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From YouTube: CQC board meeting - July 2022
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A
Well,
good
afternoon,
everybody
and
welcome
to
the
board
meeting
of
the
care
quality
commission.
This
is
the
first
of
the
new
times
of
deputies
in
the
afternoon.
I
hope
it's
convenient
for
everybody.
A
I
just
wanted
to
make
sure
probably
useful
to
explain
where
everybody
is.
We
are
here
in
redmond
place
and
the
majority
of
the
board
is
here:
one
member
was
unable
to
get
here
because
of
problems
with
the
the
trains
yesterday
and
we've.
A
Also,
a
number
of
our
presenters
are
actually
dialing
in
online,
which
seemed
at
the
only
sensible
response
to
the
the
difficulties
of
travel
yesterday,
but
I
think
in
the
circumstances
we've
got
a
remarkably
good
turnout
here,
including
a
very
long
bus
ride
by
one
of
our
members
to
make
it
so
congratulations
to
them.
A
We're
also
joined
by
karen
hill,
who
you
may
see
on
the
screen.
Karen
is
our
equality
network
representative
from
the
disability
equality
network,
so
welcome
karen.
A
I
wanted
to
apologize
robert
francis
one
of
the
board
members
is
unable
to
join
us
today.
So
I
apologize
for
him,
but
also
chris
usher
and
chris
day
from
the
executive
team
who
often
join
us,
are
not
able
to
do
so
today
and
lastly,
in
terms
of
faces,
I
should
welcome
sean
who
shawn.
Thank
you.
I
can't
even
find
you
sean
of
course
joined
the
organization
a
little
while
ago,
but
this
is
his
first
public
board
meeting
since
he
joined
the
board
so
sean.
Thank
you
very
much
indeed,
for
joining
us.
A
Let's
move
on
to
the
formal
business
and
the
presentations.
Are
there
any
conflicts
of
interest
or
new
conflicts
of
interest?
To
note,
I
don't
see
anybody.
A
I
had
no
urgent
business
to
pick
up
at
one
point
I
would
flag,
which
is
not
urgent,
that
is
to
say
that
we
are
in
due
course,
as
is
public
and
we're
losing
a
couple
of
online
executives.
They
will
be
here
for
the
next
meeting,
so
this
isn't
urgent.
We
are
in
the
process
of
working
with
the
department-
and
I
have
mentioned
this
publicly
before
to
find
successes.
A
I
really
appreciate
at
the
moment,
but
that
that
can
be
a
challenge,
but
we'll
keep
you
updated
in
due
course.
As
things
progress,
I
think
on.
Having
said
that,
then,
let's
move
on
to
the
formal
business
of
the
meeting
and
the
first
item
is
the
equality
objectives
which
we
are
to
consider
and
approve.
Lucy
wilkinson
and
jill
nicholson
can't
head
over
to
you.
B
Thank
you
ian.
It's
lucy
wilkinson
here,
I'm
head
of
equality,
health
inequalities
and
human
rights,
and
just
a
few
introductory
remarks,
the
first
being
that
the
equality
objectives
were
published
in
july
2021.
Just
two
months
after
we
published
our
new
strategy
so
and
publish
following
board
approval,
so
they're
very
closely
aligned
to
our
strategy.
B
We
have
four
regulatory
equality
objectives
which
relate
closely
to
our
strategy
theme
about
reducing
inequalities
in
access,
experience
and
outcomes
for
people
using
health
and
social
care
services,
and
one
equality
objective
relating
to
equality,
diversity
and
inclusion
for
cqc
staff
and
I'm
joined
by
jill
nicholson,
who's
a
director
of
people
to
address
any
questions
relating
to
that
objective.
B
The
first
year
has
been
very
much
a
kind
of
a
foundational
year
where
we've
focused
on
ensuring
that
the
equality
objectives
are
reflected
in
cqc's
priorities
in
in
various
and
important
pieces
of
work
like
our
data
strategy,
our
independent
voice
strategy,
our
research
priorities
and
so
on,
and
also
the
opportunities
that
we've
had
in
embedding
tackling
inequalities
in
our
in
our
new
regulatory
model
for
both
providers
and
local
systems.
B
We've
also
been
doing
quite
a
lot
of
work
engaging
internally,
including
with
leaders
and
with
with
other
staff
and
externally,
including
looking
at
opportunities
for
for
cross
arms
length
body
working
on
on
advancing
equality
through
the
topics
in
our
equality
objectives,
and
then
finally,
we've
been
trying
to
accelerate
some
specific
pieces
of
work
which
are
covered
in
the
paper,
and
I
won't
go
into
in
detail
a
couple
of
minor
amendments
to
making
that
we
were
working
on
the
we
were
working
on
the
appendix
right
up
to
the
last
minute,
and
I
did
notice
that
we
haven't
quite
got
the
overall,
the
overall
distributions
right
in
the
main
paper
about
and
the
deliverables
and
the
success
measures.
B
So
I
need
to
correct
those
for
the
record
so
on
the
deliverables.
22
are
on
green,
six
are
on
amber,
none
are
on
red
and
six
have
not
started
yet
and
they're
just
deliverables
for
this.
This
financial
year,
though,
the
equality
objectives
do
cover
a
four-year
period.
The
success
measures
are
more
long-term.
B
There
are
some
challenges
in
measuring
them,
yet
particularly
the
ones
where
we
need
to
build
up
our
capacity
to
disaggregate
data
that
we
gather,
for
example,
in
surveys
and
so
on
by
equality,
characteristics
and
the
distribution
of
them
is
that
12
out
of
29
are
not
yet
measurable,
because
they're
too
early
to
be
able
to
do
that
and
then
and
then
nine
are
green.
Seven
are
amber
and
and
two
are
red-
it's
it's
quite
challenging
to
to
design
success
measures
for
equality
objectives.
B
I
know
that
that's
been
an
issue
raised
by
both
the
board
and
the
executive
team
before
we're
working
on
that,
particularly
linking
with
the
strategy
assurance
work.
It's
maybe
easier
to
do
the
success
measures
on
the
internal
cqt
workforce,
equality
objective,
because
we
have
like
a
whole
data
set
about
our
own
staff,
but
it's
harder
in
relation
to,
for
example,
people
who
use
services.
B
Just
a
final
point
is
that
the
board
reporting
doesn't
yet
align
really
with
how
we
plan
the
the
priorities,
because
the
we're
on
an
annual
work
planning
cycle,
along
with
the
rest
of
cqc,
because
it's
embedded
in
cqc
work,
which
is
kind
of
april
to
march,
but
because
we
publish
the
equality
objectives
in
july
you're.
Getting
kind
of
port
of
the
way
to
you
know
four
months
through
the
year
a
view
of
how
we're
doing
so.
B
A
So,
thank
you
very
much
ask
colleagues
of
questions
for
lucy.
C
Mark
thank
you
chairman
and
thank
you
lucy
for
a
very,
very
good
report.
They're,
really
excellent,
to
see
the
work
on
executive
engagement
in
this
area,
the
oversight
and
rigor
of
the
oversight
of
our
progress
and
some
changes
in
our
processes
as
well
also
really
good
to
see
collaboration
with
other
albs
and
our
own
work
in
terms
of
the
independent
panel
members
and
the
appointment
of
our
diversity
and
inclusion
coordinators,
and
very
good
to
see
the
work
around
inclusive
leadership
pathway.
C
So
this
this
is
all
great.
As
you've
said,
there
still
needs
to
be
some
work
done
on
measures
and
obviously
still
some
work
to
be
done
in
terms
of
training
of
our
staff
in
measuring
data
and
how
we
influence
providers
through
our
well-led
framework
did
have
a
couple
of
questions.
Lucy.
If
I
could
one
why
the
second
iteration
of
the
reverse
mentoring
program
is
not
green,
it's
amber,
it
seems
to
me
we
we
could
be
ready
to
go
on
that
straight
away,
and
I
did
wonder
in
terms
of
selection
processes.
C
You've
demonstrated
there
that
we're
going
to
be
looking
to
make
sure
that
our
advertisements
and
our
processes
are
not
exclusive
are
inclusive,
but
I
just
wonder
whether
you've
you
as
a
team
have
looked
at
the
use
of
a
I
in
selection
and
whether
we
are
it.
You
know
if
we
are
using
ai
at
all
in
our
selection,
whether
we're
ensuring
there's
no
exclusivity
there
and
then
finally,.
B
B
C
Just
want
to
say
in
terms
of
the
shortlisting
bias
for
promotions
and
acting
arts,
we
have
asked
for
that
information
to
come
to
the
public
board
and
I'm
very
hopeful
that
that
comes
and
that's
something
that
gets
a
lot
of
visibility
at
the
board.
But
thank
you
very
much
indeed
for
the
report.
B
I'll
ask
jill
to
answer
those
because,
because
of
the
people
directorate
lead
on
the
detail
of
the
delivery
of
the
equality
objective,
five
so
I'll
pass
over
to
jill.
D
Thanks
mark
help
really
helpful
reflections
and
questions
so
I'll
take
them
in
the
order
in
which
you
made
them,
so
the
reverse
mentoring,
I
think
probably
it
was
amber
at
the
time
that
we
pulled
this
paper
together.
We
had
a
people
committee
meeting
shortly
after
that
we
concluded
and
finalized
this
paper,
which
confirmed
our
the
approval
to
go,
live
with
the
next
cohort
of
of
this
really
important
initiative.
D
As
you
know,
you
will
know
all
of
the
board
for
those
of
you
who
were
actively
involved
yourself
within
their
our
first
cohort
of
reverse
mentoring.
