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From YouTube: CQC board meeting – May 2017
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A
Just
ride
good
morning
everybody
and
welcome
to
the
meeting.
It
had
been
my
attention
in
intention,
rather
to
start
the
meeting
by
asking
everybody
to
observe
a
minute's
silence
for
people
who
were
killed
and
injured
and
traumatized
by
the
events
in
Manchester.
But,
as
you
probably
all
now
know,
there
is
a
national
minute's
silence
at
11
o'clock,
so
we
weren't
to
observe
one
now,
but
we
will
Atia
live
in
a
clock.
So
wherever
we
are
in
mid-sentence
at
11
o'clock,
we
will
stop
stand
and
observe
the
minute's
silence.
A
I
think
that
a
bell
or
alarm
of
some
sort
and
the
building
will
probably
release
11.
So
don't
be
surprised
and
it's
not
a
far
alarm.
If
that
happens,
but
if
it
doesn't
I've
got
a
watch,
so
I
will
know
when
it's
11
o'clock,
so
that
was
the
first
bit
of
introduction.
I
wanted
to
say,
and
then
secondly,
by
way
of
introduction,
those
of
you
I
think
would
have
been
made
a
way
that
there's
a
paper
that
wasn't
on
the
original
agenda
for
this
meeting
on
our
digital
strategy.
A
We
will
be
taking
that
in
a
couple
of
minutes
and
as
a
result
of
bringing
this
extra
item
onto
the
agenda,
the
public
session
of
the
board
will
run
on
for
about
another
45
minutes
or
thereabout.
So
it's
a
longer
meeting
anybody
needs
to
go.
That's
understood,
right,
I,
think
that's
what
I
wanted
to
say
by
way
of
introduction.
A
A
Okay,
that's
good.
There
are
two
items
on
our
action
log
that
need
to
come
back
to
the
board,
dates
not
being
fixed
to
do
that.
I
think
we
do
need
to
fix
dates.
Otherwise
they
have.
These
things
have
a
habit
of
dragging
on
telling
what
we
will
do
that
there's
anything
arising.
Anybody
else
wanted
to
raise.
A
Okay,
then,
without
further
ado,
we're
going
to
go
to
the
additional
item
on
the
agenda,
which
is
our
digital
strategy.
Pete
you're
extremely
welcome
I
think
you're
going
to
be
a
very
regular
attendee
at
the
board,
and
this
is
a
really
important
part
of
CQC's
strategy.
This
is
quite
complex.
It's
quite
multifaceted.
It's
going
to
be
something
that
will
run
over
a
period
of
time.
A
It
is
something
we
are
going
to
get
right,
I'm,
absolutely
clear
and
determined
and
confident
that
that
will
happen.
I
think
it's
important
to
say
that
it's,
it's
not
the
case
that
our
existing
systems
are
about
to
fall
over.
There
is
a
whole
new
way.
We
can
use
digital
technology
to
do
our
job
and
to
do
it
better
and
more
efficiently
and
more
effectively.
That's
what
this
is
all
about.
So
with
that
by
way
of
introduction,
Pete
can
I
hand
over
to.
B
You
please
sure
thank
you,
Peter
and
yes,
absolutely
and
reiterate
that
point
as
well.
So
I
came
to
the
board
in
the
private
session
a
month
ago
to
explain
where
we
were-
and
this
is
an
update
as
to
where
we've
got
to
since
that
point.
So
the
first
few
first
couple
of
months
here
we're
about
understanding
the
landscape,
understand
position,
understanding
the
priorities
for
care.
Quality.
B
Commission
I
think
that
the
critical
part
there
was
making
sure
that
we
retain
the
focus
around
those
items
that
are
going
to
give
the
most
impact
as
early
as
possible,
both
on
the
effectiveness
of
CQC
in
terms
of
its
regulatory
improvement
activities
and
on
the
efficiency
with
which
we
manage
to
do
that.
So
those
were
the
drivers
behind
that
we
went
through
an
exercise
internal
consultation,
to
make
sure
that
we
understood
what
was
most
important
to
the
organization
itself.
B
B
How
do
we
put
some
feet
forward
rapidly
to
start
moving
in
the
right
direction,
to
help
that
transformation
that
will
help
CQC
to
move
forward
and
really
take
a
slightly
different
way
of
achieving
impact
than
a
great
speed
and
great
effect
within
health
and
social
care,
and
in
doing
that,
we
will
continue
that
prioritization
throughout
the
year.
This
is
not
a
one-time
both
map
for
the
next
12-24
months.
This
is
a
where
are
we
starting?
B
That's
most
important
that
we
can
build
from,
and
everything
that
we
do
build
will
be
a
foundation
that
we
can
build
from
not
a
point
solution
and
in
doing
that,
we've
identified
the
first
six
areas,
so
it's
sort
of
three
areas
where
I
was
considering
to
be
more
change
in
a
way
that
we've
chosen
to
do
big
things
in
three
which
are
more
running
the
organization
as
we
go
here
to
get
there.
So
the
first
one
is
around
registration.
