►
From YouTube: CQC Board Meeting – October 2019
Description
Give Feedback on Care video: https://youtu.be/q6geiWNJLFc
A
Right
good
morning,
everybody
and
welcome
to
the
public
board
meeting
of
16th
of
October
and
particular
welcome
this
morning,
Paul
Kirby
who's,
the
vice
chair
of
the
disability,
Equality
Network,
Paul,
you've
been
here
before
you're,
very
welcome
and
please
feel
free
to
speak
at
any
time
as
you
may
wish.
We
have
no
apologies
for
absence.
Are
there
any
declarations
of
interest
anybody
needs
to
raise
excellent?
Then
we
move
on
to
the
minutes
of
our
meeting
of
the
18th
of
September.
Were
they
a
true
and
accurate
record
of
all
that
we
discussed?
Thank
you
very
much.
A
They
are
approved
on
the
action
log.
There
is
one
item
on
transformation
which
we're
dealing
with
later
on,
and
the
agenda
and
the
other
three
items
on
the
action
log
are
not
yet
goo.
Is
there
anything
arising?
Anybody
wants
to
raise.
I
have
one
matter
arising,
which
is
the
independent
review
into
the
regulation
of
Walton
Hall.
The
review
that's
been
conducted
by
David
Noble.
It
had
been
hoped
that
we
would
have
that
review
at
this
meeting
today.
A
B
B
I
did
welcome,
particular
one
of
the
recommendations
that
confirms
that
that
David
did
not
find
evidence
of
abuse
during
the
2015
inspection
that
was
carried
out
at
Walton
Hall,
and
he
also
notes
that
the
concerns
that
were
raised
about
the
hospital
at
the
time
were
examined
by
the
inspection
team
outlets
at
the
time
but,
as
I
say,
I,
welcome,
understanding
the
detail
of
all
of
the
of
his
recommendations
and
understanding
how
how
he
arrived
at
his
conclusions
and
then
looking
forward
to
to
deciding
how
we
act
from
that
point
forward.
Thanks.
B
Thanks
Peter
I'm,
going
to
begin
by
by
talking
about
the
state
of
care
report,
we
launched
our.
We
laid
our
state
of
care
report
with
Parliament
on
Monday,
and
there
was
some
follow-up
work.
Yesterday,
I'd
like
to
put
on
record
my
thanks
to
to
Chris
day
and
the
engagement
team
for
the
hard
work
they
did
in
publishing
the
report
and
organizing
the
activities
that
will
shatter
round
that
I'd
also
had
to
put
them
on
record.
B
My
my
thanks
to
the
teams
that
were
involved
in
contributing
to
that
and
all
of
the
directors
and
their
respective
teams
made
contributions
to
the
report
in
a
range
of
different
ways.
The
report
is
an
important
one
for
us.
We
do
75
inspections
every
day
and
it
is
a
bringing
together
of
the
information
that
we
that
we
have.
B
B
So
I'd
like
to
say
I'd
like
to
thank
thank
colleagues
for
that
for
the
support
in
in
delivering
what
I
think
is
a
successful
report
and
a
report
which
seems
to
have
have
really
landed
well
with
the
public
and
the
media
and
I
hope.
There's
some
important
lessons
that
we'll
be
able
to
to
take
forward
in
in
the
coming
coming
months
can.
A
B
Appreciated,
thank
you
Peter.
So,
in
terms
of
moving
on
to
on
to
the
performance
element
of
of
my
report,
I
think
what
we've
seen
is
is
small
declines
in
in
the
performance
of
the
registration
or
the
registration
function
during
August,
but
we
do
know
that
there
are
a
number
of
process
improvement
activities
which
are
going
on
and
I'm
hope,
I'm
hopeful
that
we'll
see
we'll
see
improvements
in
overall
performance
in
that
within
that
team.
B
Shortly
the
inspection
and
the
inspection
directorates
are
are
working
well
in
terms
of
timeliness
of
reports,
I
was
particularly
pleased
to
see
the
urgent
enforcement
action.
Timelines
are
on
trial,
largely
on
target
and
also
safeguarding
alerts
are
performing
well,
so
those
those
those
parts
of
our
performance
were
where
speed
is
of
the
essence,
we're
doing
well
in
terms
of
report.
C
Know
it's
completely
unrelated
I
was
wondering
what
efforts
there
are
to
encourage
frontline
inspectors
to
have
flu
jabs,
particularly
this
year.
My
colleagues,
friends
in
Australia
have
had
a
really
bad
Australian
winter,
and
it
doesn't
always
follow
that.
We
have
bad
ones
here,
but
there's
a
higher
probability
and
given
the
context
in
which
many
people
go
into
organizations
and
premises
and
just
think
it'd
be
good.
If
we
could
encourage
as
many
people
as
possible
to
do
that,
we.
B
Have
absolutely
are,
as
soon
as
you
may
know,
flu
jobs
are
offered
free
to
all
sing,
QC
colleagues
and
that's
done
through
through
boots
the
boots.
The
chemist
I've
had
mine
and
and
I've
I've
encouraged
through
things
like
blogs
and
and
other
campaigns
on
the
internet
and
so
forth.
For
colleagues
to
have
their
flu
jabs
and
we'll
continue
to
encourage
people
to
do
that.
For
all
of
the
reasons
that
you
outlined.
D
So
I'm
just
want
to
talk
to
the
board
about
an
up
and
coming
publication.
We
are
going
to
be
releasing
in
November
about
sexual
safety,
with
a
particular
focus
on
sexual
safety
in
care
homes.
There's
been
some
history
to
this
piece
of
work.
So
back
in
2018,
we
looked
at
sexual
safety
on
mental
health
wards.
D
Earlier
this
year
we
released
the
publication
about
supporting
adults
with
social
care
needs
around
their
sexuality
and
relationships,
and
for
this
piece
of
work,
we've
worked
very
closely
with
a
couple
of
families
who
have
had
very
poor
experiences
of
relatives
or
loved
ones
where
they
have
had
issues
around
this
area.
They
have
helped
us
to
develop
this
report,
so
it's
been
co-produced
from
start
to
finish
with
families
who
have
been
involved.
D
E
Thank
you.
The
my
report
starts
off
just
highlighting
the
latest
work
that
we've
been
doing
in
regulating
closed
environments
following
the
panorama
program.
Walton
Hall
colleagues
will
remember
from
yesterday's
report
that
we
have
put
14
of
these
hospitals
into
special
measures
over
the
last
year,
six
of
them
since
that
program,
and
since
the
program
it
has
been
really
very
good
that
we've
had
more
people
raising
concerns
with
us
and
I'd
like
to
encourage
people
out
there
who
do
have
concerns
about
these
services
to
raise
them
with
us.
E
So
we
can
take
action
on
them
as
we
are
doing
demonstrated
by
the
action
and
over
the
last
few
months
recently,
we
wrote
to
130
providers
of
care
in
closed
environments
to
emphasize
the
importance
of
considering
the
human
rights
of
the
people
they're.
Looking
after
and
the
importance
of
everyone
engaged
in
these
services
and
everyone
involved
in
visiting
these
services,
including,
of
course,
the
CQC
to
take
into
account
any
concerns
about
abuse
of
human
rights
in
these
environments
and
I.
Think
it's
very
important
part
of
what
we
do
to
stress.
E
That
aspect
of
care
is
really
very
important,
will
shortly
be
published.
Some
guidelines
on
our
approach
to
inspecting
of
regulating
closed
environments
and
they
will
be
put
in
the
public
domain
because
I
hope
they'll
be
useful
to
everyone
involved
in
overseeing
these
services,
but
we
see
them
as
very
much
interim
guidelines.
E
We
want
to
work
with
people
in
the
sector,
people
to
use
these
services
to
improve
the
guidelines
and,
of
course,
we
will
be
looking
for
more
advice
and
recommendations
coming
out
of
the
independent
reviews
to
help
us
make
sure
the
guidelines
are
as
good
as
they
can
be.
I'm
highlighting
two
publications
are
coming
out
shortly:
they're
both
statistical
publications,
so
we
can't
preempt
the
results
today,
but
I
think
they're
really
very
important
because
they
give
us
information
that
they're
large
services
give
us
really
very
useful
information
about
people's
perception
of
the
care
they
receive.
E
When
the
information
comes
out,
I
will
write
individually
to
providers
who
are
provide.
His
survey
results
suggests
that
the
experience
of
patients
in
their
care
is
less
good
than
than
average,
and
so
we
will
be
tackling
that
and
we're
asking
our
relationship
owners
to
take
that
forward
with
them
to
make
sure
that
people
are
using
this
survey
to
drive
forward
it
improvements
in
the
in
care
and
just
finally
to
highlight
today,
we've
published
a
report
on
the
world
Papworth
hospital.
E
It
is
the
first
report
on
NHS
trust
where
the
trust
has
come
out
outstanding
for
all
five
key
questions
and
I
think
this
is
many
congratulations
to
wrap
up
with
their
staff
and
their
leadership.
It
is
a
great
achievement
for
them,
but
it
does
reflect
an
overarching
pattern
of
improvement,
we're
seeing
in
many
NHS
trusts,
and
that
was
in
yesterday's
state
of
care
report.
But
of
course
it
didn't
feature
very
prominently
in
lots
of
the
stories
about
it
and
I
think
it
is
important.
We
do
pay
a
tribute
to
the
really
good
work.
A
So
Ted
III
absolutely
echo
that
last
point.
It's
a
huge
tribute
to
people
in
the
services
that
that
quality
has
not
just
been
maintained,
but
often
improved
and
Papworth
is
a
really
good
example
of
that.
But
there
are.
There
are
many
others
as
well
as
so.
It's
really
good,
just
just
on
the
the
closed
environments
that
been
put
into
special
measures.
Do
you
have
any
any
sense
of
the
the
the
engagement
that's
taking
place
to
try
and
help
these
these?
These
places
to
improve.
E
Well,
that's
very
important
to
note
that,
while
these
are
NHS
patients
in
these
services,
they
are
predominately
run
by
independent
healthcare
and
I.
Think
we
are
working
very
closely
relates
improvement
to
establish
ways
that
those
services
can
be
supported
to
improve
because
energy
trusters,
what
into
special
measures,
get
a
large
package
of
support,
and
that
is
proved
very
successful.
E
The
number
of
trusts
in
special
measures
has
decreased
markedly
over
the
last
few
years
and
I
think
this
has
been
a
very
successful
program
and
we
are
looking
to
work
with
our
partners
in
NHS
improvement
to
develop
a
similar
approach,
albeit
for
these
independent
health
providers,
because
it
is
an
important
part
of
of
the
system
that
that
capacity
is
there
I,
say
I
think
we
need
to
be
very
careful
that
we
don't
just
see.