It
was
a
very
powerful
thing
and
for
all
concerned-
and
we
were-
we
took
some
good
time
to
make
a
proper
evaluation
of
the
activity
so
that
we
could
be
really
clear
that
we
were
building
on
strong
foundations
for
how
we
roll
this
out
further.
D
Obviously,
the
paper
indicates
that
we're
expanding
this
out
to
to
colleagues
with
a
disability,
as
well
as
those
from
an
ethnic
minority
background
or
black
black
or
asian
background.
So
we
are,
we
were
wanting
to.
We
wanted
to
make
sure
that
we
were
really
ready
to
to
roll
this
out.
D
Well,
we,
as
I
said,
agreed
this
at
the
people
committee
earlier
this
month
and
and
so
our
plans
will
be
in
place
to
roll
this
out
sort
of
in
the
autumn
time
and
so
that
we
can
actually
properly
manage
that
with
with
colleagues
across
the
organization.
D
So
that
was
that
one
on
the
selection
processes.
I
think
it's
a
really
good
reflection
and
I
can
take
that
away
to
the
team.
We
are
looking
at
a
whole
raft
of
activity
under
our
qi
project,
so
there's
there's
no
reason
why
we
cannot
build
in
ai
into
into
that
sort
of
in
terms
of
a
sort
of
a
scoping
and
a
a
a
and
a
review
point
so
happy
to
take
that
away,
and
then
the
shortlisting
bias
information.
D
A
Thanks
jill
mark
other
questions,.
E
B
B
This
relates
to
issues,
particularly
with
qualitative
data,
about
how
we
can
disaggregate
that
by
equality
characteristics
so,
for
example,
information
that
comes
into
us
from
give
feedback
on
care
from
from
members
of
the
public
and
people
who
use
services
where,
where
we
might
not
be
aware
of
their
their
equality
characteristics
or
the
way
that
things
are
phrased,
might
not
be
easy
to
work
out
whether
or
not
there's
a
there's
an
equality
dimension
to
the
to
the
issues
that
they're
raising
with
us.
B
So
there's
some
things
about
about
how
we
use
and
score
qualitative
data
there
are
other
issues
are
that
the
most
of
the
data
that
we
collect,
that
we
use
in
data
sets
around
around
quality
of
care.
So
that's
equality,
data
around
people,
patients
and
people
who
use
services.
We
don't
collect
directly
and
is
collected
by
other
bodies
such
as
nhsci,
nhs,
digital,
individual
trusts
and
unless
and
even
there's,
even
less
in
in
gps
and
in
adult
social
care
than
there
are
in
the
larger
services.
B
So
that
is
one
of
the
areas
that
came
out
very
strongly
in
terms
of
joint
work
with
arms
length
bodies
about
aligning
and
strengthening
data
collection
on
equality.
So
we
can
look
at
the
quality
of
care
for
different
different
groups
of
people,
obviously
that
the
primary
responsibility
for
that
is
on
the
care
provider.
So
the
other
thing
that
we're
doing
is
writing
into
our
single
assessment
framework
quality
statements
around
how
they
are
looking
at
and
the
quality
of
care
that
they
provide
in
terms
of
equity
in
access
experience
and
outcomes.
B
So
we're
not
expecting
to
do
all
the
data
analysis
across
the
whole
of
health
and
social
care
to
uncover
equality
issues.
But
we
do
come
across
difficulty
when
we're
trying
to
use
data
sets
by
others
that
are
not
yet
good
enough
on
equality.
E
Yeah,
I'm
just
wondering
if
we're
sort
of
leveling
up
this
sort
of
equality
of
everybody
sort
of
having
the
same
quality
of
care,
but
we're
not
collecting
the
data,
I'm
sort
of
like.
What's
the
mitigation,
I
wasn't
quite
clear
on.
Are
we
saying
that
it's
up
to
the
providers
to
improve
the
quality
of
data
they
collect,
or
are
we
sort
of
holding
them
to
account
to
improve
the
data
that
they're
collecting?
So
we
can
assess
that?
E
B
The
first
is
that
we're
working,
naturally
to
improve
improved
data
collection
and
you've
picked
a
very
good
example
there
jorah,
because
there
isn't
yet,
for
example,
in
the
the
nhs
accessible
information
standard
doesn't
yet
have
good
data
collection,
and
one
of
the
things
that
we've
been
we've
been
asking
as
part
of
the
accessible
information
standard
review
is
about
whether
or
not
metrics
can
be
improved
at
a
national
level,
so
that
there
is
a
framework
for
providers
to
to
actually
to
actually
collect
and,
more
importantly,
analyze
and
use
that
data.
B
Looking
at
using
that
as
a
measure,
because
it's
comparable
across
all
the
organizations
that
are
expected
to
use
the
mental
health
standard
data
set,
so
where
it's
a
provider
failing
to
collect
or
to
use,
then
we
will.
We
will
build
it
in
there
and
where
it's
providers
maybe
would
like
to.
But
there
isn't
the
national
framework
to
do
that.
Then
we're
trying
to
work
with
others
to
develop
that.
F
Yeah
thanks
very
much
ian
and
thanks
to
lucy
and
jill,
I
had
a
specific
question
on
5.4,
which
is
around
diversity
data
as
well,
and
then
a
more
general
point
about
section,
3
working
with
others.
So
on
5.4,
it's
rated
green,
but
we
have
a
target
of
95
percent
of
data
collected
and
all
of
those
figures
are
below
95..
F
F
A
lot
of
the
measures
are
about
us
asking
providers
or
stakeholders
how
they
think
we
are
doing,
and
I
wonder
going
back
to
the
gp's
report
that
rosie
might
want
to
comment
on
last
time
around
perceptions
of
equality
in
our
own
regulation
and
the
need
for
us
to
work
with
other
bodies
like
nhs
england
on
some
of
the
issues
there.
F
Although
this
is
year,
one
perhaps
over
year,
two
I'd
like
to
think
about
not
just
asking
providers
for
their
comments
but
to
think
more
proactively
and
strategically
about
how
we
work
with
other
bodies
in
health
to
be
able
to
push
this
agenda
forward
and
make
a
real
difference
for
people
who
use
services.
Thank
you
shall.
G
F
H
Comment
on
the
gp
aspect,
because
for
board
members
who
may
not
have
seen
this,
we
did
a
large
piece
of
work
looking
at
inequalities
faced
by
gps
of
black
and
minority
ethnic
background
and
the
potential
inequalities
that
they
faced
and
the
impact
of
our
regulation
and
some
of
the
findings
very
much
highlighted
the
need
for
good
data
collection
that
actually
none
of
the
system
had
really
in
terms
of
that
quality
of
data.
H
And
I
think
it's
really
important
that
we
work
and
we
we
continue
to
work
with
other
parts
of
the
system
so
that,
when
we're
looking
at
data
collection,
we're
not
all
going
into
providers
collecting
data
in
lots
of
different
ways,
but
we're
doing
that
in
a
sensible
way
that
doesn't
kind
of
create
impact,
but
enables
to
understand
the
the
issues.
But
also,
I
think
it's
really
important.
H
One
of
the
things
that
was
flagged
in
that
report
is
that
we
found
that
there
was
a
lot
of
practices
led
by
gps
from
black
minority
ethnic
background
who,
who
were
working
in
environments
where
they
were
just
not
getting
the
support
that
they
needed
in
very
deprived
areas
and
areas
with
less
funding
and
a
whole
range
of
other
issues.
And
so
it
is
vital,
and
I
I
completely
agree
with
sally
it's
going
to
be
vital
for
us
to
work
with
other
partners
and
we're
doing
that
to
look
at
actually.
H
How
do
we
make
sure
that
people
get
the
support,
get
the
resource
that
they
need
to
be
able
to
give
good
quality
care
and
and
thrive,
and
I
think
integrated
care
systems
as
we
go
forward,
have
a
really
vital
role
in
looking
at
the
inequalities
that
exist
potentially
across
their
areas
and
being
able
to
address
them.
So
I
think
part
of
our
ics
regulation
needs
to
be
looking
at.
A
B
Yes,
so
I
think
jill
will
need
to
pick
up
the
one
on
5.4
so
just
to
say
that
it's
a
really
good
challenge
over
the
measures
for
three.
We
can
go
away
and
look
at
them.
So
there
is
the
activity.
The
kind
of
activity
report
at
the
front
of
it
gives
a
bit
more
detail
on
what
we're
doing
getting
good
measures
for
for
how
the
impact
of
what
we're
doing.
I
think
we
need
to
develop
over
time,
and
I
think
that's
a
really
good
thing
that
I
can
take
away.
D
And
I
think
on
5.4,
so
we've
probably
been
perhaps
optimistic
in
our
or
a
bit
sort
of
positive
in
our
rounding
up
and
then
looking
on
balance
that,
whether
or
not
we
felt
that
they
that
all
of
the
indicators
were
sufficiently
robust,
that
we
could
give
ourselves
a
green,
a
green
score
on
that.
I
think
you
know
we've
got
sort
of
in
terms
of
rounding.
D
We
are,
if
we
round
it
up
when
then
our
disability
at
declaration
rates
are
on
target
and
we're
not
that
far
off
with
with
the
ethnicity
declaration
rates
and
slightly
lower
than
we
would
want
to
be,
perhaps
on
the
sexual
orientation
and
religion
and
but
and
if,
if
people
feel
strongly
at
the
board
that
they
should
be
amber
rather
than
green,
then
we
can
happily
change
that.