B
We
register
the
providers
as
we
need
to
at
the
moment,
but
registration
itself
underpins
quite
a
lot
of
other
activities
that
we
need
to
perform.
Well,
and
in
a
complex
environment
where
we
move
into
new
models
of
care-
and
there
are
different
ways
of
thinking
about
providers,
there's
different
ways
of
understanding
providers,
there's
different
ways
of
managing
the
intelligence
that
Helen
can
talk
about
in
terms
of
how
we
we
get
to
really
understand
what
was
important.
We
need
to
get
that
registration
process
right.
B
We
also
need
to
think
about
it
from
a
from
a
customer
perspective
and
the
people
that
we
register
need
to
be
able
to
register
with
limited
burden
in
a
way
that
is
helpful
to
them,
and
that
is
helpful
not
just
to
us,
but
then
directly
systems
a
whole
novel
out
there
and
they
need
to
be
able
to
do
that
easily
with
with
limited
limited
handoffs
limited
numbers
of
repeat
sort
of
registrations,
make
it
as
simple
as
possible.
So
all
of
those
things
are
really
important.
So
that's
that's
chosen.
B
Is
that
the
first
thing
we
need
to
to
really
look
at
in
the
initial
selections,
it's
worth,
stating
that
we
we
in
addition
to
the
priorities
that
people
expressed.
We
also
looked
at
the
capabilities
that
you
have
at
hand
now,
because
there
are
some
things
that
we
might
really
want
to
do
right
now,
but
we'll
take
a
little
bit
longer
to
get
to
and
it's
something
that
you
can
do
right
now
and
if
we
do
them
right,
they
will
form
the
foundations
of
those
other
things
we
need
to
achieve.
B
So
that's
where
the
information
collection
service,
for
example,
the
second
priority
we're
talking
about
comes
in.
We
are
ready
to
go
now.
We
understand
the
problem.
We
have
the
team
on
the
ground
and
and
that
will
form
the
foundation
of
quite
a
lot
of
other
services
that
we
need
to
put
in
place
so
that
that
came
I
very
strongly
as
well.
We're
then
looking
at
the
enabling
the
information
lead
approach
to
regulation.
So
it's
really
important
to
us.
That's
one
of
our
strategic
priorities
that
we
fully
evidence-based
and
understand.
B
What's
going
on
through
new
ways
of
looking
at
large
large
volumes
of
information
or
specific
types
of
information,
really
using
some
of
the
algorithmics
and
automating
things
as
we
can
and
to
make
that
possible,
we've
got
to
get
the
date
of
the
data
processing,
the
data
handling
all
right
under
the
hood,
so
that's
a
real
key
priority
for
us
as
well.
In
addition
to
that,
we
know
we
have
an
end
of
contract
point
with
our
core
networking
and
desktop
services.
So
we
need
to
do
something
about
that.
B
We're
doing
that
jointly
with
our
alb
partners
in
a
way
that
will
be
beneficial
to
us
and
to
the
rest
of
the
departments
within
the
D
H
family,
then
we're
looking
at
what
we're
calling
stones
in
their
shoes
projects
so
effectively.
While
we're
looking
at
these
three
or
four
big
change
pieces,
what
we
don't
want
to
do
is
ignore
things
that
are
not
quite
what
they
should
be,
but
at
the
same
time
not
expose
ourselves
to
not
really
prioritizing
and
doing
other
ten
things
as
well.
B
So
this
is
very
much
a
constrained
program
of
work
where
things
that
frustrate
employees
on
a
regular
basis
or
frustrate
those
we
work
with
on
a
regular
basis
that
are
relatively
easy
to
solve,
have
an
active
focus,
active
management
and
are
directly
addressed
as
fast
as
we
can.
So
that's
the
stream
of
work
in
the
social
issues
and
the
last
piece
is
everything
else,
becomes
a
business
as
usual
and
with
a
really
clear
assessment
that
we
are
reviewing
that
carefully
to
understand.
B
Is
it
really
business
as
usual,
or
is
it
a
lot
of
small
change
that
was
unnecessary
and
really
constraining
that
pipeline,
so
that
we
can
use
that
to
free
the
space?
That's
required
to
deliver
the
other
objectives
in
doing
that
within
looking
at?
What's
coming
next
there's
a
few
things,
so
there
are
some
some
pieces
that
we
should
be
able
to
deliver
ahead
of
the
the
change
to
our
core
IP
contract
around
the
right
devices.
A
C
We
read
anything
there
in
selecting
what
we
we've
chosen
to
do
so,
for
instance,
if
you
are
in
a
big
utility
with
a
big
billing
system,
that's
a
really
high
risk
thing
to
do
so.
You
can't
forget
that
how
you
do
that,
whereas
an
email
processing,
a
pretty
standard
thing
where
she
can
bring
it
there
or
developing
website,
but
have
we
taken
valent.
B
That's
we
have
something
gender
cells.
We
definitely
have
to
take
that
into
account,
particularly
in
this
initial
phase.
It's
a
little
bit
implicit
in
the
paper.