This
is
an
opportunity
if
you
like
to
take
that
capacity
out
of
the
system.
E
F
You
I
just
wanted
to
raise
two
pieces
of
work
around
online
services
that
we've
published
this
month.
So
as
the
board
is
aware,
we
have
a
seen
a
significant
growth
in
the
use
of
online
services
and
the
first
publication
is
a
joint
statement
with
our
regulators
that
we
are
working
very
closely
with.
So
we
work
very
closely
with
people
like
the
GMC,
the
the
general
pharmaceutical
Council,
to
look
at
how
we
can
tackle
some
of
the
risks
associated
with
online
regulators
online
services.
F
So
the
first
publication
was
a
joint
statement
from
the
cross
regulatory
group.
The
second
piece
of
work
was
an
update
on
the
choosing
on
online
health
care
service
that
had
previously
been
published,
and
this
is
really
aimed
to
helping
people
support
people
in
choosing
an
online
service
when
they,
when
they
need
to
access
them
and
make
sure
that
they're
accessing
safe
care
through
those
services.
H
Chris
scheme
I'll
tell
oh
I'm,
so
phase
we're
now
at
full
cost
recovery,
which
means
all
of
active
activity.
Our
regulatory
activities
is
recovered
through
provider
fees
over
the
journey
to
get
to
full
cost
recovery.
We've
amended
off
the
scheme
every
year
and
we've
consulted
on
changes
to
those
fees.
The
fee
scheme
for
twenty.
Twenty-One
we've
agreed
that
the
fee
scheme
will
not
change
and
therefore
no
consultation
is
required
on
that.
A
I
So
we
will
continue
to
register
to
monitor,
to
inspect
and
where
necessary,
enforce
against
services.
As
we
do
now,
we
will,
of
course,
if
there
is
particular
pressures
and
individual
providers
be
able
to
take
account
of
us
on
a
case-by-case
basis.
In
the
same
way,
we
already
do
today
where
there
are
significant
events
around
particular
services
like
during
winter,
for
example,
particular
pressures.
We
very
much
expect
that
to
be
the
exception.
I
Rather
than
the
rule,
but
we
have
that
flexibility
where
it
is
required
and,
of
course,
where
there
is
sniffing
issues
arising
across
the
health
and
social
care
sectors,
will
be
working
very
closely
with
all
our
partners
to
ensure
that
people
receive
care,
safe
care
and
that
improvement
is
taking
place.
Thank.
A
Okay,
so
we
can
move
on.
I
was
always
told
that
it
was
very
dangerous,
very
unwise
to
for
actors
to
perform
with
children
and
animals.
I
was
also
always
taught.
It
was
very
unwise
to
try
and
do
a
live.
A
technology
demonstration
in
a
meeting
so
I
think
very
courageous
of
you
to
do
this.
Gemma
and
Owen
you're
very
welcome
Walter.
Do
you
want
to
say
anything
by
way
of
introduction,
Chris,
okay,.
J
Just
just
to
help
the
Thank
You
clothes
that
have
helped
to
me
about
the
way
the
giving
feedback
on
care
drives,
everything
that
we
know
about
health
and
care
and
having
a
service
that
works
well
for
people
to
use.
It
is
vital
in
our
work
this
year
stated
care
is
an
example
of
how
we've
used
the
voice
of
people
to
drive
our
understanding.
So
colleagues,
from
across
CQC
have
been
involved
in
the
redevelopment
of
this
important
service,
and
the
video
that
they're
going
to
introduce
will
just
shows
how
the
new
service
would
operate.
K
Hi
I'm
Gemma
I'm,
the
product
manager
on
give
feedback
on
care
give
feedback
on
care
is
a
project
which
started
actually
in
about
2016
and
it's
a
new
way
for
members
of
the
public
to
give
feedback
online
to
CQC
about
their
experience
of
care.
So
if
they
go
to
a
hospital
or
a
GP
and
they
want
to
tell
CQC
about
something
which
happened,
it
replaces
the
existing
share.
Your
experience
form,
which
we
have
on
the
CQC
website
at
the
moment.
K
So
when
this
work
started
in
2016,
we
found
that
the
share
your
experience
form
wasn't
really
fit
for
purpose.
We
only
had
about
10%
of
people
that
started
it
actually
completing
it
and
members
of
the
public
and
whistleblowers
for
having
real
issues
with
things
like
finding
their
service
and
also
using
it
on
a
mobile
because
it
wasn't
responsive,
so
it
just
shrunk
and
it
was
very
small.
So
this
is
the
first
agile
software
development,
I,
guess,
project
which
has
happened
in
CQC,
and
that
means
that
we're
being
assessed
against
the
government
digital
service
standard.
L
L
Conducting
research
with
users
with
low
digital
skills,
as
well
as
those
comfortable
online,
ensures
that
we
build
something
that
works
for
everybody
and
lets
everyone
complete
their
goal,
telling
CQC
bite
their
experience
of
cat
I'm,
continuing
research
throughout
our
public
pizza
and
as
our
numbers
increase,
we
are
conducting
ongoing
internal
research
with
inspectors
to
understand
that
the
NuStar
submissions
are
meeting
their
needs.
One
area
were
looking
into
at
the
moment,
is
our
Liberty
and
how
to
ensure
that
users
am
making
an
informed
citizen
about
the
choices
to
give
their
contact.
L
M
Take
my
name
is
Chris:
gallant
are
in
the
content
designer
on
this
project
and
I've
been
involved
in
interaction
design
as
well.
So
interaction
design
is
to
do
with
the
flow
of
the
service,
the
way
that
the
pages
sawed
together
and
the
structure
of
the
pages
or
they
were
using
the
GDS,
the
wk
design
system,
which
means
we're
we're
using
standard
elements.
M
The
way
those
elements
fit
together
depends
very
much
on
the
way
our
users
are
using
the
service
and
what
comes
out
of
our
user
research
and
our
analytics
one
area
that
we've,
where
we've
taken
the
service
through
quite
a
number
of
iterations,
and
it's
involved
quite
close
collaboration
between
me
and
the
use
of
researcher
and
the
performance.
Analyst
is
the
way
that
we
serve
guidance
information
to
people
as
they
as
they
fill
in
the
form,
because
we
need
that
guidance
information
to
be
as
concise
and
specific
to
their
feedback
as
possible.
M
One
good
example
of
that
is
on
the
page
where
they
give
their
feedback
about
service.
To
start
with,
we
had
quite
quite
generic
guidance
text
on
that
page
and
we
really
just
let
the
user
to
say
whatever
they
wanted
in
that
in
that
feedback
box.
But
as
we
went
into
private
Vita,
we
started
to
find
out
from
from
user
research
with
inspectors
that
they
weren't
really
getting
the
specifics
that
they
needed
from
that.
From
that
feedback
and
and
often
people
included
quite
a
lot
of
superfluous
information
that
there
wasn't
helpful
to
inspectors.
N
So
my
main
role
in
this
project
is
performance
analysis
services
performing.
So
we
think
then,
what's
working
well
and,
more
importantly,
what
is
read:
focus
on
to
improve
services
for
our
users
so
to
analyze
the
performance
of
the
GFC
service,
we've
utilized
tools
such
as
Google,
Analytics,
optimize
tag
manager
or
chart
and
CRM
and
the
main
things
we
monitor
our
completion
grade
teacher
grades,
mobile
device
users
and
unpervaded
on
stage
performance.
K
J
Okay,
that's
a
an
overview
of
the
development
I.
Think
probably
things
to
note
in
that
are
there's
a
heavy
reliance
sort
of
John's
earlier
point:
there's
a
heavy
reliance
on
the
conversation
to
have
both
internally
and
externally,
with
colleagues
to
make
this
service
work.
In
addition
to
that,
there's
a
real
sense
of
starting
trialing
and
developing
over
time.
J
So
the
service
that
we'll
have
in
four
weeks
time
will
improve
again
and
I
think
that
the
the
risen
sir
there
isn't
a
sense
of
we
have
to
have
a
perfect
service
that,
as
we
launch
was
they've,
already
launched
a
soft
element
of
the
service.
Now
we
want
to
continue
to
focus
on
how
we
can
make
the
interactions
even
better,
and
we
will
at
the
point
where
we
feel
assured
that
we've
made
the
changes
to
the
website.
We
will
obviously
begin
to
talk
about
this
more
with
our
with
our
partners,
particularly
our
public
partners.
J
Who've
been
with
us
on
this
journey,
we've
got
sure,
experienced
partners
and
across
all
the
sectors
that
we
regulate,
so
I
don't
want
to
pay
tribute
to
the
team.
The
team
that
worked
on
this
and
any
other
people
are
not
in
the
room
but
have
been
involved
in
the
work
all
the
way
through
and
very
happy
to
take
any
any
questions
or
comments.
B
I
was
good,
I
was
inserted.
Just
add
my
my
my
thanks
to
the
team
that
have
worked
on
this
piece
of
work.
It's
a
really
impressive
piece
of
work.
I
think
we
slightly
skated
over
the
fact
that
it's
been
approved
by
government
digital
service
I
think
it
was
more
than
approved.
They
described
it
as
an
exemplary
piece
of
work,
so
I
think,
given
that
government
digital
service
review
all
of
these
services
right
across
government,
the
fact
that
they
were
so
complimentary
about
this
service
just
gives
you
some
sense
of
how
good
it
is.
B
I
think
the
second
thing
to
say
is
that
is
that
what
this
program
represents
is
is
a
pattern
of
how
we
will
do
our
business
from
this
point
forward.
So
you
saw
lots
of
reference
to
agility
lots
of
reference
to
trying
new
things
reference
to
involving
users,
whether
that's
internal
and
external
users,
to
make
sure
that
the
service
and
we're
deliberately
calling
it
a
service,
not
a
piece
of
technology,
delivers
for
both
external
users
and
for
and
for
internal
users
and
I.
B
Think
that
the
big
figure
that
was
really
important
is
the
old
system
to
only
10%
of
people
actually
got
to
the
end
of
completion.
The
new
system
is
43
percent
now
and
I.
Think
speaking
to
the
team,
privately
they're
they're,
confident
that,
as
this
starts
to
roll
out,
that
number
will
get
bigger
and
I
think
the
act.
B
The
accessibility
around
mobile
devices
in
particular,
has
been
a
really
really
big
surprise
and
just
demonstrates
the
way
people
are
living
their
lives,
so
I
think
adding
lots
of
good
lots
of
good
work
here
for
this
service,
but
I
think
we
also
need
to
need
to
recognize
that
this
is
how
we
all
do
business
from
this
point
forward.
So
well
done.
Thank.
D
I
wanted
to
echo
means
congratulations
on
a
product
that
we
hope
will
encourage
more
and
more
people
to
talk
to
us
and
we'll
see
through
their
feedback
to
completion.