A
I
I
don't
think
you
need
to
retroactively
change
this
report.
No,
I'm
not
suggesting
either
a
new
category
of
almost
green,
but
I
think,
as
a
general
rule
for
future
reporting,
we
just
sally
said
you
want
to
be
clear.
We
either
do
it,
we
don't
achieve
it
or
we
find
a
slightly
different
way
of
measuring
it,
not
on
almost
green
but
something
that
flags
what's
going
on.
A
I
mean
an
indicator
of
direction
of
travel
once
we
are
into
a
second
period,
would
also
be
quite
helpful
because
often
that's
as
interesting
as
the
the
level
status,
any
other
questions
for
lucy
or
jill.
A
Just
one
final
one
from
me,
then
lucy
and
I
this
is
probably
an
unfair
question
of
the
public
meeting,
but
I'll
ask
you
anyway.
I
mean
this
is
us
and
clearly
we're
interested
in
what
we're
doing,
but
you
have
talked
about
working
with
other
albs
as
well.
So
I'm
not
asking
you
to
comment
on
others.
This
is
a
report
about
us,
but
do
you
have
any
observations
from
working
with
others
as
to
where
we
were
two
questions?
A
Actually,
one
is
kind
of
where
we
stand
anything
to
learn
from
others
where
we
are
more
successful
or
perhaps
less
successful
than
others
and
why
that
might
be,
and
the
second
question
is:
to
what
extent
are
these
things
all
within
our
control
are
or
are
some
of
these
to
some
extent
influenced
by
what's
going
on
in
the
wider
system,
and
therefore
we
don't
have
complete
control
over.
B
Really
good
question.
Thank
you.
So,
in
terms
of
where
we're
at,
I
think
one
of
the
things
we've
got
is
we've
got
a
new
rece.
I'm
gonna
fudge
this
slightly.
B
We've
got
a
new
research
budget
and
in
cqc,
and
one
of
the
one
of
the
themes
on
that
is,
is
about
tackling
inequalities
and
one
of
the
things
that,
as
the
sponsor
for
that
part
of
the
research
budget
I
want
to
do,
is
an
actual
kind
of
assessment
of
what
we
can
learn
from
other
regulators
in
other
sectors
and
also
in
other
countries
about
how
they
have
not
what
they're
doing,
but
how
they
have
actually
made
an
impact
on
tackling
inequalities.
B
I
think,
generally
speaking,
we
we've
got
a
level
of
clarity
and
the
level
of
commitment
and
the
level
of
kind
of
development
of
the
program
that
is,
that
is
quite
strong
compared
to
many
other
organizations.
I
don't,
I
wouldn't
like
to
say
where
we
would
rank
compared
to
other
organizations,
but
I
think
we've
got
a
high
ambition,
so
we
want
it's
key
to
our
core
purpose,
because
we're
here
to
regulate
that
care
quality
is
good
and
that's
care.
B
Quality
is
good
for
the
people
that
are
more
likely
to
have
poor
care
is
really
really
important,
so
we
need
to
keep
on
with
it,
and
we've
got
a
good
foundations
in
place.
We
need
to
kind
of
not
rest
on
our
laurels.
I
would
say
so
what's
in
control
that
the
activity
is
definitely
in
control,
there
is
sometimes
confounding
factors
in
the
success.
Measures
is
what
I
would
say
which
we
need
to
be
aware
of.
So
everything
that's
in
the
deliverables
is
within
our
control,
but
the
success
measures
might
have
confounding
factors.
H
I
just
add
that-
and
I
just
want
to
say
well
done
to
lucy,
because
I
know
lucy's
built
very,
very
constructive
relationships
with
arms
length
bodies
across
the
system
and
those
relationships
are
really
growing
and
really
productive
and
we're
working,
particularly
with
people
like
bola
olawabi
from
nhs
england,
the
director
of
inequalities,
and
so
I
think,
I
think
we're
positioned
well
to
progress
this
and
to
to
play
our
part
across
the
system,
and
I
think
lucy's
brought
this
agenda
forward
massively
in
the
last
year
or
two.
H
What
I
would
say
is,
I
think,
all
of
us
as
arms
length.
All
the
arms
length
bodies
have
so
much
more
to
do
in
this
area.
I
think
we're
we're
only
being
really
starting
to
understand
some
of
the
inequalities
that
exist
and
if
you
look
at
the
work,
we've
done
around
general
practice.
A
Thanks
rosie
and
thanks
lucy
as
well.
I
was
pleased
to
hear
you'll
be
looking
at
what
others
do.
I
mean
it's
important
to
obtain
the
focus
here,
but
equally
nobody
has
all
the
wisdom
so
see
what
we
love
mothers,
including
international,
each
other
was
interesting
hold
on.
A
If
there
are
no
other
questions,
I
don't
seem
to
be
looking
around
the
table
so
lucy.
Thank
you
very
much
indeed
good
report,
both
in
terms
of
its
comprehensibility
and
its
content.
So
we
we
look
forward
to
meeting
you
again
and
having
at
least
equally
as
good
reports
from
you.
A
A
If
we
move
on,
we
now
have
the
people
plan
so
jill.
I
think
you're
remaining
with
us
and
this
one's
down
for
you.
D
Yeah
yeah,
it
certainly
is
okay,
so
I've
shared
with
you
our
sort
of
draft
people
plan.
Just
by
way
of
context
as
to
why
this
is
with
you.
We've
reviewed
and
refreshed
our
existing
people
plan,
which
was
launched
in
march
2020
running
for
three
years,
but
we
felt
it
was
probably
time
to
actually
give
it
a
bit
of
a
refresh
at
this
stage
before
we
reach
the
end
of
the
of
the
three
year
period
and
we
the
reason
why
we
wanted
to
do.
D
That
was
to
one
to
reflect
what
we
had
achieved
so
far,
but
then
also
where
we
needed
to
focus
in
the
future
to
support
our
transformation
journey.
So
really
tying
our
people
plan
into
the
transformation
journey
and
you'll
see
from
the
draft
plan
that
I
have
tabled
for
you
that
our
overall
ambition
is
to
create
a
great
employee
experience
for
all
of
our
colleagues
every
day,
and
I
do
recognize
that
the
organizational
changes
that
are
and
are
underway
can
be
unsettling
and
can
have
an
impact
on
how
people
feel
and
experience
working
with
us.
D
So
we
need
both
to
be
mindful
of
the
here
and
now,
but
also
still
try
striving
for
our
ambition
for
the
future,
and
we
also
know
from
previous
surveys
that
we
need
to
really
continue
to
focus
on
how
our
colleagues
understand
and
experience
change.
So
our
leaders
at
all
levels
are
critical
to
this
point.
D
The
people
plan
that
I've
provided
for
you
provides
a
focus
on
our
core
people
activities
and
the
key
touch
points
for
our
colleagues,
which
all
contribute
to
create
a
great
employee
experience
and
you'll
see
from
the
plan
and
that
the
role
of
the
line
managers
is
critical
in
all
of
these
touch
points
right,
the
way
through
from
attraction
and
onboarding
to
how
people
feel
developed
mana,
how
performance
is
managed,
how
the
people
feel
and
our
colleagues
feel
connected
to
the
organization
so
that
they
feel
engaged
and
motivated
so
line
management
activity
really
critical
to
all
of
those
key
touch
points
in
the
employee
journey
and
life
cycle,
and
there
are
also
within
the
plan
three
specific
areas
for
focus.
D
One
is
the
is
the
diversity
and
inclusion
agenda,
so
we
have
achieved
a
huge
amount
since
we
launched
our
dni
strategy
in
june
2020,
and
but
there
is
still
more
to
do,
and
we
have
some
work
underway
now
to
review
the
achievements
to
date
and
really
focus
on
where
we
need
to
add
our
focus
and
value
going
forward
and
our
activity.
D
The
second
area
for
focus
is
people's
experience
and
insight.
So
I
really
given
that
all
of
our
strategy
across
the
organization
is
about
being
a
data
driven
and
insight-driven
organization.
We
really
need
to
continue
in
our
people
agenda
to
look
at
how
we
use
people
data
effectively
to
inform
our
priorities
and
our
actions
so
really
getting
to
the
heart
of
how
people
experience
working
with
us,
but
also
how
people
what
insights
people
can
share
with
us
in
various
different
mechanisms
for
doing
so
and
then
finally,
leadership
and
change.
D
So
this
is
a
high
level
delivery
plan
attached
to
the
to
the
overarching
plan.
It's
supported
by
very
detailed
project
plans,
which
obviously
are
some
of
the
detail
that
I
wouldn't
probably
I
wouldn't
share,
necessarily
with
the
board,
and
but
we
are
reporting
on
that
progress
to
the
people
committee
on
a
quarterly
basis,
and
we
will
bring
a
summary
of
our
progress
to
board
on
a
twice
yearly
basis.
D
So
the
people
plan
finally
has
been
approved
by
people
committee
and
also
by
the
executive
team.
So
I'm
bringing
it
here
to
board
ahead
of
sharing
it
with
a
wider
organization
in
this
of
period
of
august
into
early
september.
A
Okay,
many
thanks
joel
stephen
first.
E
E
Could
I
pick
up
the
comment
you
made
because
I
strongly
agree
with
it
about
the
importance
of
line
management
you're,
absolutely
right
how
important
it
is.
Could
I
sort
of
push
you
a
little
to
give
your
assessment
of
how
good
it
is?
Currently,
what
how
would
you
rate
the
current
sort
of
quality
confidence
of
managers,
we're
setting
them
a
huge
task
of
change
management
and
culture
change
management?
