'm
I'm
signing
off
I'd
just
like
to
say
thanks
to
everybody,.
A
Okay,
thanks
so
much
Sally
Mark.
Do
you
want
to
give
a
brief
oral
update
on
the
recent
rgc
meeting
very.
F
Happy
to
thank
you.
Yes,
we
had
our
first
meeting
of
the
relaunch
and
reconstituted
rgc
following
the
approval
of
the
terms
of
reference
to
the
last
board,
welcome
Stephen
and
Belinda
to
the
to
they
committee.
The
focus
of
our
committee
workers,
you
know
at
a
very
high
level,
is
going
to
be.
You
know
how
the
design
of
our
regulatory
model
it,
you
know,
fits
to
our
regulatory
responsibilities
and
looking
at
the
effectiveness
and
its
Effectiveness
and
implementation.
F
So
you
know
part
of
that
is
going
to
be
keeping
an
eye
on
our.
F
You
know
the
outputs
of
our
proactive
Improvement
program,
how
we're
responding
to
external
developments,
how
we're
responding
to
changes
in
the
external
environment,
reviewing
our
own
measures
of
Effectiveness,
our
kpis
in
relation
to
the
the
model
and
insights
from
Key
stakeholders
as
to
as
to
how
we're
doing
the
the
first
meeting,
we
spent
time
reviewing
our
current
design
and
and
how
it
maps
to
our
regulatory
responsibilities
and
then
discussing
the
the
the
the
shape
and
what
we
hope
is
going
to
be
the
standing
report
for
future
meetings.
F
F
You
know
with
using
that
Core
paper
as
a
as
the
as
the
frame
in
first
hour
of
the
meeting
and
then
deep
dives
into
into
that
a
number
of
areas
and
we've
already
discussed
how
we
can
prioritize
those
and
make
sure
that
they're
coordinated
with
the
board
activities.
We
will
look
at
the
risk
register
at
the
end
of
the
at
the
end
of
each
meeting.
F
That's
not
to
undermine
the
audit
and
risk
committees,
holistic
view
of
of
risk,
but
it's
to
make
sure
that
we
can
feed
back
not
just
to
the
to
the
board.
In
terms
of
you
know
our
Assurance
conclusions
but
feedback
to
Iraq
on
any
views
on
significant
risks
that
we
have
seen
during
the
meeting
or
our
views
on
the
effectiveness
of
of
internal
controls
that
relate
to
risks
on
the
risk
register.
So
that's
where
we
are.
A
Thanks
very
much
block
I've
been
two
important
updates
there,
particularly
for
I,
guess
well,
geez
the
the
rcg
given
the
bet
we
haven't
hadn't
met
for
a
little
while
do
any
of
my
colleagues
have
questions
for
either
Sally
or
Mark?
A
No
okay.
Well,
thank
you
very
much.
Both
of
you
I
think
that
does
bring
us
to
the
end
of
the
formal
agenda
before
I
move
to
questions
from
the
public
at
first
I
can
ask
colleagues
of
any
other
business.
I
haven't
been
notified
of
anything.
I
A
So
can
I
just
deal
with
a
a
couple
of
things.
I
would
just
want
to
comment
on
two
people
I'm
going
to
take
this
alphabetical
order.
So
don't,
if
that's
the
only
thing
you
can
read
into
it
and
I
suppose
I
should
make
it
I'm
using
surnames,
because
I'd
have
come
up
with
a
different
result
if
I'd
use
the
first
names,
but
anyway,
Cheshire
you're,
closely
you're
close
the
beginning
of
the
alphabet.
I
did
mention
that
earlier.
A
You've
already
talked
about
leaving
I'd
just
like
to
give
my
thanks
on
behalf
of
the
board
and
obviously
I've
known
you
less
time
than
the
other
member
of
the
board
since
I'm
still
the
newest
member.
But
I
would
like
to
thank
you
on
behalf
of
all
colleagues,
but
also
personally.
A
We
we
have
made
quite
a
lot
of
change
over
the
last
little
while
including,
for
example,
the
the
joined
up
thinking,
you've
talked
about
and
the
bigger
focus
on
risk
in
the
renamed
order
from
risk
Assurance
committee,
but
I
think
you've
done
a
great
job.
There
and
I've
been
a
great
support
to
me
as
I
settled
in
I
posted
I.
A
Don't
need
to
say
a
lot
more
because
you
are
of
course
going
on
to
at
NHS
resolution
and
for
their
body,
so
I'm
sure
that
em,
quite
a
part
of
any
other
contacts,
I'll
be
seeing
you
in
in
our
before
in
relation
to
that
role,
but
can
I.
Thank
you
very
much
indeed
for
this
and
can
I
wish
you
every
good
luck
is
chair
of
NH
resolution
both
for
your
career
as
a
chair,
but
also
for
the
good
of
the
organization
which
obviously
I
have
a
long
Affinity
with.
A
So
thank
you
very
much
indeed
Sally
and
then
the
other
a
if,
if
only
we
were
meeting
physically,
we
could
do
this
in
a
much
better
way,
but
the
other
is
Rebecca.
A
So
you
come
second
on
the
basis.
Lloyd
is
after
Cheshire,
Rebecca
Ian's
already
commented,
but
from
your
input
as
a
member
of
the
executive
team.