I
know
in
this
year's
State
of
care.
We
were
able
to
use
a
lot
more
of
the
intelligence
that
we've
received
to
reflect
back
to
the
country
about
how
people
are
experiencing
health
and
care.
Are
you
able
to
say
a
bit
more
about
how
we
will
provide
that
feedback
loop
under
this
new
option?.
O
So
it's
one
of
the
so
we're
obviously
working
on
public
beta
plans
a
moment,
so
we're
launch
to
everyone
so
from
next
month
it'll
become
the
default
for
everyone
and
that's
one
of
the
main
things
on
our
backlog.
So
there
is
some
limitations
on
that
because
of
the
CRM
work.
That's
going
on.
So
it's
order
to
close
the
feedback
loop
in
an
ideal
world
you'd
have
the
way
we
manage
our
contacts
and
the
way
that
we
received
the
feedback
working
seamlessly
together
so
that
you
can
update
people
whenever
we
take
actions
within
our
CRM.
O
Obviously,
we've
got
another
big
transformation
project
going
on
around
the
use
of
that
CRM.
So
we
we're
having
to
work
within
the
constraints
of
what
we
have
there,
but
yeah
there's
absolutely
one
of
the
main
main
further
development
things
on
our
agenda
is
to
to
understand.
Users
needs
about
finding
out
what
we've
done
as
a
result
and
telling
them
and
how
they
want
to
be
told,
and
that
sort
of
thing
that's
all
they
think
them
into
our
roadmap.
I.
J
Think
the
form
the
form
give
us
the
ability
to
do
that
and
as
we
develop
this,
the
CRM
solution
will
be
able
to
link
into
that
I.
Think.
It's
also
useful
that
we'll
be
able
to
my
ambition
is
that
we're
able
to
make
some
information
public
as
well
as
people
can
see
the
information
alongside
our
inspection
reports
and
I,
think
that
would
be
a
really
good
indication
that
we've
understood
and
and
are
using
that
information
in
our
in
our
work
and
as
we
move
to
look
at
regional
reporting
around
state
of
care,
we
can.
K
It's
like
we,
we
set
out
with
users
like
how
we'll
use
their
information
so
giving
really
clear
information
to
people
that
how
they're
going
to
be
using
it,
what
different
things
that's
going
to
be
used
for,
and
also
telling
them.
You
know
that
we
do
give
them
a
reference
number,
but
also
trying
to
make
it
really
clear
with
users
that
this
is
not
a
complaint
service.
You
know
you're
not
necessarily
going
to
hear
back
from
somebody
and
I
think
that
that's
something
which
has
come
out
really
strongly
from
speaking
with
inspectors
as
well.
D
So
I
think
the
me
it's
just
it's
about
that
clarity
of
expectation,
upfront
about
what
we
will
do
with
that
information
and
just
that
continuous
reiteration
that
every
every
time
people
take
the
effort
to
give
us
feedback.
That
feedback
is
used
and
is
useful,
even
if
you
don't
get
a
bespoke
response
to
what
we
did
with
your
your
particular
contribution.
I.
J
P
Jorah
and
then
Liz
yeah
I
mean
great
approach.
I,
really
like
it
like
this
lean
way
of
working
using
tests
and
learn
with
data
and
analytics
to
help
pivot
I,
like
that
you've
set
out
your
objectives
early
in
terms
of
completion
rates,
etc.
I
sort
of
had
sort
of
two
questions.
One
was
following
on
from
Kate's,
so
there's
gonna
be
a
lot
of
quantitative
analytics
through
your
Google
stuff,
but
the
quality
side
of
things
that
people
can
freeform
and
oh
I
want
to
know
how
that
was
working
and
I.
P
O
So
I
think
there's
two
so
on
the
first
part
and
so
on.
So
the
two
parts
were
how
not
accessible
so
people,
not
digital
savvy,
so
part
of
the
we
talked
about
Ian
mentioned
about
seeing
as
a
service
rather
than
a
piece
of
technology,
and
so
we
are
working
really
closely
with
our
concerns
team
in
in
CSC
and
Newcastle
to
look
at
online
and
offline,
so
not
treating
it
in
the
past.
O
We
might
have
thought
about
it
as
the
share
experience
form
on
the
website
and
then
how
we
answer
calls
and
they
might
have
completely
different
projects
or
different
approaches,
because
now
we're
seeing
it
all
as
one
one
kind
of
service
together
working
very
closely
with
with
people
that
are
answering
calls
answering
emails
and
also
people
that
are
triaging
stuff,
that
comes
through
our
service,
so
that
people
are
getting
a
kind
of
unified
customer
experience.
If
you
like,
no
matter
how
they're
sharing
that
information
with
us-
and
the
first
point
was
so,
he.
J
O
So
Chris
touch
another
tiny
bit
in
the
court
in
the
video,
but
what
we've
done
is
we've.
We've
already
started
pulling
from
having
a
single
text
box
so
actually
having
more
text
boxes,
asking
more
specific
questions
to
try
and
get
more
structured
data,
and
we've
also
got
a
lot
of
user
research
going
on
with
inspectors
to
understand
how
how
where
how
the
information
that's
coming
in
is
meeting
their
needs.
So
there's
there's
kind
of
a
tightrope
that
we
walk
between
that
I
you.
O
O
At
the
same
time,
you
may
need
to
make
sure
we
get
the
structured
data
we
need
so
answering
the
particular
question,
so
we're
definitely
finding
the
line
between
those
two
things
and
at
the
moment
it's
mainly
around
having
more
qualitative
feedback
rather
than
just
a
single
story
box
we've
got
a
story
box
and
then
particular
questions.
Where
did
it
happen?
When
did
it
happen?
These
kinds
of
things
where
we
can
get
more
specifics,
that's
more
useful
to
inspectors
and
subsequently
making
those
slightly
tailored
to
the
to
the
sector's
there's
obviously
touched
on
so.
K
Of
adding
status
well,
there's
also
that
ongoing
work
with
our
colleagues
and
intelligence,
who
are
doing
like
severity
analysis,
sentiment
analysis
so
looking
at
patterns
and
what
people
are
saying
and
then
being
able
to
draw
out
stuff
from
it.
So
I
think
that
that's
quite
like
that.
There's
a
lot
of
potential
with
that
as
well,
and
they
need
lots
of
data
to
be
able
to
really
get
that
stuff,
which
is
why
it's
better
that
we're
getting
more
people
through
and.
J
Either
side
of
that
feedback
is
the
feedback
we're
getting
from
our
experienced
partners
so
how
they
and
their
because
we've
a
while
ago,
we
did
some
training
for
organisations
that
provide
some
of
the
information
back
to
us,
so
that,
if
you
go
to
an
ADK
helpline,
you'll
get
our
information
and
they'll
help
you
to
complete
that
form
and
therefore
we
can.
We
can
go
to
them
and
use
them
as
for
feedback
from
the
public
about
how
the
service
is
working
for
them
and
they'll
be
important
part
of
how
we
develop
it.
Moving
forward
good.
Q
Yes,
you
just
partly
answered
my
question.
Really
I
I
was
wondering
to
what
extent
themes
that
are
coming
through
if
we're
analyzing
those
are
feeding
into
things
like
future
strategy.
Future
independent
voice
work,
whether
we
as
the
board
might
from
time
to
time
see
what
are
some
of
the
key
themes
that
are
coming
out
and
also
how
that's
fed
back
so
I'm,
very
supportive
of
the
idea
that,
as
much
as
we
can
say,
you
said
we
did
will
make
people
feel
it's
worthwhile
and
reduce
any
frustration.
Q
J
The
themes
I
mean
this
year
said
to
care
focus
on
access
was
in
part,
driven
by,
though,
that
that
feedback
that
we've
had
from
from
people
view
services
in
across
the
country
and
certainly
going
forward
our
independent
voice.
Work
is
very
much
based
upon
what
we
know
from
our
inspections
and
their
intelligence.
J
We
share
information
we
way
with
with
HealthWatch
they
we've
been
really
I
mean.
This
year's
Educare
is
a
good
example
of
it.
They've
their
information
is
contributed
to
the
themes
of
state
of
care,
and
certainly
we
do.
We
recognize
it
that
give
you
feedback
on,
carries
only
one
element
of
that
and
we
have
alongside
HealthWatch.
We
have
relationships
with
a
number
of
organizations
that
represent
different
communities,
and
we
want
to
bring
all
of
that
to
bear
when
we
talk
about
our
independent
boys
themes
so.
R
K
L
K
At
the
moment,
that
is
what
happens,
but
we've
been
trying
to
previously
inspectors
were
telling
us
that
they
weren't
getting
the
information
that
they
need
it.
So
you
would
say
something,
but
you
weren't
really
like
the
show
you
experience,
form,
wasn't
really
driving
the
information
that
we
really
needed
so
where
something
happened
when
it
happened,
who
you've
already
told
about
it,
cetera
and
so
inspectors
are
having
to
do
a
lot
of
follow-up
and
so
ncsc,
sometimes
as
well.
K
So
there
was
a
lot
more
like
work
around
it,
whereas
now
an
inspector,
hopefully
in
an
ideal
world
which
I
think
is
happening,
there's
better
quality
information
coming
through,
so
that
you're
having
to
do
kind
of
less
follow-up
on
it,
and
you
can
say
actually
that's
a
really
useful
piece
of
information
but
I'm
not
gonna,
do
anything
with
it.
You
know,
you
just
add
it
to
your
kind
of
inspection
planning.
R
K
So
it
goes
yeah,
so
somebody
will
give
their
feedback
and
then
they,
the
submission,
is
integrated
with
the
CRM
and
then
it
will
go
to
like
a
pre
enquiry,
q4n
CSV
and
then
it
gets
assigned
to
somebody
in
an
CSV
and
the
concerns
team.
They
will
then
triage
it
based
on.
You
know
how
severe
it
is.
If
it's
positive
feedback
negative
feedback,
they
do
something
different
with
it
and
then
they
pass
it
over
to
an
inspector
for
NCSC.
K
E
Congratulations
on
this
piece
of
work,
I
think
is
really
very
exciting
and
at
the
I
mean
you've
been
talking
a
bit
about
the
improving
the
qualitative
information
coming
back,
and
that's
that
sounds
really
good,
but
also
the
the
completion
rate.
The
increase
in
Commission
rate
is
really
impressive,
so
that
presumably
we're
going
to
get
a
lot
more.
E
This
feedback
coming
back
to
us
and
I
suppose
just
building
on
what
you
were
just
saying
a
few
moments
ago.
Do
do
you
understand
how
this
is
going
to
influence
our
regulatory
and
inspection
activity
on
the
ground
and
haven't
got
a
way
of
monitoring
how
it
does
influence
our
reg
reg
inspect
2002,
because
if
there's
a
kind
of
little
sense
of
here,
this
is
a
power
to
change
some
of
our
priorities,
your
what
they're
going
to
do
next
to
where
we're
going
to
inspect.