It's
you
know
it's
it's!
It's
a
lot
we're
expecting
of
our
managers.
E
Could
I
then
ask
a
different
a
second
question.
I
couldn't
see
anything
in
the
report
about
the
consequences
of
two
years
of
working
from
home
on
what
you
want
future
working
practices
to
be.
It
may
not
be
true
here
in
many
organizations
I
mean
I
think
people
are
now
wrestling
with
what
is
a
future.
E
D
Okay,
thanks
steven,
so
I'll
take
those
in
the
order
in
which
you've
shared
them.
So
good
challenge.
For
me,
how
do
I
rate
our
line
managers?
D
If
we
look
to
our
survey
data,
I
think
our
our
colleagues
have
a
very
strong
connection
with
their
with
their
line
manager
and
they
and
they
are,
they
rate
them
really
highly,
and
I
think
that
is
so
sort
of
is
relatively
unusual
and
certainly
in
the
organizations
in
which
I've
worked
previously,
and
I
think
we
have
pockets
of
really
excellent
line
management
practice
as
you'd
expect
in
an
organization.
D
I
think
we
have
some
some
colleagues
who,
in
line
management
roles
who
perhaps
have
do
lack
a
little
confidence,
and
so
I
would
say
it
was
probably
patchy.
We
have
some
really
really
brilliant
line
managers
and-
and
we
have
some
people
for
whom
actually
some
of
the
interventions
that
we
have
available
in
terms
of
our
line-
management
off
learning
offering
has
been
really
helpful
for
them
and
we
have
now
got
a
quite
an
established
cohort
of
internal
coaches
who
can
offer
specific
coaching
to
line
managers.
D
So
it's
a
work
in
progress.
I
think
we've
got
some
great
people.
What
I
really
want
to
do
is
make
sure
we're
role,
modeling
the
they're,
really
great
people
management
skills
that
we
see
next
people
and
our
colleagues
experience
as
well
as
making
sure
that
we've
got
the
tools
available
for
for
all
of
our
colleagues.
Who've
got
a
line,
management
responsibility
to
be
able
to
feel
confident
to
work
in
that
way,
and
much
of
that
is
to
do
with
how
they
are
coached
and
supported
by
their
line
managers
up
the
chain.
D
So
you
know
right
from
the
very
top
ever
all
of
us,
as
line
managers
need
to
be
really
really
demonstrating
great
line
management
skills,
and
that
includes
you
know
giving
giving
constructive
free
feedback
when
it's
when
it's
required.
D
So
I
think,
without
wanting
to
put
a
sort
of
a
marker
on
it,
stephen,
that's
kind
of
my
that's
my
summary
of
what
I
think
I
what
I
see
in
experience-
and
I
think
then
on
your
second
point
I
think,
unlike
unlike
their
other
organizations,
we
we
entered
into
the
into
the
pandemic,
with
67
of
our
workforce
already
home
workers.
So
we
we
already
had
this
as
an
established
way
of
working.
D
I
think
we've
proved
over
the
last
two
years
that
we
can
actually
function
really
well
as
an
organization
on,
as
with
a
with
a
high
degree
of
homework
in
our
midst,
and
so
our
technology
platforms
support
that
entirely
our
ways
of
working
our
colleagues
are,
you
know,
used
to
traveling
to
connect
with
their
colleagues.
I
think
we've
made
great
and
there's
been
a
huge
amount
of
activity
going
on,
which
is
probably
completely
unreported
at
board
around
the
sorts
of
social
interventions
that
people
have
initiated
within
their
teams.
D
You
know
children
bringing
children
in
christmas,
carols
story
time
for,
for
those.
When
you
know
a
great
number
of
our
colleagues
were
home
schooling
that
had
their
children,
home
schooling,
so
some
really
brilliant
initiatives,
and
I
think
that
actually
it's
not
an
issue
for
us.
I
think
we
can
manage
well
where
we
are.
We
currently
have
91
of
the
of
the
organization.
D
Now,
on
a
on
a
home-based
contract
that
feels
comfortable,
it's
not
diminished
our
ability
to
deliver
our
and
performance,
and
so
we
are
open
to
considering
home-based
contracts
on
an
ongoing
basis.
I
think
it's
a
it's.
It's
certainly
something
which
I
think
we
have
proved
that
we
can
do
well.
G
And
can
I
just
add
to
jill's
comments?
I
think
I
think
I'd
actually
really
turn
that
around
and
say
actually
we're
turning
that
into
a
positive
in
some
areas.
In
some
teams
you
know
we're
able
to
recruit
hard
to
recruit
skills,
because
we
can
offer
that
flexibility
and
because
the
organize,
as
jill
described,
you
know
it
was
not
a
cultural
shock
to
to
to
move
to
home
working.
We
already
had
a
national
footprint.
G
We
had
a
significant
number
of
people
in
the
field
force
and
another
and
a
significant
number
of
people
working
from
home
anyway.
So
I
think
what
we,
what
we've
managed
to
do
is
to
is
to
build
on
that
and,
as
jill
described,
we've
made
some
investments
in
technology
platforms
as
well,
which
again
put
us
in
good
stead.
So
I
think
that
combination
of
of
culture,
national
footprint
and
technology
meant
we
were.
We
were
well
placed,
and
we
are
now
attracting
some
some
really
talented
individuals
who
maybe
we
wouldn't
otherwise
have
got.
E
Just
click
on
chill
on
the
delivery
plan
on
slide
48
of
our
pack.
It
talks
about
sort
of
increasing
you
know,
maybe
having
more
diverse.
E
D
So
the
I
think
the
success
measure
is
actually
in
the
diversity
and
inclusion
strategy,
which
is
where
these
all
fit
together.
So
our
our
ambition
and
our
target
is
to
is
to
effectively
map
against
the
economically
active
population
for
both
ethnicity
and
disability.
So,
overall,
at
the,
I
think,
the
I
think
for
ethnicity,
it's
currently
14
and
we're
overall,
I
think
at
14.1
percent.
But
when
you
look
at
that
on
us
great
spread,
so
we're
not
quite
there.
D
So
that's
our
target
is
to
continually
meet
that
so
that
we
are
representative
of
the
economically
active
population
that
we
serve.
We're
not
quite
there
with
disability,
but
that
certainly
is
there.
But
we
can
you
know
it's
it's
there
in
another,
another
part
of
the
sort
of
interconnected
strategy.
So
the
dna
strategy
has
that
very,
very
clear.
C
Thank
you
chairman,
and
thanks
jill
for
a
very
good
report.
I
certainly
want
to
endorse
the
good
progress
that
you've
made
so
far
in
terms
of
recognition,
leadership,
development,
independent
panel
members
and
the
diversity,
inclusion
and
well-being,
focus
and
and
and
and
actions.
So
you
know
I
really
do
applaud
you
for
that.
I'm
gonna
say
I'm
gonna
miss
your
old
people,
pla
people
plan.
C
C
C
Establishing
our
regular
survey
rhythm
and
the
expected
outcome
is
to
be
confirmed
in
this
pack
and
I
would
have
thought
we
already
have
some
measures
that
we
would
want
to
use
in
in
terms
of
evaluating
our
performance
in
that
area,
and
I
mean
sort
of
areas
such
as
that
we
survey
in
terms
of
people
recommending
cqc
as
a
place
to
work.
C
You
know
has
a
concern
for
their
well-being.
We
have
some
measures,
so
I
was
a
bit
surprised
to
see
that
not
having
any
measures
confirmed
at
the
moment-
and
I
think
I
you
know-
I
draw
your
attention
again
to
the
one
below
that
about
developing
and
producing
informative
and
relevant
people.
Data
packs
again.
C
The
expected
outcome
is
to
be
confirmed,
but
I
would
have
thought
that
and
the
outcome
there
is
sort
of
improved
resourcing
effectiveness
and
improved
shaping
of
our
workforce,
and
I
just
ask
you
why
those
outcomes
have
not
yet
been
determined.
D
I
think
the
where
we've
got
the
to
be
confirmed,
certainly
in
the
context
of
the
people
survey,
is,
is
to
do
with
the
fact
that
we
are
are
just
on
boarding
a
new
survey
provider
so
sort
of
our,
and
I
expect
us
to
continue
to
ask
the
questions
that
we've
broadly
asked
in
previous
years,
so
that
we
can
maintain
our
trajectory
and
make
our
sort
of
importance
of
trend
analysis
work
on
where
we,
where
we
see
things
so
improving
or
dipping
and
where
we
need
to
pay
a
particular
attention.
D
So
the
to
be
confirmed
that,
in
that,
that
context
relates
entirely
to
that,
and
I
think
we
are
also
just
then
on
the
back
of
that
looking
at
really,
because
what
we
want
to
do
is
ensure
constantly
that
we're
providing
colleagues
in
the
in
the
business
and
leaders
in
the
business
with
the
right
people
data.
That
is
a
good
opportunity
for
us
to
really
reflect
on
the
sort
of
on
the
people.
D
Data
that
we
that
we
provide
to
our
colleagues
so
is
is
what
we
have
in
our
extensive
people
pack
helpful
and
does
it
contribute
to
the
right
conversations,
and
so
can
we
actually?
Is
there
a
point
at
which
we
can
refine
that
that
perhaps
we
can
tighten
that
up
and
happen
to
take
that
away?
We
can
bring
it
back
to
board
in
february.