But
my
colleagues
told
me
that
you
did
your
best
to
keep
them
completely
honest
over
the
last
few
years
as
the
the
legal
counsel
to
the
board.
A
So,
thank
you
very
much
indeed,
for
that
and
again,
at
a
personal
level,
you've
been
very
patient
in
explaining
the
regulations
to
me
which
stand
about
eight
feet
high
and
then
re-explaining
them
to
me
what
I've
forgotten
on
the
first
time
around
the
the
complexity
of
the
regulations
surrounding
what
we
do
is
is
quite
astounding,
so
I
appreciate
that
personally,
so
you
are
I,
believe
retiring
or
something
close
to
it.
A
So
we
wish
you
and
your
partner
Good
Fortune
in
doing
that
and
a
good
break,
and,
of
course,
if
you
get
bored
in
the
beginning
of
January
like
to
come
back,
will
the
doors
always
open,
but
thank
you
very
much
indeed
to
both
of
you
I
just
wish.
We
could
have
a
around
the
collapse,
but
I
see
a
few
going
up
on
the
screen.
A
A
We
did
have
three
questions
from
the
public
from
Mr,
Pike
and
Sean.
There
were
two
for
you
and
Kate
one
for
you.
I'll
take
them
individually
if
I
could
so
sure.
Let's
begin:
what
train
does
the
CQC
intend
to
make
to
improve
its
regulation
of
secure
psychiatric
hospitals.
N
Thank
you,
Ian.
There
are
a
number
of
ways
in
which
we
plan
to
improve
our
approach
to
inspecting
psychiatric
hospitals.
Firstly,
we'll
be
undertaking
a
greater
number
of
unannounced
inspections
in
locations
and
services
that
we
consider
to
be
at
a
greater
risk
of
developing
closed
cultures
such
as
forensic
Services
learning,
disability
services
and
psychiatric
intensive
care
units.
We
will
also
be
increasing
the
number
of
out
of
hours
inspections
to
gain
a
broader
view
of
how
these
units
function.
N
Irrespective
of
time
of
day,
we
will
be
increasing
the
numbers
of
experts
by
experience
joining
our
inspections.
Experts
who
can
help
us
gain
an
authentic
appreciation
of
what
life
is
like
what
life
is
really
like
for
users
of
services
in
specific
locations,
and
we
are
also
developing
an
observational
methodology
for
inspections,
so
that
inspectors
can
spend
more
time
seeing
how
staff
interact
with
patients
and
how
staff
respond
to
and
support
patients
when,
for
example,
they
are
in
distress.
N
Currently,
a
significant
focus
of
our
inspections
is
on
reviewing
records
and
interviewing
patients
and
staff,
and
while
this
is
important,
of
course,
observing
how
staff
and
patients
relate
to
each
other
in
a
therapeutic
way
in
a
therapeutic
environment
should
be
a
significant
addition
to
our
assessment
approach.
Thank
you.
All.
A
A
We
need
to
look
separately
at
whether
a
lot
of
there
were
changes
of
regulations
or
things
we
could
do
differently,
but
I
think
you
thank
you
for
that
answer
and
then
the
second
question
for
you
is:
how
does
CQC
regulate
NHS
Dental
practices
to
ensure
they
comply
with
the
NHS
Constitution
and,
in
particular,
with
patient
choice?.
N
Yes,
well,
CPC
regulates
Dental
practices
through
inspection
and
assessment
of
their
safety
and
Effectiveness,
and
the
NHS
Constitution
does
not
mention
Dental
Services
specifically
and
as
Dental
practices
are
independent
contractors,
they
can
choose
how
much
NHS
work
they
undertake.
This
can,
unfortunately,
have
a
limiting
effect
on
the
patient
choice
and
the
availability
of
NHS
Dentistry,
but
the
cqc's
role
is
to
ensure
that
when
where
dental
services
are
provided,
they
meet
the
required
quality
and
safety
standards.
Thank
you.
A
Okay,
thank
you
very
much
Sean
and
then
Kate.
Finally,
for
you,
how
is
CQC
planning
to
assess
the
performance
of
integrated
care
boards?
Thank
you.
Probably
not
the
three-day
answer.
Okay,.
B
Yeah
no
I
can
do
I
can
do
it.
So,
as
colleagues
will
be
aware,
we've
developed
a
new
single
assessment
framework,
which
is
our
new
methodology.
First,
assessing
providers
like
local
Care
Systems,
the
Secretary
of
State
sets
our
priorities
for
integrated
Care
Systems,
which
is
leadership,
integration,
quality
and
safety,
and
currently
our
proposal
about
that
methodology
and
approach
is
with
the
Secretary
of
State
for
approval.
Once
we've
got
that
we'll
be
sharing
that
more
widely
through
the
springtime.
A
Okay,
thanks
very
much
Kate,
so
I
think
that
having
done
with
the
form
of
business,
I'll
start
with
the
questions.
So
sorry
it's
a
few
minutes
over,
but
it
was
a
tight
agenda
so
for
all
of
those
of
you
listening.
Thank
you
very
much
indeed
for
being
with
us
for
the
last
several
hours
to
my
colleagues
on
the
board
and
others
on
the
executive
team
at
the
Paul
Kirby
with
the
the
networks.
Thank
you
very
much
indeed,
for
joining
us.
We'll
see
you
again
on
the
1st
of
February.
Thank
you.