E
K
This
is
actually
something
I
was
talking
to
Frazee
about.
You
know
how,
like
we
kind
of
also
need
to
think
about
some
of
the
stuff
around
what
inspectors
are
doing
with
the
information
as
well,
because
our
research
with
inspectors
kind
of
shown
that
there's
not
there's
not
like
standardization
among
the
inspectors
about
what
they
do
with
feedback
that
comes
from
give
feedback
home
care
or
by
the
phone.
K
You
know
that
they
will
do
different
kind
of
things
with
it,
and
so
I
think
that
there's
definitely
potential
for
us
to
think
about
kind
of
the
information
that
we're
giving
to
inspectors
about
how
they
should
be
dealing
with
this
information,
trying
to
standardize
that
a
bit
more.
So
then
it
will
help
us
be
able
to
have
the
information,
have
more
impact
and
be
more
effective.
I
think.
J
Just
to
build
on
that,
there's
there's
a
piece
about
and
Beyond
and
voice
that
we've
spoken
about.
If
we
are,
if
we
know
there
are
themes
emerging
on
particular
topics,
whether
we
need
to
build
on
our
understanding
so
either
our
guidance
to
providers
and/or
our
guidance
to
colleagues,
so
that
that
we
can
address
any
issues
that
are
emerging
nearly
but
the
particular
sectors
or
indeed
cross
sectors.
E
Absolutely
and
I
think
the
idea
about
influencing
themes
or
independent
voice
and
thought,
but
equally
this
may
build
up
to
more
information
about
individual
providers
and
we
say
we're
going
to
bring
that
inspection
forward
except
in
fact,
I
hope.
It
worked
because
I
mean
it
gives
us
kind
of
much
more
dynamic
information
about
people's
perception
of
their
care.
But
will
we
know
if
that's
happening
and
are
we
prepared
you
know?
Do
we
have
a
dynamic
enough
approach
to
actually
take
account
of
it?
So.
O
We've
got
a
dashboard
as
well,
so
we've
got
a
way
of
analyzing
in
CRM,
so
we've
got
the
actions
that
there's
a
form
of
inspectors.
Phil
Abbott
says
they
can
put
one
or
two
actions
they've
taken
as
a
result.
So
the
moment
we
track
you
know
over
the
over
the
quarter
for
show
experience
how
many
responsive
inspections.
How
many
times
do
we
go
out
and
actively
as
a
direct
result
of
that
submission?
How
many
times
did
we
go
in
to
an
immediate
inspection?
So
yeah?
O
We
can
look
at
those
numbers,
and
that
would
be
really
it's
not
perfect,
but
it's
a
really
strong
model
of
what's
changing
as
a
result
that
we
do
more,
it
done
a
more
responsive
inspections.
Are
we
having
more
our
Em's?
Are
we
having
you
know
more
any
of
those
actions
that
inspector
might
loggers
as
a
direct
result
of
that
submission,
good.
P
Think
it's
going
to
really
bring
in
inspection
is
one
way
of
getting
information,
and
this
is
another
way
of
bringing
in
information,
and
it
almost
like,
you
know,
potentially
more
of
a
real-time
way
of
sort
of
maybe
alerting
to
the
system,
knowing
there's
something
that
should
aid
a
service
now
where
we
need
the
inspectorate's
to
trigger
an
action.
So
in
a
way
this
is
a
call
to
action
to
do
something
or
potentially
a
call
to
action
to
do
something.
P
G
You,
yes,
so
what
I
was
gonna
say
is.
This
is
just
one
part
of
a
very
complex
set
of
programs
which
will
enable
us
to
do
just
that,
so
we're
pulling
in
the
data
there's
a
huge
program
around
all
our
analytics,
which
will
help
inform
how
we
do
our
regulation
and
inspection
in
the
future.
So
absolutely
I
think
we'll
get
there,
but
this
is
just
the
first
step
in
that
process.
G
A
So,
thank
you
very
much
for
answering
the
questions
so
many
questions.
Thank
you
very
much
for
the
great
video.
The
only
thing
that
was
missing
was
the
popcorn
which
no
doubt
will
be
present
next
time.
This
is
really
really
exciting
and,
as
others
have
said,
you
know
a
great
step
forward
for
us.
So
thank
you
very
much
deed.
Having
said
it's
a
great
step
forward,
I'm
going
to
take
a
step
backwards
because
I
didn't
make
it
clear
when
I
was
saying,
were
there
any
questions
around
the
ET
report?
A
S
You
chairman,
yes,
I,
wondered
if
I
could
ask
a
question
about
chart:
18
the
process's
chart
decreased,
cost
loss
to
IT
issues
when
I
was
up
in
the
Newcastle
office.
Last
week,
I
came
across
the
tech
bar
innovation
and
there
was
a
huge
amount
of
energy
there
and
I'm
sure
that
that
is
very
much
wrapped
up
in
this
approach.
To
trying
to
reduce
time
lost,
I
just
wondered
mark.
S
If
you
could
give
us
some,
you
know
a
bit
of
an
update
about
tech
bar
and
whether
there's
any
plans
to
to
roll
it
out
and
indeed
how
we
measure
the
effectiveness
there.
As
I
said,
there
was
a
huge
amount
of
energy
and
there
was
an
engagement
going
on
whilst
I
was
there
and
I
was
very
impressed
with
great.
T
Thank
you
very
much
mark
so
I'm
doubly
delighted
about
this
because
kind
of
setting
out
the
need
for
us
to
improve
the
service
to
our
our
customers.
But
my
team.
It
sort
of
spontaneously
developed
this
initiative
and
it
was
really
a
pilot
to
test
to
see
if
that
sort
of
approach
would
work
for
our
for
our
colleagues
and
it's
been,
it's
been
a
tremendous
success.
T
But
what
what
will
take
from
that
is
the
the
understanding
that
that
works
very
well.
It
provides
a
fantastic
in-person
service
to
our
our
colleagues
and
look
to
build
a
case
to
develop
that
wider.
So
that's
not
just
for
office
based
colleagues,
but
our
remote
working
colleagues
that
come
together
for
for
conferences
or
department
meetings
or
regional
meetings
will
have
a
roving
version
of
that.
We
can
bring
out
to
to
provide
that
level
of
support,
and
what
we
found
is
that
that
sort
of
in-person
treatment
allows
people
to
address
therein.
T
Any
issues
they
might
have
very
quickly
in
person
and
often
that
they're
issues
that
people
are
sort
of
been
grumbling
along
with
for
a
period
of
time
they
actually
they're
able
to
resolve
the
surface.
Those
and
resolve
them
resolved
from
there
in
terms
of
metrics.
We
can.
We
have
the
ability
to
measure.
T
C
T
A
It's
not
where
you
go
for
a
drink,
John,
sorry,
I
resent
the
implication.
Is
there
anything
else
on
the
performance
report?
Having
not
made
it
clear
that
I
meant
to
have
covered
that
right,
in
which
case
we
move
on
Mary,
where
it
great
welcome
to
marry
Krish
coming
to
give
us
our
your
annual
report
on
the
speak
up
Guardian
of
what
Mary
over
to
you
well.
U
Thank
you
very
much,
I'm
very
pleased
to
be
here
presenting
in
speak
up
months
in
the
report.
I
presented,
I've
summarized
the
activity
over
the
last
year
and
make
a
reference
to
the
internal
and
external
connections
that
work
with
us
and
support
us
I've.
Given
you
something
of
the
numbers,
I've
pulled
out
some
insights
and
some
themes.
Overall,
it's
been
a
busy
year
and
I
have
enjoyed
support
at
all
levels,
but
at
times
it
has
felt
hard,
I
think
that's
because
of
competing
pressures
and
demands
and
I've.
U
Our
themes
and
our
challenges
continue
to
mirror
those
of
other
organizations
that
we're
aware
of,
and
certainly
those
in
the
NHS,
as
reported
by
the
National
Guardians
office,
and
we
take
account
of
her
published
findings
from
the
case
reviews
that
she
undertakes
and
from
that
I
can
see
that
there
is
a
consistency
of
experience
for
those
of
us
who
are
grappling
with
this.
There's
lots
of
good
news.
I.
U
Think
we've
got
evidence
of
increasing
awareness
of
the
of
the
power
of
the
positive
speaking
up
culture
and
are
determined
to
make
that
determination
to
make
it
so
ambassadors
are
increasingly
active
both
in
terms
of
promoting
positive
speaking
up
and
also
increasingly
used
to
support.
Colleagues,
the
challenges
I
think
are
to
continue
to
grow
our
confidence
that
something
will
be
done
and
also
supporting
colleagues
to
respond.
U
We've
been
very
pleased
recently
engaging
with
our
new
director
of
people
and
so
the
invitation
for
the
speak
up
lessons
to
be
part
of
the
review
of
HR
policies.
That's
underway,
that's
a
very
positive
development
on
numbers,
24
to
the
end
of
March
and
15
cents
compared
to
35
over
the
12
month
comparison
period,
not
a
significant
change.
I,
don't
think
ambassadors
are
reporting
an
increase
in
activity.
U
The
only
rather
negative
increase
has
been
the
number
of
people
not
willing
to
take
things
further,
and
that's
a
challenge
to
us
to
make
those
those
speaking
up
feeling
really
welcome.
But
we
have
some
insights
through
three
surveys.
Over
the
last
year,
I've
reported
before
that
the
question
around
confidence
in
raising
a
concern
around
here.
How
safe
is
it
is
a
benchmark
question
in
our
national.
Our
annual
survey
that's
been
stuck
at
42%
for
the
last
two
years.
U
We
had
the
Speak
Up
survey
that
Professor
Rees
ran
and
for
us
and
which
the
board
has
presentations
of
earlier
in
the
year,
which
told
us
that
we're
average.
So
all
the
challenges
and
barriers
to
speaking
up
are
the
same
for
us
as
anywhere
else,
but
I
can
assure
you
that
we
act
differently
with
our
regulatory
hats
on
there's
no
lack
of
courage
when
it
comes
to
inspectors
deep,
following
up
concerns
that
are
raised,
we're
just
less
brave
when
it
comes
to
our
own
internal
working
environment,
and
that's
not
unusual.
U
The
pulse
survey
tells
us
that
awareness
of
how
to
raise
a
concern
is
increased.
A
very
pleasing,
87
percent,
overall
aware
of
how
to
raise
a
concern
work
to
do
on
the
confidence
in
whether
people
feel
they'll
be
listened
to
53
percent
overall,
but
I
think
that's
a
really
important
increase
in
awareness,
because,
without
that
we
won't
get
further.