C
D
Yeah,
of
course,
so
so
we
know
from
from
our
research
that
actually
peer-to-peer
recognition
can
be
really
powerful,
and
so
we've
never
really
had
a
mechanism
for
doing
that
before,
and
so
this
is
an
opportunity,
and
it's
it's
in
training.
Now
we
have,
we
have
some.
We
have
a
a
platform
which
allows
peer-to-peer
recognition
and
recognition
up
for
line
it's
not
as
sophisticated
as
we
would
like,
and
so
it
gives.
What
we
really
want
to
do
is
give
it
as
providing
a
really
easy
route.
D
D
The
experience
had
really
great
experience
of
team
working
in
collaboration
with
a
colleague
whether
they've
seen
some
really
excellent
inputs,
or
they
you
know,
have
demonstrated
integrity
or
caring,
so
really
wanting
to
make
sure
that
we've
got
a
mechanism
that
which
is
a
bit
less
clunky
than
we
currently
have,
which
is
essentially
where
we
have
to
get
root
everything
through
the
line
manager
in
order
to
trigger
the
sort
of
the
recognition
award.
D
So
our
the
objective
around
that
is
to
make
sure
that
we're
building
on
the
ethos
and
culture
of
recognition
in
the
broadest
sense
and
and
do
so
in
a
way
where
we've
got
a
platform
that
supports
that.
A
Thank
you
any
other
questions
from
people
jill.
I
have
a
a
couple
which
has
sort
of
been
touched
on
already,
so
I
wouldn't
ask
you
to
repeat,
but
I
may
just
try
and
tie
them
together
you
you
talk
about
the
the
need
for
everyone
to
be
leaders,
the
training
of
requirement
of
that
the
tools
etc.
A
I'd
just
be
interested
to
give
a
better
feel
for
the
resource
required
to
do
that
and
whether
we
actually
have
that
in
place
already
or
whether
that's
something
that's
got
to
be
found
in
the
more
detailed
plan
you
refer
to
underneath
and
then
secondly,
home
working
as
ian,
I
think
said.
A
Absolutely
you
know
I've
seen
this
myself
my
time
here
it
does
work
successfully
and
I
I
think
the
organization's
kind
of
is
doing
good
job
of
using
what
was
almost
a
slight
advantage
when
even
better
competitive
advantage
to
recruit
people
in
but
homeworking,
or
at
least
collaboration
by
things
like
teams
works
really
well
for
people
that
know
one
another.
It's
much
less
effective.
A
D
Okay,
okay,
so,
on
the
first
point,
yes,
we
do
have
the
resources
are
identified
to
for
all
the
learning,
including
all
the
learning
that
is
related
to
our
transformation
activity.
D
So
we
we
have
got
a
I've,
got
a
very
skilled,
look
bunch
of
learning
professionals
in
the
academy,
and
we
have
identified
the
the
funding
that
we
need
for
the
various
different
programs
that
we
are
about
to
launch,
including
our
inclusive
leaders.
Programme,
which
is
I'm
really
proud
of,
and
and
is,
I
am
hoping,
is
going
to
be
really
effective
in
the
organization.
D
Our
broader
leadership
program
is,
is
resourced
and
and
we'll
be
able
to
we'll
be
able
to
roll
that
out
so,
and
I
think
there's
also,
we
mustn't
underestimate
the
the
power
of
really
really
strong
role
models
in
the
organization,
so
as
well
as
sort
of
investing
in
training
and
learning
and
and
opportunities
for
people
to
develop.
I
do
think
we
also
need
to
recognize
that
our
our
leaders
themselves
are
really
powerful
advocates
for
what
good
good
leadership
looks
like,
and
what
good
change
leadership
particularly
looks
like
in
in
the
organization.
D
So
I
think,
a
combination
of
of
of
training
people
of
some
of
our
sort
of
strong
advocates,
some
of
our
really
powerful
role
models.
I
think,
will
get
us
to
a
point
where
we've
got.
We've
got
a
kind
of
sweet
spot
in
terms
of
our
resourcing
for
for
that
and
on
the
the
homeworking
we
we
are
now
able
to
bring
people
together,
and
so
I-
and
what
I
see
and
I
hear
from
colleagues-
is
a
lot
more
of
of
collaboration
happening,
because
people
are
coalescing
around
a
particular
place.
D
So
more
team
based
activities
are
now
happening,
as
people
are
able
to
we're
out
of
the
restrictions
that
we
had
for
the
vast
majority
of
the
last
two
years,
and
so
that
is
starting
to
sort
of
manage
itself
again,
there's
always
been
our
way
of
working,
so
our
teams
have
been
really
used
to
coming
together
for
a
purpose
and
we
are
inducting
in
the
way
that
we
had
previously
so
we're
looking
to
to
bring
people
together
and
line
managers.
D
I
know,
are
always
really
keen
to
meet
people
face
to
face
when
as
soon
as
they
can.
I
know
that
from
my
own
teams,
when
we've
brought
new
people
in
and
the
fact
that
it
says
you
know
that
that
our
organization
has
has
caring
as
one
of
our
values.
I
don't.
I
do
believe
that
actually
means
that
people
are
reaching
out
to
colleagues,
and
we
see
a
lot
of
that
and
through
the
regular
communications.
A
Thanks
so
much
there's
no
doubt
that
the
technology,
the
collaborative
element
of
the
technology,
has
improved
dramatically
over
the
last
couple
of
years,
so
I
I
agree
it
much
easier
than
it
was
any
other
questions
for
jill,
if
not
well.
Jill
thanks
very
much
indeed,
I'm
sure
mark
will
get
over
the
fact
that
you've
taken
away
the
picture
he
liked,
but.
D
A
Okay,
well,
thank
you
for
that.
I
think
next
item
up
is
a
report
from
the
executive
team,
so
there'll
be
a
number
of
contributors,
but
here
and
perhaps
I
can
hand
to
you
if
there's
anything,
you
want
to
say
and
then
we'll
hand
it
on
to
the
others.
G
Thank
you
very
much
ian,
so
I
think
there
are.
There
are
four
items
from
sean,
rosie
and
tyson
which
we
will
come
out
and
come
off
talk
about
in
a
second,
please
take
the
the
report
as
written,
and
we
will
have
an
opportunity
at
the
end
of
the
meeting,
to
to
formally
thank
kirsty
and
rosie
for
their
contributions
to
to
the
board
as
well.
So
if
I
could
hand
over
to
sean
in
the
first
instance
to
talk
about
urgent
and
emergency
care,
thank
you.
I
Thank
you
ian
just
to
confirm
to
the
board
that
the
ambulance
service
remains
under
intense
pressure
with
a
number
of
key
performance
indicators,
including
call
response
times
across
all
four
categories
of
call,
including
999
call
answering
times
and
including
ambulance
handover
times,
have
all
have
all
either
lengthened
or
increased
over
the
last
month.
I
A
H
H
I
have
felt
very
privileged
to
work
with
a
group
of
people
who
have
are
so
dedicated
about
improving
care
for
people
using
services,
and
I
think
many
of
our
teams,
particularly
our
inspectors,
have
very
difficult
jobs
and
they
go
about
them
with
huge
dignity
and
professionalism
and
are
hugely
patient
centered
at
all
times,
and
and
so
just
a
big.
Thank
you
for
me
and
good
luck
with
all
of
your
future
work.
Two
things.
The
first
thing
I
just
wanted
to
mention
was
about
the
fuller
review.
H
As
you
might
have
seen
in
the
report,
we
have
seen
claire
fuller's
report,
which
sets
out
a
lovely
vision
for
the
future
of
primary
care.
I
think,
over
the
last
few
years
we've
seen
I've
been
increasingly
concerned
about
general
practice,
particularly
since
I've
been
in
this
role.
H
We
have
a
workforce
that
has
recruitment
problems
that
is
struggling
with
enormous
demand,
and
that
has
just
got
more
and
more
difficult
during
the
pandemic,
and
I
think
we
that
the
workforce
in
primary
care
is
tired.
It's
exhausted
and
in
some
places,
really
struggling
to
to
to
manage
those
demands
and
at
the
same
time,
we've
also
had
increasing,
give
feedback
on
care
and
increasing
patient
feedback.
H
That
says,
they're
not
getting
access
and
they're
not
getting
the
care
that
sometimes
they
expect-
and
I
think
that
points
to
the
fact
that
the
current
model
of
primary
care
and
the
current
model
of
general
practices
is
not
sustainable
and
we
need
to
look
at
how
we
can
develop
new
models
of
care
in
light
of
the
the
wider
integrated
care
system
and
all
of
the
services.
And
so
I
think
it's
going
to
be
primary
care
is
fundamental
to
the
future
of
the
nhs.
It's
fundamental
to
be
thriving.
H
It's
fundamental
for
patient
care
and
I
think
we
need
to
ensure
that
all
all
people
work
with
primary
care
to
ensure
that
we
have
a
thriving
and
and
and
good
service
for
patients
that
is
sustainable
for
people
working
in
the
services.
They
can
really
welcome
claire
fuller's
report
and
very
much
keen
to
support
it
as
we
go
forward,
and
I
can.
I
just
also
take
this
opportunity
to
thank
all
my
colleagues
who
are
working
incredibly
hard
in
all
primary
care
settings
and
dealing
with
very,
very
challenging
situations
at
the
moment.
H
So
thank
you
for
all
you're
doing
just
a
few
things
to
mention
about
oral
health
as
well.
One
is
that
oral
health
and
care
homes
the
board
may
remember.
Just
over
three
years
ago,
we
published
a
report
looking
at
oral
health
and
care
homes
that
hasn't
gone
off
our
agenda.
H
At
the
time,
we
found
some
fairly
shocking
things
about
the
lack
of
oral
health
in
care
homes,
it's
so
important
for
people's
dignity,
people's
well-being,
people's
health
to
have
good
oral
health
care,
health
care,
and
we
are
reviewing
the
progress
that
we
made
since
that
report
was
published
three
years
ago
and
the
findings
of
that
will
come
back
to
the
board.
H
A
couple
minor
things
just
mentioned:
one
is
that
we,
as
you
know,
well
they're,
not
minor,
they're,
very
important,
but
brief
things.
We've
had
long
standing
problems
about
access
to
dental
care,
just
a
flag
that
nhs
announced
yesterday
new
reforms
to
the
dental
contract
to
improve
access
to
dental
care,
and
I
think
we
welcome
anything,
that's
going
to
improve
access
to
care
for
people's
dental
health
and
also
just
to
flag.
Also,
we
will
be
responding
to
the
general
dental
council
consultation.
H
That's
just
been
launched
about
their
new
strategy.
We
work
very
closely
with
the
general
dental
council
and
other
dental
stakeholders
and
continuing
to
work
with
them.
So
we
will
be
responding
to
that
in
due
course.
J
Tyson,
I
think
it's
me
next
I'll,
be
very
brief.
Thank
you
chair.
I
just
want
to
give
a
couple
of
updates
on
on
my
written
report.
In
my
written
report,
I
say
there
were
870
inspections
in
june.
We've
now
further
validated
much
of
the
data,
and
the
figure
is
now
standing
at
924,
which
is
closer
to
may
figure
and
there's
still
42
inspections
to
be
validated,
so
I'm
hoping
that
the
final
reckoning
will
be
closer
to
950.
J
and,
very
briefly,
on
registration.
Things
remain
stable
despite
vacancies
in
the
team
and
the
overall
amount
of
work
in
the
system.
It
is
pretty
much
the
same
in
june
as
it
was
in
may.
One
thing
we
have
been
focusing
on
is
the
very
old
are
the
very
old
cases,
the
very
old
applications
in
the
system
as
of
march
this
year,
the
oldest
application
was
november
2020.
J
As
of
in
my
in
my
written
report,
I
talked
about
the
oldest
application
being
april
2021.
I'm
really
pleased
that
today,
the
latest
figure
is
the
oldest
case
in
the
system
is
january
2022.
So
we
brought
the
tail
into
almost
within
six
months
and
I
think
that's
a
sign
of
a
good
health
in
the
system.
That's
all
I
wanted
to
update
on.
K
I
can
just
very
briefly
flag
the
board
that
we
are
doing
some
active
engagement
with
health
and
social
care
providers
about
our
up-and-coming
role
around
assuring
local
authorities
and
systems,
and
there
are
two
pilots
for
local
authorities
are
underway
and
are
going
well
and
we
are
about
to
start
our
piloting
with
icss.
A
So
very
brief
right,
I
thought
it'd
be
easy
to
take
all
the
reports
together,
but
questions
from
colleagues
on
any
of
the
areas
mark
you're
going
to
go
first,
I
think.
C
Thanks
chairman
and
firstly,
I'd
like
to
say
it's,
you
know
you
really
get
a
sense
as
a
non-exec
director
here
of
the
work
that
goes
on
on
a
month-to-month
basis,
so
thanks
very
much
to
the
exec
team.
For
for
these
reports,
sean,
I
was
just
wondering
in
the
the
ambulance
sector.
C
I
I
was
reading
somewhere
that
there's
a
perception,
perhaps
that
people
feel
they
get
treated
quicker
at
a
e
if
they
arrive
in
an
ambulance
than
if
they
don't.
Is
there
a
a
strategy
to
try
to
address
that
perception
to
take
pressure
off
the
ambulance
service.
I
I'm
not
aware
of
any
figures
myself
that
indicate
that
patients
do
get
managed
more
quickly
if
they
arrive
ambulance
than
if
they
arrive
themselves.
I
think
it's
you
know.
Patient
disposition
at
ed
will
be
a
function
of
triage
processes
and
they're
their
their
clinical
need.
I
I
would
have
thought
that
that
would
be
the
the
thing
that
we
would
want
to
make
sure
was
was
was
always
present
and
preserved
in
emergency
department
function,
that
patients
are
managed
and
seen
on
the
basis
of
clinical
need,
rather
than
any,
you
know
any
any
any
convincing.
C
I
I
totally
agree
with
you.
I
was
just
saying
that
I've
read
this
perception
is
out
there
and
that's
what's
putting
the
pressure
on
to
the
service,
and
so,
if
you
could
dissipate
that
idea
in
people's
minds
that
you
get
treated
you
walk-ins
get
treated
as
quickly
as
ambulance
arrivals
might
take
some
pressure
off
off
the
of
the
system.
C
Could
I
ask
another
question,
please
chairman
and
it's
to
tyson
tyson
thanks
a
lot
for
for
your
report,
just
looking
at
the
dma
performance
in
in
june
being
down
on,
may
I
think
you
said
to
us
before
that
you
were
using
the
bank
to
try
to
give
more
resource
to
the
dma.
Is
that
still
part
of
the
process,
or
you
know
has
has,
has
that
actually
stopped.
J
J
I
think
it's
12
bank
inspectors,
fde
equivalents
and
seven
seven
of
our
colleagues,
so
so
the
size
of
the
dma
team
is
smaller
than
it
was
we're
not
looking
to
recruit
new
inspectors
at
the
moment,
given
the
pressures
on
the
other
inspection
teams,
but
I
think
the
main
reason
for
the
figures
of
dnas
being
lower
in
june
than
may
is
because
of
the
vacancies
that
have
come
about
and
the
bank
inspectors
that
we
have
who
have
left
have
left
for
a
number
of
reasons.
We
are
using
bank
across
the
across
the
operation.
J
E
Stephen
thanks
ian
two
questions.
If
I
could
one
to
rosie
very
interesting
comments
to
us,
particularly
about
the
current
challenges
in
the
whole
primary
care
system
and
the
need
for
a
new
model
of
primary
care,
it
feels
like
quite
a
big
issue,
how
what
what's
your
advice
to
us
on,
so
how
would
we
or
others
working
together?
How
do
we
generate
such
a
thing?
You
know
how?
How
do
we
get
to
that
new
model
of
care?
H
That's
a
good
question
and
I
I
think
the
first
thing
says
I
don't
think,
there's
one
model
that
fits
all.
I
think
it
will
depend
on
the
population
needs.
It
depends
on
the
environments
that
people
are
working
in
and
the
the
local
setups.
I
think
I
think
the
system
has
become
very
fragmented
and
I
think
we
need
to
encourage
with
our
ics
regulation
how
systems
are
working
together.
I
think
primary
care
is,
it
is
dependent
on
how
systems
and
providers
around
it
work
as
well.
H
H
We
need
to
really
hold
on
to
the
things
that
we
know
are
important
in
primary
care,
like
continuity
of
care,
huge
amount
of
evidence
that
continuity
of
care
improves
outcomes
for
people
using
services,
and
particularly
people
with
complex
needs.
So
we
need
to
look
at
the
important
things
in
primary
care
and
the
things
that
we
know
are
fundamental
to
good
patient
outcomes,
but
then
think
about
how
do
we
design
services?
So
they
really
support
sustainability
deal
with
the
workforce,
challenges
that
we're
seeing
across
primary
care,
which
are
significant
and
really
think
about.
H
What's
going
to
deliver
best
outcomes
for
people
using
services,
so
I
think
it
there's
not.
I
don't
think,
there's
there's
a
there's
a
specific
model.
I
think
that
different
places
are
trying
lots
of
different
ideas.
We've
got
vertical
integration
with
acute
trusts.
We've
got
some
great
examples
of
where
practices
are
working
together
with
their
local
communities
and
providing
good
care,
and
I
think
there
are
pockets
of
really
exciting
things
happening.
I
think
the
question
is:
how
do
we
support
those?
How
do
we
share
that
best
practice?
H
I
think
we
have
a
role
with
that.
How
do
we
make
sure
our
regulation
is
enabling
so
that
we
encourage
that
innovation
and
we
encourage
those
new
ways
of
working
and
how
do
we?
How
do
we
work
with
national
stakeholders
as
well
to
to
make
sure
that
we
we
help
systems
nudge
in
the
right
direction?
H
I
guess
so,
I
think,
there's
lots
of
things
we
we
can
do
and
we
have
been
doing
working
with
other
partners
in
this
area,
but
I
think
that
there's
no
doubt
that
I
don't
think
people
using
services
or
people
working
in
primary
care.
It's
it's
not
doesn't
seem
to
be
working
in
a
lot
of
places.
I'm
sure
there's
some
places
that
it
is
working,
but
in
a
lot
of
places,
there's
huge
strains
and-
and
that
makes
me
think
it's
it's
not
down
to
the
people.
H
Despite
what
the
there's
been
a
lot
of
negative
media
about
primary
care,
which
I
think
has
been
very
difficult
for
people
working
in
services
to
deal
with,
and
it's
been
quite
demoralizing
for
them
and
I
don't
think
it's.
I
think
it's
not
because
people
aren't
working
hard.
People
are
working
extremely
hard
at
the
moment
and
I've
been
out
to
lots
of
practices
and
seen
the
pressures
that
they're
under
working
extremely
hard.
So
I
don't
think
it's
due
to
anyone's
lack
of
dedication
or
commitment.