U
U
In
our
context,
it
means
temporary
debilitation
in
terms
of
our
effectiveness
and
performance
and
obviously
that's
something
we
all
want
to
avoid.
So
no
quick
fix
to
that.
The
key
lesson
is
early,
timely,
good
conversations
where
we
give
each
other
feedback,
whether
it's
about
an
idea
we've
had
or
the
fact.
We
think
that
someone
else's
idea
isn't
going
to
fly
or
its
behavior
we've
seen.
Nothing
beats
that
early
conversation,
so
our
focus
going
forward
for
next
year
is
on
equipping
all
colleagues
in
CQC
with
some
tips
and
techniques
to
make
that
easy.
U
When
we
cut
our
pulse
survey,
results
by
looking
at
equality
characteristics,
those
with
a
disability
and
those
from
the
BMI
community
have
less
confidence
in
speaking
up
significantly
so
so
we
absolutely
have
have
more
work
to
do,
but
I
feel
confident
going
forward,
confident
that
our
hearts
in
the
right
place
and
in
our
very
busy
agendas
just
following
through
on
some
of
the
practical
differences
that
we
can
make.
Thank
you
thanks.
A
F
You
Mary
I,
was
just
going
to
say:
I
was
fortunate
enough
to
be
a
judge
for
the
hsj
freedom
to
speak
up
organisation
of
the
year,
and
some
of
the
themes
that
were
coming
through
in
the
really
high
performing
organizations
in
this
are
absolutely
I.
Think
what
you're
working
towards
with
with
us
internally
and
those
were
about.
F
Actually,
how
do
we
look
at
people
with
diverse
backgrounds
and
how
do
we
make
sure
they
get
the
that
the
same
feel
comfortable
as
well
to
speak
up
and
I
wondered
if
we're
doing
any
work
with
our
networks
around
that
internally
and
I
think
the
second
theme
that
came
through
very
much
on
the
judging
day
was
about.
Actually,
how
do
we
make
sure
that
freedom
to
speak
up
is
not
seen
in
isolation,
but
very
much
as
part
of
the
overall
culture
within
the
organization
and
embedded
in
the
organizational
development
of.
F
U
Microphone,
sorry,
when
it
comes
to
networks,
we
haven't
actually
assessed
how
diverse
our
ambassador
group
are
and
which
so
we're
going
to
do
that.
We
think
the
more
that
we
can
reflect
reflect
that
in
that
group
that
increases
our
chances.
We
are
increasingly
working
together
with
the
networks
in
inless.
In
the
speak
up
reference
group.
We
do.
We
do
work
together
on
areas
of
priority
and
focus
it's
just
it's
that
bit
of
this.
That's
what
I
mean
when
I
say:
there's
no
lack
of
will
to
get
this
right
and
do
it
right.
U
Does
that
mean
in
terms
of
practical
action
and
I
think
it
is
about
it,
maybe
about
partly
training,
but
it
is
about
making
role,
models
and
content
and
just
continuing
with
the
with
the
communication
in
terms
of
are
we
making
it
part
of
our
wider
sort
of
work?
I
was
enormous
ly
delighted
to
be
invited
to
deliver
a
Speak
Up
slot
as
part
of
our
Qi
Gold
training,
with
the
recognition
that
a
positive
speaking
up
culture
is
essential
for
those
organizations
where
quality
improvement
has
flown
so
I
I
think
there's
there's
that
recognition.
U
It
gets
sticky
when
the
problems
occur
and
Henrietta
Hughes
in
one
of
her
recent
national
Guardian.
One
of
her
recent
reports
refers
to
organizations
unintentionally
creating
barriers,
and
one
of
those
barriers
is
a
sense
that
this
issue
isn't
a
speaker
issue
when
in
fact,
they're
all
speak
up
tissues
and
helpfully
in
our
recent
review
of
North
West
ambulance
has
listed
the
things
that
are
definitely
speak
up.
Issues
which
include
employee
experience,
bullying,
harassment,
diversity,
training
opportunities,
so
I
think
I.
U
V
You
highlight
issues
that
involved.
Whole
teams
have
been
particularly
challenging
to
resolve
and
I
just
wondered
I'm,
assuming
that
this
is
where
the
speaker
is
about
the
whole
team,
rather
than
the
whole
team.
Speaking
up
but
and
I
just
wanted
to
understand
how
prevalent
the
issues
are
about
a
whole
team
as
opposed
to
individuals.
U
I'm
not
sure
that
I
have
the
data
they
have
prevalence,
it
is
I
there
have
been
I,
wouldn't
need
two
hands
to
count
the
number
of
those
over
the
last
year
there
weren't
any
of
that
nature
the
year
before
I
think
what
it.
What
it's
presented
to
me
is
the
challenge
to
stay
the
right
side
of
the
line
as
guardian
and
the
ambassador's
in
that
week.
You
know
we
must
not
become
advocates.
I
Thank
you.
Thank
you
very
much
as
a
freedom
to
speak
up.
Ambassador
myself,
I
can
only
really
emphasize
and
say
thank
you
to
all
the
great
work
that
you're
doing
and
fellow
ambassadors
having
been
involved
in
a
couple
of
cases,
while
I've
seen
how
powerful
it
is
to
be
able
to
talk
to
a
colleague
about
how
they
can
speak
up
better
and
have
the
have
the
right
type
of
conversation.
The
the
question
I
want
to
ask
you.
I
Mary
is
whether
there's
more
that
we
can
do
as
an
executive
team
and
as
a
board
to
to
talk
about
and
showcase
where
people
have
been
able
to
speak
up,
how
they've
been
doing
that
and
the
results
that
it
has
had
at
them.
In
the
same
way
we
talked
about
this
when
people
come
to
us
and
raise
concerns,
we
say
we
want
to
talk
about
that
fathers
to
see
it,
encourage
that
to
do
that,
whether
we
can
do
that
more
with
our
own
teams
as
well.
I
Well,
that
is
by
inviting
some
of
the
ambassadors
and
their
experience
or
whether
whether
whether
even
some
people
would
be
willing
to
talk
about
their
personal
experience.
After
that,
I
think
doing
that
and
emphasizing
encouraging
others
to
come
forward
through
the
example
of
where
head
has
work.
Well,
it's
possibly
the
best
way
that
we
can
achievement.
U
We've
seen
from
our
hospital
inspections,
the
power
of
patient
stories
when
done
in
the
right
way
in
terms
of
setting
the
tone
for
discussion
and
some
trusts
I've
been
in,
have
had
staffs
stories
at
the
start
of
relevant
committees
and
so
on.
So
I
think
of
it,
where
it's
not
a
token
gesture
as
I'm
sure
it
wouldn't
be
here
and
where
people
feel
safe
to
do
it.
I
would
encourage
the
invitations.
D
Just
wanted
to
say
personal,
thank
you
to
Mary
so
as
we
start
to
think
about
transitioning
the
Guardian
role
on
and
we're
having
a
conversation
at
the
moment
about
how
we
ensure
the
sustainability
and
visibility
of
this
role.
I
just
wanted
to
say
a
personal
thank
you
for
their
kind
of
championing
you've
done,
as
well
as
the
individuals
support
you've
given
to
people
through
and
the
speaker
route
and
the
kind
of
ongoing
active
challenge
you
provide
to
us
as
an
exec
team
and
the
board
which
I
think
we
welcome.
So
thank
you
very
much.
Mary.
A
E
I'll,
certainly,
second,
that's
Mary,
and
thank
you
for
this
report,
which
is
full
of
really
rich
themes
in
it
that
that
I
think
we
need
to
learn
from
so
can
I
just
touch
on
a
couple
of
those
one
is
excuse
me,
you
were
talking
about
the
difference
between
people's
awareness
of
how
to
speak
up
and
their
confidence.
Does
it
lead
anywhere
and
I
mean
that
is
a
striking
difference?
E
Isn't
it-
and
you
said
you-
you
I,
think
you're
implying
that
that's
fairly
typical
of
what
what
organizations
find
I
suppose
closing
that
cap
is
is
absolutely
key
to
this.
Isn't
it
it's
given
people
that
means
to
speak
up,
but
also
the
confidence
to
speak
up
I.
Suppose
the
question
is:
what
do
we
know
from
other
organizations
that
have
been
able
to
close
that
gap
and
there's
anyone
ever
effectively
throws
that
gap
with
it?
E
They
must
be
learning
there
as
well,
and
my
second
point
is
your
teams
are
around,
and
this
comes
to
what
you
were
just
talking
about,
I
think
around
things,
personal
relationships
with
the
manager
with
with
the
immediate
team
sometimes
described
as
willing,
but
clearly
difficult
and
I.
Suppose,
what's
the
lesson
there
about,
how
do
we
get
teams
to
actually
look
after
their
relationships
better
so
that
they
don't
get
into
a
position
where
someone
feels
they
have
to
speak
up?
They
have
no
other
way
of
doing.
U
Big
questions
Ted,
thank
you.
So,
in
terms
of
closing
the
gap,
I
think
where
we've
seen
it
happen
really
well
in
the
organizations
that
we
inspect
is
the
theme
for
those
organizations
that
have
really
improved
is
really
the
same.
Isn't
it
it's
the
well-led
domain,
it's
leadership
at
all
levels.
It's
confidence
of
of
managers
and
colleagues
that
certain
behavior
is
is
welcomed
and
celebrated
and
others
others
are
not
I.
U
So
I
think
some
teams
have
challenged
that
by
putting
in
not
even
an
hour
or
two
a
month
where
a
senior
leader
is
available
and
anyone
can
dial
in
to
speak
to
them
or
come
and
see
them
on
so
on.
I.
Think
simple
steps
like
that,
and
then
there
some
cracking
stories
we
knew
if
we
could
have
a
story
where
someone
would
feel
that
they'd
really
seen
the
end
end
of
their
story
come
out
really
well
and
we've
got
some
potential
for
that,
because
we've
had
some.
U
Some
outcomes
have
been
to
ask
for
particular
policies
to
be
reviewed
where
that
policy
is
reviewed
and
someone's
very
happy
that
you
know
the
original
spoke
speaker
upper
is
happy
about
that.
We
could
really
promote
that
because
I
think
it
will.
People
will
gain
confidence
through
that
in
terms
of
interpersonal
relationships.
I
think
the
Academy
has
some
great
offers
for
teams
and
I
would
encourage
people
to
consider
their
needs
insight
into
each
other's
behaviors
understanding.
How
someone
you
know
the
difference.
Difference
is
under
stress,
particularly
in
the
context
of
so
many
people
being
home
workers.
U
Home
working
relationships
have
to
be
really
good
working
relationships
plus
because
you
have
to
take
extra
steps
to
create
the
same
sort
of
environment
and
support
that
you
would
get
if
you
saw
your
colleagues
every
day,
so
I
think
I
think
it's
doable,
but
it's
concentrating
on
it
and
valuing
it
and
I
think
our
well-being
strategy
is
another
great
support
for
that.
The
importance
of
connectedness
will
make
a
difference
to
well-being
and
that
will
make
a
difference
to
performance
and
our
impact.
It's
just
a
win-win-win.
U
C
L
C
We
progress
with
the
transformation
program
and
the
pressures
that
there
are
alongside
that
in
the
pace.
It
will
be
easy
to
villainize
people
who
object
or
raise
issues
or
whatever,
when
in
fact
the
converse
is
true.
Out
of
that
challenge
comes
a
strengthening
of
the
decision-making
and
a
gathering,
a
pace
and
I
think
it
would
be
important
that
that's
perceived
in
the
context
in
which
you
have
placed
it
go
on
your
air
Robert.
A
R
First
I
just
want
to
say
thank
you
for
what
you
are
doing
and
my
and
the
report
and
everything
else,
it's
absolutely
what
I
would
have
envisaged
when
I
first
read
a
report
on
freedom
speak
up
two
questions.
What
one
is
in
relation
to
the
importance
of
civility,
which
is
the
way
in
which
we
behave
to
each
other
in
normal
life
and
with
all
the
stresses
and
strains
to
go
without
realizing.
R
We
need
a
bit
of
resilience
with
each
other,
but
it's
about
the
learning
how
to
listen
to
people
that
I
think
sometimes
is
what
starts
to
go
wrong
and
it's
the
can
be
the
are
in
such
as
the
bit
of
irritation.
There
is
when
I
got
something
better
to
do,
and
someone
comes
up
with
a
complicated
problem
and,
as
a
leader,
I
suspect
you
have
to
look.
You
have
to
learn
very
quickly
that
you
can't
even
do
that,
because
any
signs
can
be
destructive
and
I.
R
Just
wonder
whether
we
have
enough
support
in
the
system
to
remind
people
of
that
and
how
one
does
that,
and
the
second
thing
is
actually
slightly
more
personal
about
you
and
your
fellow
ambassadors,
whether
you
feel,
collectively
or
individually.
You
have
enough
support
in
doing
what
can
sometimes
be
an
extraordinarily
difficult
job.
U
Thank
you
on
the
civility
point.
I
think
this
is
our
ambition
to
provide
some
further
tools
to
all
colleagues
and
particularly
managers
at
the
discourse
around
disagreement.
There
there's
an
outbreak
of
discussion
around
this
there's
a
recent
book.
You
know
rebel
thinking
which
should
be
on
everyone's
Christmas
list.
U
I
think
valuing
difference
in
views
is
really
important,
but
doing
it
well.
We
have
a
phrase
that
Ian
is
used,
disagreeing
well,
I
think
that's
a
skip.
That's
a
life
skill
and
I.
Think
if
we
all
did
that
a
bit
better,
all
sorts
of
areas
of
life
and
performance
of
work
would
be
increased,
but
it
is
easy
to
say
and
how
to
do
consistently,
and
this
is
why
I
think
the
teams
working
together
to
understand
what
makes
each
other
tick
understand
the
stresses.
But
individuals
is
a
really
important
key
to
that.
U
We
need
to
understand,
what's
normal,
for
people
and
understanding
that
when
someone
is
particularly
quiet,
that
might
be
a
sign
of
stress
in
one
person
where
it's
merely
a
sign
of
a
good
concentration
in
another.
So
it
is
really
that
that's
simple
and
that
difficult
to
address
some
of
that
in
terms
of
support
there
have
been
times
over
the
last
year.
It's
felt
quite
lonely.
U
The
Ambassadors
are
are
a
great
support
network
in
themselves,
but
I
think
in
our
discussions
with
HR
around
the
future
and
coincidentally
NHS
I
Andy,
who
came
up
with
the
original
guidance
on
the
policy,
are
reviewing
that
over
the
coming
year.
So
it's
likely
we'll
be
updating
our
policy
in
line
with
national
guidance.
I
think
support
for
those
doing
this
is
important
because
it
can
you
know
one
takes
on.
U
A
Great,
so
I
was
going
to
thank
you
for
the
report,
but
more
particularly
for
the
work
you
have
done
over
the
last
period
and
actually
really
establishing
speak
up
and
see
you
see,
Mary
done
a
fabulous
job.
Kate
sucks
slightly
preempted.
My
saying
that,
but
I
was
worth
saying
several
times.
Thank
you
very
much
for.
L
A
You've
done
I
feel
well
on
the
journey
now
and
that's
that's
where
we
needed
to
be
so.
Thank
you
very
much
indeed,
and
good
luck
in
your
fantastic
new
role
with
us,
I,
hasten
to
add
good
good.
Thank
you
so
that
moves
us
on
to
the
the
people
survey
welcome
to
Jill
and
and
Karen
Kirsty.
Do
you
want
to
say
anything
by
way
of
introduction,
just
very.
G
W
And
hello,
everyone
I've
met
most
of
you
last
time.
I
was
here
observing
so
delighted
to
be
here
this
morning
and
can
I
just
offer
by
were
at
the
beginning
my
appreciation
to
whoever
put
the
agenda
together
because
there's
a
seamless
pattern
here,
around
feedback
and
listening,
which
I
think
is
really
important
for
us
to
sort
of
just
hold
in
the
context
of
the
this
discussion
this
morning
and
into
the
afternoon
so
I
think.
As
Kirsty
said,
this
is
an
opportunity.
W
It's
the
first
one,
because
we've
not
done
a
pulse
survey
before
so
first
opportunity
to
bring
a
sort
of
a
pulse
survey
temperature
check
data
set
to
to
the
board.
So
that
feels
quite
important
to
us
and
pulse
and
people.
Surveys
are
I,
think
it's
important
to
say
a
way
in
which
the
organization
has
an
opportunity
to
listen
and
therefore
respond
to
our
employees.
Voice
and
we've
heard
a
little
bit
of
that
from
Mary,
and
it
continues
to
be
a
conversation
that
I'm
starting
to
have
with
our
trade
union
side,
but
also
with
our
networks.
W
So
but
back
to
why
we're
here
this
morning
and
I
will
try
to
sort
of
not
not
rehearse
too
much
the
data,
because
you've
had
an
opportunity
to
look
at
that
already.
I
think
what
we
have
in
terms
of
the
the
data
that
we
got
and
bearing
in
mind
that
this
this
temperature
check
pulse
survey,
was
really
about
testing
a
couple
of
key
areas.
W
So
that
was
testing
how
communications
are
working
and
landing
in
the
organization
and
also
how
we
are
leading
change
and
given
the
amount
of
change
that
we
have
going
on
and
will
continue
to
go
on.
They
feel
like
pretty
important
issues
for
us
just
to
do
a
little
bit
of
a
temperature
check
into
so
you
have
a
summary
of
the
headlines
from
the
data
and
the
data
packet
organizational
level.
You
already
I
think
it's
fair
to
say
it's
the
mixed
picture
and
it
wouldn't.
W
It
would
be
disingenuous
of
me
not
to
do
that,
but
we
have
got
some
very
positive
headlines
in
there.
So
77%
of
those
who
responded
feel
positive,
that
they
understand
why
the
organization
is
changing.
That
is
a
massively
positive
score
and
we
shouldn't
underestimate
that
other
organizations
going
through
change
in
just
business
as
usual
change
would
give
their
right
arm
for
that
level
of
understanding.
W
So
I
think
we
should
really
Bank
that
and
reflect
well
on
that
in
terms
of
what
we
are
doing
as
an
organization
how
our
communications
is
helping
people
understand
what's
happening
now
and
in
the
future,
there's
also
some
really
positive
stuff
about
sort
of
their
IT
improvements,
the
technology
that
we're
bringing
in
and
and
how
that
is
really
helping
people
to
do
their
jobs
well
and
better.
So
they're
really
really
positive
things
that
I
think
this
survey
tells
us,
and
there
are
some
further
points
for
focus,
I.
Think
it's
disappointing.
W
If
I'm
honest
II
use
that
kind
of
language
that
we've
only
got
34
percent
of
respondents,
you
feel
able
to
contribute
their
ideas
to
changes
that
are
impacting
on
them.
That
tells
me
we've
got
some
way
to
go
in
terms
of
being
able
to
properly,
listen
and
and
provide
opportunities
for
people
to
contribute,
and
that's
not
just
through
speaking
up,
but
that
is
actually
through
an
engagement
and
a
connection
with
what
is
happening
locally
and
organizationally
and
I.
Do
wonder
whether
actually
the
sort
of
the
work
that
we're
just
starting
around
Qi?
W
W
Are
we
properly
saying
thank
you
to
people
for
the
small
things
that
happen
on
a
day
to
day
basis,
so
the
the
micro
behaviors
around
just
saying:
do
you
know
what
that
was
a
really
really
good
job
and
how
we
make
that
an
important
part
of
the
organization
and
the
culture
and
their
ways
of
working
strikes
me
as
an
opportunity
to
really
sort
of
look
at
what
sits
behind
some
of
this
data?
The
question
on
an
ET
providing
clear
direction
and
leadership
and
there's
clearly
more
to
do
there.
W
We
have
an
executive
team
which
is
only
just
newly
completed
so
I
think
this
is
a
work
in
progress.
There
was
a
discussion
on
the
back
of
this
of
these
emerging
responses
and
already
we've
seen
a
real
commitment
and
shift
in
the
behaviors
of
those
around
the
ET
table
to
really
recognize
that.
Take
that
to
heart
and
do
something
very
practical
about
that.
W
So
there
is
a
sort
of
that
I
think
there
is
a
movement
and
we
will
continue
to
see
I
hope
sort
of
further
progression
on
that
and
what
sits
behind
that
data
in
terms
of
the
the
opportunity
that
we
have
to
shift,
that
is,
there
are
large
groups
of
neutral
schools
there.
So
we
haven't
got
a
polarized
position.
W
We
have
a
some
people
are
positive,
some
people
still
yet
to
be
convinced
and
I
think
we
have
an
opportunity
to
convince
those
who
are
sitting
on
the
neutral
fence
at
the
moment
and
and
then
I
think,
there's
finally,
sort
of
the
and
continuing
on
the
theme
that
sort
of
that
mary
has
raised
around
speaking
up.
There
is
still
more
for
us
to
do
to
properly
listen
as
an
organisation
to
the
issue,
so
so
giving
people
to
Ted's
point
about
how
do
you
close
the
gap
and
I
think
I
think
there
are
some
issues
around.
W
And
it's
difficult
for
us
always
to
make
a
big
and
a
big
positive
noise
about
some
of
the
things
where
people
have
raised
issues
and
have
sought
and
got
resolution,
because
they
are
of
a
personal
nature,
and
we
need
to
make
sure
that
we
are
continuing
to
protect
that
confidentiality,
whilst
actually
being
able
to
really
focus
on
closing
that
gap
and
I
would
just
say,
I.