E
E
Could
I
ask
a
second
question,
which
is
this
is
sorry,
my
ipad's
just
gone
to
sleep
again:
here's
page
64
of
the
pack,
it's
the
bit
about
adult
social
care
funding
reform
and
I
was
really
interested.
The
second
paragraph
seems
to
be
signaling
an
issue
that
potentially
section
18
brackets
3
might
change
the
way
the
market
works
and,
if
I'm
understanding
it,
I
think
it's
because
if
people
are
given
the
sorry,
if
cell
funders
are
given
the
right
to
pay,
no
more
than
the
local
authority
pays.
K
Should
I
come
in
on
that,
so
we
need
to
watch
this
really
closely,
so
the
guidance
that
was
published
about
a
week
or
two
ago
from
the
government
was
how
they
intend
to
operationalize
this
part
of
of
the
care
act
and
what
this
means
is,
as
you
say,
stephen.
If
you
are
a
self-funder,
this
gives
you
the
opportunity
to
go
to
your
local
authority
and
to
have
your
needs,
assessed
and
potentially
get
access
to
equivalent
costs
to
what
that
local
authority
might
be
paying
for
a
placement,
so
big
implications.
K
This
will
have
an
impact
on
the
sector
and,
as
you
say,
through
our
role
in
market
oversight,
where
our
laser
focus
is
on
about
ensuring
continuity
of
care.
For
people,
we
need
to
observe
very
closely
the
impact
that
this
has.
However,
the
approach
of
kind
of
staggering
its
introduction
should
go
some
way
to
mitigating
the
impact
on
the
market,
rather
than
it
all
going
live
on
the
same
date
that
everyone
who's
currently
resident
in
residential
nursing
homes
and
all
new
applicants
for
it
as
well.
A
So
watch
for
space
steve
on
your
previous
observation,
I
mean
I,
I
take
the
point
roses
put
down
the
challenge
I
mean
stating
the
obvious
for
the
particularly
the
benefit
of
the
public.
I
mean
we're
not
responsible
for
the
quality
of
care.
That's
provided
we're,
not
a
provider,
but
we
do
have
an
overarching
obligation
to
see
if
we
can
do
our
conduct
our
affairs
in
a
way
that
encourages
improvement.
So
I
think,
in
that
context
the
question
is
very
fairly
left
out
there
any
other
questions
for
the
management
team.
A
From
anybody
I
mean
the
the
feature
benefit
or
disadvantage
when
I
do
it
getting
last.
Is
that
usually
your
questions
were
asked
by
others,
so
I
had
two
one's
already
been
asked.
Actually,
my
this
is
a
request
rather
than
a
question,
and
it's
probably
for
you,
kate
and
that's
where
he
won't
speak
it
up,
but
under
ics
you
did
mention
that
that
the
questions
we're
dealing
with
indicate
misunderstandings
about
our
role
and
the
example
you
gave
was
enforcement
powers
don't
apply
to
systems
and
local
authorities?
A
K
Yeah,
happy
too,
and-
and
this
is
feedback-
that's
come
from
our
meetings
with
health
and
social
care
providers,
so
supporting
them
to
understand
what
our
role
will
be
around
local
authority
assurance
and
integrated
care
systems.
So
this
is
very
much
about
providing
transparency,
opportunities
for
local
authorities
and
integrated
care
systems
to
improve
and
the
ability
rosie
was
talking
earlier
about
how
there
will
be
excellent
examples
around
the
country
of
where
health
and
social
care
providers
are
doing
really
innovative
work
together.
K
This
is
the
opportunity
for
us,
as
the
independent
regulator,
to
spotlight
that
to
encourage
that
improvement
elsewhere.
So
the
the
purpose
of
this
is
around
transparency,
driving
improvement
and
supporting
ics
is
to
deliver
the
ambition
I
think
we
all
have
for
them,
which
is
that
they
tackle
inequalities
in
their
area.
They
drive
improvement
and
they
support
people
to
get
better
outcomes.
I
don't
want
to
come
in
on
anything
else.
Rosie
yeah.
K
H
Won't
have
enforcement
powers
in
ics's.
We
will
continue
to
have
the
enforcement
powers
with
providers
and
I
think
that
there
needs
to
be
a
very
fluid
relationship
between
the
ics
work
and
the
provider
work
so
that
there's
there's
a
two-way
process,
and
certainly
you
know
providers
are
not
taking
part
in
their
local
ics
work.
I
think
that's
something
we
will
need
to
very
much
look
at
with
their
the
provider
regulation
that
we
do.
H
There
will
be
roots
of
escalation,
though,
if
we
are
aware
of
concerns
that
emerge
through
the
ics
work
and
we
will
be
working
with
partners
like
nhs
england,
like
the
lga
and
others.
Just
if
there
are
concerns
being
raised,
we
need
to
make
sure
that
those
are
addressed
and
ultimately,
if,
if
we
we're
not
confident
and
in
a
last
case
scenario,
we
will
have
a
route
of
escalation
through
to
the
secretary
of
state.
A
A
But,
as
I
say,
it's
something
that's
come
up
in
some
of
my
discussions
and
if
you're
finding
it
come
back,
it
probably
suggests
we
just
need
to
make
sure
that
we
are
proactively
communicating
the
what
we
are
doing,
but
the
limits
of
what
we're
doing
so
that
we
can
try
to
have
misunderstandings
off
any
other
questions
of
people,
if
not
well
I'll.
Thank
the
executive
team
or
members
of
this
next
team
for
their
response.
A
So
thank
you
very
much
indeed,
for
that
we
have
a
few
final
matters
on
the
agenda,
most
of
which
are
by
way
of
formalities
to
approve.
The
first
is
the
minutes
of
the
previous
meeting.
Then
we
closed
in
the
pack.
Can
I
take
those
as
agreed
or
any
comments,
everybody's
nodding,
so
those
are
approved?
A
There
is
an
action
log
which
I
temporarily
can't
find.
There
was
only
one
item
on
it,
the
which
was
something
that
that's
it's
on
track
and
we'll
pick
it
up
in
september.
So
unless
anybody
wishes
to
comment
or
add,
I
think
that's
that's
correct
and
so
outstanding.
A
F
That
better
good!
Yes,
thank
you.
So
this
is
our
audit
and
corporate
governance
committee's
annual
assurance
report
to
the
board.
It's
the
11th
one,
several
of
our
non-exec
colleagues
serve
on
that
committee,
along
with
two
independent
members
from
outside.
So
I'd
like
to
say
thanks
to
them
for
being
so
diligent
and
committed
during
the
year
before
we
start.
F
So
that's
probably
autumn
in
terms
of
internal
audit,
we
have
a
positive
opinion
from
pwc
our
head
of
internal
audit.
They
have
given
us
a
rating
of
moderate
same
as
last
year.
It
sounds
underwhelming,
but
moderate
actually
means
generally
satisfactory,
with
some
improvements
to
be
made,
as
is
inevitable
in
an
organization.
F
That's
as
complex
as
ours,
they
produced
13
reports
during
the
year
of
which
only
one
was
high
risk
around
consistency
of
our
regulation,
which
we
know
is
the
key
point
of
our
transformation
program
and
management,
have
responded
and,
as
the
transformation
program
delivers,
then
we'll
be
able
to
improve
that
consistency.
We
have
a
number
of
agreed
actions
just
to
give
you
a
flavor
of
the
type
of
work
we
do.
F
We
obviously
oversee
the
risk
register,
strategic
and
high
level
operational
and
we've
oversee
quite
a
few
changes
to
that
risk
profile
that
cqc
has
this
year.
F
We
focused
also
on
cyber
security
and
I.t
disaster
recovery.
There
is
a
quite
a
large
and
specific
program
in
place
to
ensure
we
have
as
few
cyber
security
incidents
as
possible
and
that
work
is
progressing
well
in
terms
of
counter
fraud.
We
only
have
very
few
cases
that
are
investigated
and
none
of
those
have
led
to
further
action.
F
It's
important
to
say
that
we
also
oversee
risk
for
the
national
guardians
office
and
healthwatch
england,
and
we
were
delighted
to
have
two
really
in-depth
and
impressive
presentations
from
the
leaders
of
those
organizations
not
about
their
overall
governance,
but
about
their
risk
and
financial
management.
F
There
are
some
funding
issues
around
healthwatch
england
in
particular,
but
we
have
confidence
in
the
people
leading
those
organizations.
We've
played
our
own
part
in
the
board
effectiveness
review.
The
feedback
for
acgc
was
largely
positive
and
we
have
a
few
minor
things
to
improve
around
additional
assurance.
F
I
think,
in
conclusion,
unless
people
have
got
questions,
acgc
are
assured
by
the
governance
and
risk
management
and
audit
processes
that
we
have
in
place
and
content
that
that
assurance
is
reliable
and
comprehensive
for
the
purposes
of
the
board.
So
it's
a
positive
report
and
again
I'd
just
like
to
say
thank
you
to
all
of
our
colleagues,
non-exec
and
exec
for
the
work
they
put
in
and
particularly
in
providing
that
assurance.
Thank
you.
A
Thanks
so
much
indeed
sally
very
comprehensive,
emphasize
the
importance
of
the
report,
a
huge
number
of
our
key
responsibilities
aboard
our
dedicated
to
that
committee.
So
it's
important
to
all
of
us
that
its
affairs
conducted
well.
Has
anybody
got
any
questions
for
sally
on
her
report?
Mark.
C
Well,
not
a
question
chairman,
but
as
a
member
of
the
committee,
I
would
really
like
to
thank
sally
for
her
hard
work
and
leadership
and
producing
such
a
strong
report
as
this
and
I'd
also
like
to
thank
the
exec
team,
especially
kirsty
and
chris,
for
their
engagement
with
the
acgc
governance
process.