Think
Rosie's.
The
question
was
really
well
placed
around
the
broader
organizational
development.
W
Q
Thank
you
very
much,
really
a
helpful
presentation.
It
struck
me
that,
on
these
cultural
issues
and
I
very
much
support
what
you
said
about
that
this
needs
to
be
all
day
every
day.
It
seemed
to
me
that
there
were
two
potential
issues
coming
out.
One
is
a
sort
of
behavioral
one
that
almost
like
you
know.
Every
manager,
for
example,
needs
to
really
think
about
the
way
that
their
behavior
makes
it
easier
or
less
easy
for
people
to
speak
up.
Q
Do
people
feel
that
bullying
is
properly
tackled?
Those
sorts
of
issues?
So
there's
something
about
really
integrating
this
into
all
the
the
leadership
programs.
The
training
then,
but
the
day
to
day
line
management,
support
of
every
manager,
but
then
there's
also
the
more
systemic
points
about
when
people
are
raising
issue.
Does
the
organization
or
the
the
the
director
at
all
the
team
respond
by
changing.
Q
And
I
mean
we
heard
earlier
that
there
was
some
differences
in
experience,
but
between,
for
example,
black
Ammannati,
black
BMI
colleagues
and
others
between
disabled
and
non-disabled
colleagues,
and
in
terms
of
that
latter
point
of
are
things
being
done.
I
mean
actually,
we've
talked
offline
about
the
importance
of
making
sure
that
the
things
like
the
follow-up
to
the
Roger
Klein
report
that
was
done
is
get
properly
built
into
our
key
performance
indicators
and
that
we
we
are
tracking
what
is
happening
in
response
to
some
of
these
key
issues.
Q
Around
equality
and
inclusion
and
I
know
you're
on
the
case.
I
am
about
thinking
about
what
is
an
inclusive
organization
and
how
we're
going
to
track
that
over
time,
but
I
think
that's
really
important,
because
some
of
this
is
about
these
rather
different
experiences
of
different
colleagues,
and
we
need
to
understand
that
depth
and
that
diversity
of
experience
and
and
be
really
clear
what
we're
doing
about
it.
So
we
can
say
to
people.
We've
got
this
far
and
next
we're
going
to
do
you
know
the
next
suite
of
activities
or
whatever.
So
thank
you
so.
A
B
It's
not
so
much
a
question
just
just
some
observations
really
just
just
to
come
in
on
the
back
of
Jill's
remarks,
I
mean
for
me,
I
think
there
was
some.
There
was
some
real
challenges
for
us
as
an
exec
team
and
as
a
senior
leadership
group
I
think
some
of
the
things
we
have
been
doing
for
quite
some
time
were
necessarily
reflected
in
some
of
the
answers.
B
Some
really
did
something:
there's
a
good
news
story
here
around
our
ability
to
to
make
the
case
for
change,
and
the
piece
that's
missing
is
that
is
that
return
and
and
and
that
dialogue
that
I
think
is
was
which
certainly
came
out
for
me
and
I
think
we
need
to
have
that
kind
of
two-way
process.
I
think
we've
done
a
lot
of
work
on
on
new
technology,
digital
foundations
and
the
QI
program
itself
and
I.
B
Think
that
that
gives
me
cause
for
grounds
for
optimism
in
terms
of
the
things
are
now
in
place
for
us
to
start
to
see
action
on,
so
it's
not
as
if
we're
starting
from
scratch
making
plans.
Now
these
are
things
which
are
now
in
place
and
I
think
over
the
coming
year
in
particular,
we
will
start
to
see
the
impact
of
those
things.
B
I
do
think
it
was
quite
a
lot
in
the
survey
for
me
also
about
the
relationship
between
an
individual
and
their
immediate
line
manager
and
that
sort
of
those
moments
of
truth,
conversations
which,
which
are
probably
amplified
in
importance
if
that
is
taking
place
on
the
end
of
a
video
call
or
remotely
as
opposed
to
face-to-face
and
it's
at
they
are
relatively
infrequent
interactions.
So
I
think
we
need
to
reflect
on
on
how
we
make
our
employees
a
bit
more
resilient,
because
I'm
not
sure
we
necessarily
test
for
that
resilience.
B
When
we
recruit
people
to
work
at
home,
which
means
at
times
they
can,
they
can
find
that
that
the
act
of
being
at
home
on
their
own
a
lot
actually
quite
challenging.
Some
people
are
quite
ok
without,
but
some
people
actually
just
could
do
with
some.
Some
tactics
and
tips
is
to
have
to
make
that
a
more
effective
experience
for
them
in
the
workplace.
I
think
there
was
some.
B
There
was
some
pragmatic
issues
around
pay
issues
around
workforce,
which
I
think
I
think
remain
challenges
and
one
of
the
things
it's
on
on
Jill's
list
is
is.
It
is
looking
at
a
pace
strategy
because
I
think
there
are
still
some
challenges
in
our
pay
scheme
and
of
course,
a
lot
of
things
were
doing
around
around
the
change
program
are
directly
addressing
this
notion
of
productivity,
of
taking
track,
trying
to
reduce
the
workload
of
individuals,
but
again
for
some
people.
They've
started
have
an
impact
for
some
people.
B
They
probably
haven't
yet
or
haven't
yet
enough
of
an
extent
so
and
there's
lot
lots
of
stuff
in
progress.
I
think
the
only
thing
that
Jill
didn't
necessarily
talk,
talk
too
much
about
was
I
think
there
was
also
some
variation.
So
one
of
the
things
one
of
the
conversations
we've
had
an
exec
team
is,
is
what
does
this
mean
for
us
and
locally,
because
actually
there
are
local.
B
E
Ted
yeah!
Yes,
if
I
can
make
a
couple
of
observations-
and
this
is
very
interesting
and
I-
do
hope-
you
gonna
repeat
the
pulse
of
it
on
a
regular
basis,
because
a
one-off
really
doesn't
help
us
an
annual
surveys.
I,
don't
think
work
because
it's
too
long
between
it
so
I
think
regular
pulse
survey.
So
we
can
get
a
sense
about
what
people
are
really
feeling
on
a
month-by-month
basis
or
whatever
I
think.
E
Think
we've
got
a
much
clearer
message
now:
we've
got
to
be
consistent
about
communicating
that
so
so
people
understand
and
I
think
that's
a
challenge
to
us
all
to
be
consistent,
I
suppose
within
my
director.
What
what
I
get
from
the
the
people
in
the
Directorate
is
a
real
sense
that
their
workload
is
still
very
heavy
and
that's
reflected
in
the
very
busy
inspection
program,
and
we've
been
acknowledged
in
that
for
a
long
time.
E
I'm,
not
sure
we
have
really
provided
the
solutions
to
it,
and
some
of
those
solutions
are
actually
how
we
organize
the
work.
Some
of
the
solutions
are.
The
process
is
to
make
it
more,
and
some
of
us
are
technological
and
I
think
we
need
to
stop
delivering
some
of
those
benefits.
So
people
can
see
and
I
think
this
may
relate
back
to
the
the
freedom
speak
up
issue.
I
suspect.
E
A
lot
of
them
would
feel
that
you
know
if
they,
if
they
rose,
raised
questions
about
the
workplace,
what
they
probably
done
that
over
over
the
last
two
or
three
years,
and
really
they
haven't,
seen
this
able
to
turn
that
round
and
I'm
very
conscious.
The
fact
that
we
haven't
delivered
on
that
to
the
extent
I
would
like
Nike
still
do
and
I
think
that's
going
to
be
a
challenge
going
forward,
because
you
know
people
want
change,
that's
gonna
make
a
difference
in
the
future,
not
just
change.
C
You
Peter
I
just
wanted
to
gently
challenge:
Ted
I'm,
not
sure
and
I'm
talking
about
strategic
communications,
but
I'm,
not
sure
that
it's
the
message
that
hasn't
been
heard,
the
77%
suggest
the
message
has
been
heard
and
understood
and
I
think
shouting
louder
and
more
often
isn't
it,
and
the
answer
may
be
in
the
bottom
statistic
where
it
says
that
41%
disagree,
they're
able
to
contribute
views
to
decisions
that
affect
them
with
only
34%,
responding
positively
and
Mary's.
Sorry,
she
was
quite
right.
C
A
G
W
W
You
we've
already
spoken
a
lot
about
the
data
and
the
mi
stuff
and
in
in
relation
to
inclusion,
but
I
think
it
plays
to
the
whole
of
the
health
of
the
organization,
but
but
I
think
this
is
everything
that
has
been
mentioned
is
part
of
my
will
pop
up
and
when
you
will
recognise
as
part
of
the
people
plan
that
I'm
pulling
together.
There
is
something
around
the
theme
about
some
of
our
line
managers
and
that's
not
just
about
behaviors.
It's
actually
are
we
clear
and
upfront
about
the
expectations
that
we
have
of
ly
managers.
W
Do
we
give
them
enough
time
in
terms
of
their
jobs
and
how
it's
designed
so
they
have
capacity
as
well
as
capability
and
the
tools,
but
a
clear
expectation
of
what
we
absolutely
need
them
to
do
and
what
we
need
them
to
do,
which
is
amplified
because
of
the
nature
of
the
were
dispersed
workforce.
So
that
feels
really
important
to
me
and
I.
Think
on
the
point
about
inclusion.
W
In
other
places
between
the
questions
around
people
feeling
valued
for
the
work
they
do.
The
question
relating
to
I
have
an
acceptable
workload
and
the
question
relating
to
pay
and
benefits,
and
so
when
the
first
two
are
out
of
kilter
that
pops
up
as
a
pay
issue
and
and
therefore
I
think
the
the
the
trailing
of
the
piece
of
work
that
I've
started
around
pay
is
actually
wider
than
pay
it's
about
reward
and
recognition.
W
So
we
need
to
think
properly
about
how
we
reward
people
in
this
organization
and
how
we
and
we,
how
we
recognize
their
contribution
and
achievement
and
I
think
that
will
help
us
to
pick
up
a
number
of
themes
that
have
been
sort
of
just
sit
beneath
some
of
this
data
and
I.
Final
final
point
from
me
is
the
I
think
the
important
the
really
important
thing
around
sort
of
data
like
this
is
that
we
it
is
data.
It
provides
us
with
insight
which
allows
us
to
target
our
actions
jill.
A
R
So
I'll
steal
some
of
her
thunder.
You
obviously
have
the
report
and
I
was
going
to
make
two
points
before
handing
over
to
am
elder
and
perhaps
she'll
be
here
by
the
time
I've
made
them
and
I
with
the
synagogue
and
a
highlight
was
the
health
walked
conference
of
the
reports.
Library,
we
have
an
annual
conference,
which
is
the
highlight
of
the
health
walk
here,
of
course,
but
the
extraordinary
thing
about
it
was
it's
the
first
time
I
think
the
home
of
the
of
the
conference
of
the
152
local
healthwatches.
R
It
was
attended
by
over
130
of
them,
and
the
impact
of
that
is
that
you
have
in
one
room
this
case
in
Birmingham,
a
representative
of
virtually
every
local
authority
community
in
the
country
all
come
with
views
about
how
their
local
health
and
social
care
system
could
be
better,
and
this
isn't
a
political
movement.
This
is
a
movement
of
people
who
are
really
genuinely
interested
and
involved
in
making
their
communities
health
better.
R
So
it's
an
extraordinary
powerful
tool
and
is
increasingly
recognized
deception
that
and
one
of
the
big
things
that
the
conference
was
that
we
launched
a
report
on
patient
transport,
which
was
through
some
useful
management,
immediately
accepted
by
Simon
Stevens
at
a
conference,
with
an
undertaking
to
review
the
way
in
which
Penta
patient
transport
is
supplied
in
the
NHS.
And
it's
these
sort
of
common
and
generic
issues,
which
tend
to
get
forgotten
in
the
cracks
of
planning
for
integration
and
so
on,
are
what
I
think
HealthWatch
is
extremely
good
at
bringing
to
lives
and
getting
back.
R
R
Certainly
in
the
last
few
years,
and
eventually
they
will
go
back,
I,
think
to
2010
and,
and
you
can
service
them
say
if
you
want
to
find
out
what
local
HealthWatch
may
have
done
on
any
particular
subject,
whether
it
be
obesity,
diabetes
or
something
you
can
just
find
it,
and
quite
often
people
come
to
us
and
say
what
does
health.
What
to
say
about
says
this
will
actually
mean
they
can
actually
write
about
themselves,
which
will
be
helpful.
R
But
there
is
a
it's
a
the
beginning
of
a
pro
hope
ensuring
that
we
have
more
impact
even
more
impact
than
we
have
at
the
moment.
But
I
just
saw
that
just
to
mention
those
two
things
about
what
is
in
effect,
our
national
coverage
in
a
way
which
I
think
makes
patient
public
involvement.
A
very
real
thing
and
I
think
that's
increasingly
recognized,
but
in
other
words
now
here
so
I
can
hand
over
to.
Q
Q
On
our
side,
the
we
had
over
30,000
people
respond
to
the
survey
over
500
events
took
place
over
a
thousand
other
events
were
attended
right
across
the
country,
and
we've
gathered
real
depth
of
information
and
the
44
reports
that
match
each
of
the
SDP
areas
are
now
published
on
our
websites.
We
are
working
with
NHS
England
now
to
see
what
what
comes
out
of
the
reports
that
are
published
from
the
provider
side
from
the
STP
side
and
to
see
the
level
of
take-up
that
we've
had
of
our
recommendations
into
that
planning
process.
Q
There
is
an
incredibly
good
piece
of
work
that
the
whole
network
engaged
in
and
I
think
they're.
Very.
They
were
very
proud
of
that
conference.
The
main
issues
that
are
emerging
from
the
from
all
that
work,
we're
still
analyzing
a
lot
of
the
data.
Not
surprisingly,
there's
issues
around
access
to
primary
care.
The
public
are
very
concerned
about
that
transport.
That
Roberts
already
mentioned
the
public
by
and
large,
are
more
ready
to
embrace
technology
in
a
way
that
I
think
that
we're
more
reticent
to
think
that
they
will
some
basic
stuff.
Q
That
won't
surprise
anybody
here,
but
about
communication,
keeping
communications
simple,
straightforward,
understandable.
That
would
go
a
long
way
to
help
people
manage
their
own
conditions,
prevention,
hi
and
also
issues
around
mental
health.
None
of
that
would
surprise
anybody
here,
but
across
that
scale
of
the
population,
I
think
it's.
It's
really
interesting.
So
we're
taking
all
that
forward.
Just
a
note
here
about
where
we've
been
engaging
in
the
clinical
standards
review.
Q
Q
It
was
supposed
to
be
live
links
in
your
report,
so
sorry
scroll
through
trillion
pages,
but
we
recently
published
our
first
report
on
mental
health
in
this
series
and
that's
particularly
around
maternal
mental
health
and
Liz,
led
on
this
piece
of
work
for
us
and
it's
been
well
received
and
we're
now
moving
on
to
our
work
on
children
and
young
people
and
mental
health,
patient
transport.
You
know
we're
going
to
be.
That
was
a
very
nice
quick
turnaround.
Q
We've
been
saying
this
is
important,
but
actually
when
we
got
the
evidence
backs
from
the
NHS
long-term
plan,
work
NHS
England
also
said
you're
quite
right,
then
this
should
be
one
of
our
priorities
too,
and
the
last
part
of
my
report
here
just
highlights
view
the
work
that
we're
doing
all
the
time
to
improve
and
support
the
network.
So
we
have
a
quality
framework
in
place.
We
have
a
making
a
difference
toolkit
in
place
we're
giving
a
lot
of
campaign
and
communication
support
to
them,
and
this
conference
was
my
third
conference
and
I
thought.
Q
The
atmosphere
was
really
great
that
that
feeling
of
them,
you
know,
belonging
to
one
organization
rather
than
there
being
153
in
the
room,
so
it
felt
it
felt
very
good.
So
you
have
attached
our
maternal
mental
health
report
our
last
quarter.
What
does
our?
What
does
our
insight
tell
us?
What
are
the
public
telling.
L
Q
W
A
J
Or
comments
Chris,
just
to
reiterate
something
I
said
early
on.
Will
you
out
the
room?
Well,
you're
the
conversation
that
we
had
with
your
team
around
the
messages
around
site
of
care
and
the
library
that
you
develop
with
incur
excellent
resources
and
they
are
they'll,
be
very
important
to
us
in
terms
of
how
we
share
and
were
kind
of
independent
voice.
So
the
information
we've
talked
about
how
we,
how
we
can
make
sure
our
intelligence
teams
are
absolutely
aligned
when
we
come
to
using
under
some
information
how
it
works
as
a
two-way
process.
S
German
I'm
Aldo
just
a
couple
of
observations.
If
I
may
about
your
two
very,
very
good
reports,
the
mental
health
and
journey
to
Parenthood
and
I
thought
it's
really
interesting.
When
talking
about
the
journey
mummies
were
asked.
What
would
you
have
done
differently
and
the
answer
came
back,
I
would
have
sought
advice
earlier
and
this
linked
into
fear
and
stigma
and
I.
Just
wonder
whether
I
mean
I
just
thought.
S
That's
a
really
interesting
finding
and
I
just
wonder
whether
we
then
communicate
with
nursing,
midwifery
and
medical
training
organizations
that
you
know
fear
and
stigma
has
not
gone
away,
and
you
know
how
they
manage
that
and
also
whether
there
isn't
an
opportunity
for
us
to
put
it
into
our
well-led
framework.
How
fear
and
stigma
is
being
managed
going
forward.
Q
We
will
take
forward
the
issue
around
communication
stigma.
That's
one
of
our
sort
of
priorities,
messaging
from
the
report
and
I
think
the
transport
one
is
really
interesting,
because,
when
I
raised
it
as
the
early
finding
at
a
meeting
of
NHS
England
and
out
of
all
the
work
that
we've
done
around
the
country,
the
response
was:
this
is
not
P
individuals.
This
was
the
room
sort
of
what
transports.
Always
a
problem
and
I
had
to
say
I
know
it's
always
a
problem
and
those
whatever.
Q
E
Well,
can
I
congratulate
you
on
the
transport
document.
It
you
are
entirely
right
is
one
these
long-standing
issues
and
no
one
has
ever
really
addressed.
Property
and
I
have
to
say
I'm,
not
sure,
we've
addressed
it
as
well
as
we
could
have
done
in
our
reports
it,
but
actually
talking
to
patients.
It's
often
the
top
of
that
concerns
and-
and
it
has
a
huge
effect
on
the
quality
of
their
experience
of
care
if
they
have
to
travel
for
hours
and
hours
to
get
to
go
to
an
appointment
or
treatment
or
whatever
so
I
think.
E
V
V
The
point
I
was
going
to
make
is
John
may
be
able
to
I
thought.
This
was
the
best
session
we
had
with
Hwa
for
the
entire
time
that
I've
I've
been
in
the
chair
there.
It
showed
me
that
there
really
was
a
better
grasp
of
risk
within
Hwan
than
we've
seen
previously
one
of
the
issues
involved
and,
if
that's
a
particular
lens
at
looking
Hwa
at
the
moment,
its
improvement
I
was
just
you
know,
certainly
as
far
as
I
can
see,
there's
the
improvements
been
significant.
A
Why
don't
I
give
pay
tribute
to
the
chairman
of
hello
Linda
and
to
a
milder?
Thank
you
very
seriously.
I
I
thought
the
report
was
was
was
good,
the
idea,
the
energy,
the
initiative,
the
the
scope
of
the
work,
the
impact
of
the
work
it
all
came
through
and
so
to
both
of
you
and
to
the
team.
Thank
you
very
much
indeed
great
good.
So
Paul
you
dipped
into
your
you're
a
CGC
report,
but.
V
A
Does
anybody
want
to
ask
anything
perfect
moves
us
on
to
any
other
business?
Is
there
any
other
business
from
the
board
good?
So
that's
the
end
of
the
formal
board
meeting
that
does
leave
us
time
with
four
questions
from
the
public.
Robin
I
know
you've
sent
a
question
advance.
So
if
you'd
like
to
go
to
the
microphone
we'd
like
to
know
what
the
question
is.
X
Okay,
Thank
You,
chairman
Robin
Pike
Hartford,
your
HealthWatch,
a
patient
representative.
My
question
is
about
the
liaison
between
CQC
and
other
government
inspectorate's
such
as
Ofsted
and
the
Health
and
Safety
Executive.
I
seem
to
remember
that
in
the
early
days
of
CQC,
there
were
very
regular
meetings
with
Ofsted,
for
example,
and
as
other
government
inspectors
are
gathering
feedback
and
data
I,
wonder
to
what
extent
there
is
ongoing
liaison
and
discussion.
A
J
They
are
all
of
the
formal
joint
recommend
parents
of
both
the
constant
Ofsted,
HSE
and
other
organizations
are
on
the
website
and
there's
a
nominated
senior
lead
from
CQC
for
those
who
you
know
they're
all
there,
but
it's
anything
else,
anything
else
around
those
relationships
or
anything.
In
particular,
you
want
to
know
of
happy
to
have
a
conversation
with
you
after
this.