Thank
you.
A
Well,
thanks
we'll
continue
on
that
theme.
I
was
also
going
to
add
thanks
to
those
members
of
the
subcommittee
specifically
sally
mentioned
that
it
has
been
closed
for
the
benefit
of
the
public.
It's
not
that
we're
spending
less
time
monitoring
what's
going
on,
but
the
world's
moved
on
the
project's
up
and
running.
It's
a
long
way
down
the
track
and
the
things
that
are
outstanding
as
we
transition
the
business.
Usually,
I
think
all
matters
for
the
full
board,
but
a
huge
amount
of
work
went
into
that
subcommittee.
A
There
are
some
figures
on
meeting
attendance
here,
but
they
don't
do
justice.
The
amount
of
work
that
individual
leds
are,
though,
did
outside
the
meeting.
So
we've
reported
to
this
committee
at
a
very
high
level,
progress
on
really
quite
a
major
transformation
program.
So
my
my
thanks
to
everybody
there.
A
lot
of
this
predates
me,
but
even
so
I
do
see
the
huge
work
that
was
put
in
any
other
questions
for
sally
on
her
report.
A
A
G
I
just
I
hope,
board
members
can
you
can
join
me
in
thanking
both
kirsty
and
and
rosie
for
their
fantastic
contributions
over
over
a
number
of
years?
I
think
in
rosie,
we've
we've
had
a
a
fantastic
chief
inspector.
Who's
who's
been
able
to
support
the
board,
but
but
more
importantly,
support.
G
The
sector
through,
what's
argued,
been
one
of
the
most
trying
times
in
our
in
our
in
our
history
as
a
nation
actually
and
rosie
being
able
to
build
relationships
and
improve
relationships,
despite
that
complexity
across
some
pretty
complex
sectors,
in
general
practice
in
dentistry
and
with
the
military
with
prisons,
all
of
which
it
will,
of
course,
have
been
particularly
stretched.
G
So
an
enormous
thank
you
from
fro
from
all
of
us
and
rosie's
also
been
a
real,
staunch
advocate
for
integrated
care
work,
and
I
I
think
we've
we've
talked
a
number
of
times
in
in
our
meetings
recently
around
around
the
work
that
we
are
aspiring
to
do
around
integrated
care
systems.
I
think
rosie's
leadership
and
advocacy
all
the
way
through
her
tenure
here
has
has
been
fantastic,
so
I
I
think
you
know
I
really
would
want
to
thank
rosie
for
for
that.
G
For
that
work,
and
I
in
kirsty
you
know
we
we've
got
somebody
who
has
been
really
the
architect
of
our
transformation
work
and
has
talked
many
times
around
this
table
around
around
the
work
we've
done
on
change
and
it's
and
that's
been,
you
know
fantastic,
and
that
will
enable
us
it's
given
us
the
vehicle
I
think,
to
transform
as
an
organization.
What
we
don't
talk
about
very
much,
of
course,
is
is
kirsty
running.
You
know.
A
large
piece
of
our
organization
got
some
really
effective
support
services
that
quietly
you
know
behind
the
scenes.
G
Do
that
do
their
thing
and
we've
seen
somebody
some
examples
of
that
in
just
in
this
meeting
alone.
In
terms
of
things
like
the
people
plan
and-
and
that's
been,
you
know
incredibly
powerful,
and
it
gives
us
the
basis
for
for
doing
the
work
that
we
want
to
do
in
future.
So
an
enormous
thank
you
to
both
rosie
and
to
kirsty.
On
behalf
of
all
of
us
for
the
fantastic
work
they've
done,
thank
you.
Thank
you.
A
Thanks
look,
I
don't
want
to
repeat
that
you've
known
both
much
longer
than
I
have.
I've
only
been
here
three
and
a
half
months,
but
much
of
that
reflects
their
executive
experience,
but
I
mean
you've
also
been
members
of
the
board
in
my
limited
period
here,
so
even
in
a
very
short
time
enjoyed
working
with
you.
What
I
think
is
it's
always
sad
to
see.
A
Colleagues
go,
but
also,
I
think,
as
a
testament
to
an
organization
when
people
go
on
to
you
know
very
significant
elsewhere
in
the
sector,
and
I
guess
particularly
with
you
rosie,
we
look
forward
to
continuing
a
close
working
relationship.
So
I'll
add
my
congratulations,
but
thank
you
for
the
longer
version.
That's
good.
A
So
that
concludes
us.
Sorry.
It
does
conclude.
It
closes
the
the
main
business
of
the
meeting.
Now,
as
you
know,
we
do
ask
members
of
the
public
if
they
would
like
to
submit
questions,
and
we
say
that
after
the
conclusion
of
the
meeting
we'll
address
them-
and
we
do
have
a
couple
from
robin
pike,
so
I'm
going
to
take
the
first
and
totherian
is
going
to
take
the
other.
A
Robin's
first
question
was:
how
can
I'm
using
his
words?
I
can
see
you
cqc,
adapt
his
business
for
public
board
meetings
to
include
a
patient's
safety
story,
so
I
patient
story
as
it
did
in
in
june,
and
I
guess
that
reference
to
a
very
emotional
presentation
from
alexis
quinn
robert.
I
think
that
let
me
understand
two
parts
I
mean
the
public
board
meeting
we
believe
serves
two
purposes.
A
It
does
allow
public
account
for
cqc's
performance
as
an
organization,
and
it
also
shows
some
of
the
the
processes
we
go
through
for
things
to
be
approved.
A
It
also
gives
us
an
ability
to
listen
debate,
respond
to
challenges
in
the
wider
and
health
care
environment
and,
in
our
respects,
a
lot
like,
like
horizon
scanning,
for
the
latter,
a
important
component.
Part
of
that,
I
think,
is
the
voices
and
lived
experience
of
people.
Eu
services,
which
I
mean
ultimately,
is
what
we're
here
to
serve,
and
also
of
our
frontline
staff
and
the
health
and
care
systems.
A
So
I
I
think
doing
that,
helps
the
board
focus
on
the
right
issues
and
we
do
folk
keep
our
focus
there
for
only
the
public
at
large,
or
rather
than
simply
care
provide
as
important
as
they
are.
So
you
know
we
do
aim
to
list
and
act
on
the
voices
of
people
in
that
way
in
a
number
of
ways,
and
invitation
of
the
board
is
one
of
them,
but
bearing
in
mind
that
is
the
agenda
of
the
board.
A
A
So
I
can
assure
you
that,
from
the
point
of
view,
the
non-executives
and
the
way
they
conduct
their
business
and
particularly
the
executives
that
we
do
try
to
make
sure
that
we
keep
an
eye
on
and
listen
to
the
patient
stories,
but
you're,
absolutely
right
that
the
public
board
maintains
a
role
as
well.
So
you
make
a
good
point.
Clearly,
alexa
struck
a
chord
with
a
lot
of
people,
and
it
is
something
that
we
will
continue
to
keep
under
review.
A
G
Thanks
ian
and
the
second
question
from
robin
was
how
effectively
does
cqc
finder
providers
of
nhs
and
social
care
are
adapting
their
care
to
accommodate
the
current
heat
wave.
So
again,
I
think
it's
a
very
pertinent
and
very
current
question.
We
we
speak
on
our
on
the
wednesday
of
the
week
when
the
monday
and
the
tuesday
are
the
two
hottest
days
of
of
the
year
and
and
arguably
ever,
and
so
I
think
it's
too
early
at
this
point
to
make
a
definitive
judgment.
K
G
Terms
of
an
evidence-based
judgment,
but
I
think
it
would
be
worth
just
sharing
a
few
of
the
things
that
we
are
doing
to
look
at
the
way
that
providers
are
responding.
We
use
information
from
providers
to
ensure
that
systems
and
processes
are
in
place
to
ensure
that
the
risks
associated
with
the
current
heat
wave
are
mitigated
and
through
our
inspection
of
the
well-led
domain.
G
We
do
expect
care
providers
to
have
contingency
plans
more
broadly
for
adverse
weather.
Events
of
all
sorts
and
if
we
receive
information
that
suggests
that
the
provider
is
not
taking
reasonable
steps
to
reduce
the
impact
of
the
heat
wave
on
people
who
access
their
service,
we
would
treat
this
in
the
same
way
as
any
other
information
of
concern
and
use
it
to
determine
our
regulatory
response.
G
Accordingly,
the
government
has
provided
guidance
to
health
and
social
care
staff
around
the
support
for
vulnerable
people
during
the
heatwave
and
when
speaking
with
providers,
we'll
continue
to
signpost
them.
To
this.
To
this
guidance,
have
we
we
will
continue
to
inspect
and
monitor
plans
in
place
where
we
believe
that
there's
a
significant
risk
and
we
ensure
that
we
share
guidance
to
with
providers
and
on
the
14th
of
july
we
shared
the
uk
health
security
agency
heatwave
plan
for
england
and
other
guidance,
including
support
for
health
and
care
professionals
and
supporting
people
living
in
care
homes.
G
So
I
hope
you'll
agree
robin
we've.
We
have
we've
been
reasonably
proactive
in
terms
of
sharing
the
guidance
that's
out
there,
but
of
course
he
does
say
a
bit
too
early
to
tell
in
terms
of
exactly
how
how
the
last
couple
of
days
have
gone.
But
of
course
we
will
keep
that
under
review
over
time.
Thanks
ian.