So
there
is
a
table
in
here
with
speed
to
mobilize
and
speed
to
mobilize
has
within
it
a
degree
of
that
complexity,
but
thinking
about
some
of
the
things
that
we've
actively
not
prioritized
that
were
on
the
agenda
earlier,
so,
for
example,
enterprise
content
management,
looking
at
a
whole
records
management
and
replacement
for
CRM
type
processes.
B
That
is
an
operational
transactional
system
within
the
organizations
that
can't
that
cannot
go
wrong
on
a
daily
basis,
and
that's
so
that's
not
where
we're
going
to
start
because
part
of
what
we're
doing
here
is
looking
at
new
ways
of
working
bringing
in
agile
methods
of
delivery,
and
we
can't
have
systems
being
developed
in
core
systems
being
developed.
Well,
people
are
learning
how
things
differently,
so
that's
been
actively
chosen
to
not
be
the
first
thing.
At
the
same
time,
if
you
look
at
the
report,
writing
partly
why
we
deferred
it
is.
B
It
requires
us
to
collect
information
effectively
and
to
store
information
effectively
about
providers
as
they
are
registered
appropriately
and
those
both
alone.
The
first
project
we
talked
about
so
trying
to
do
that
at
the
same
time,
would
be
a
poor
way
of
trying
to
answer
that
question
all
to
make
sure
we're
getting
capability
to
write.
We've
considered
a
lot
of
this
from
the
standpoint
of
capabilities
and
outcomes
rather
than
systems,
so
I
think
historically,
CQC
is
considers
to
talked
about
technology
in
terms
of
systems
CRM,
the
Y
Drive,
the
various
the
ESB
was
actually
we're.
B
Looking
at
here
is:
what's
the
outcome
for
the
people
who
are
using
it
both
inside
and
outside
of
the
organization,
and
what
are
the
core
capabilities,
such
as
search
taxonomy?
You
would
need
to
under
get
any
of
those
systems,
so
we
focus
from
that
angle
and
we
know
which
of
those
sit
right
at
the
bottom
of
the
Foundation's,
particularly
the
data
management
space,
and
that's
what
addressing
things
first
and
we're
doing
that
there
in
a
way
that
exposes
them
to
test
them
in
a
simple
way.
E
Thank
you
I,
like
this
very
much
lots
of
energy
lots
of
common
sense,
really
user
led
welcome
service.
It's
not
a
list
and
I
was
just
wondering
I'm
assuming
the
next
document.
The
next
iteration
will
start
to
give
a
lot
of
organizational
strategic,
local
laws
or
framework
of
what
we're
trying
to
do
at
honest.
I'd
also
start
with
ax.
It
might
cipher.
Whole
thing
is
obviously
dashing
around
talking
to
the
other
find
out
what
they
really
want,
but
presumably
we're
going
to
end
up
with
a
loss
of
board
level
document.
We
go.
Oh
yes,
sir.
B
We
can
certainly
look
at
presenting
with
network
if
that's
how
you
would
like
to
see
absolutely
what
we're
looking
at
next
really
is
saying
now
that
we
have
six
core
work
screen.
Ders
is
organizing
everything
we
do
into
those
six
core
work
streams,
so
that
we
understand
the
detail
of
what
really
needs
to
be
done
in
those
areas.
We
can
explain
why
those
six
core
work
streams
collectively
meet
the
strategic
objectives.
B
If
that's
the
piece,
that's
missing
on
top
that
work
was
was
definitely
done
in
defining
the
the
16
core
objectives
that
we
were
looking
to
to
deliver
as
an
organization
before
we
went
through
the
prioritization.
So
if
there's
a
piece
missing
in
the
presentational
puzzle
very
happy
to
fill
that
out,.
F
Sure
it's
crystal
at
least
two
aspects
on
on
this
paper:
one's
more
of
a
technical
change
which
your
team
can
can
manage
salient
internally
and
independently,
the
other
one's,
a
sort
of
business
change,
where
your
team
needs
to
collaborate
with
other
units
across
from
inspectorate's
to
operational
staff,
and-
and
we
know
that
you
know,
projects
is
difficult
when
decisions
are
made
later
and
later
and
later.
So,
if
you've
made
a
decision,
then
you've
developed
it
and
then
you're
testing
it.
F
And
then
you
have
to
rework
that
have
you
got
the
right
sponsorship
and
the
right
business
partnership
to
allow
to
make
those
decisions
or
very
senior
level
decisions
cloud
ops,
or
is
that
something
you
have
to
build
into
your
your
your
thinking?
The
whole
resource
model,
not
the
technology
resource,
but
these
across
the
the.
B
Whole
organization,
very,
very
good,
pointer,
absolutely
agreed
this
there's
a
couple
of
pieces
to
that.
So
it's
something
that
we've
discussed
very
openly
very
actively
with
et
those
are
the
highest
level.
Sponsorship
is
in
agreement
that
that
is
something
we
have
to
achieve,
and
we've
had
that
very
open
conversations
in
the
term
achieve
that
it
will
be
about
when
we
actually
deliver
the
first
things
which
the
first
one
starts
next
week
about
how
that
happens
at
the
mid
level
of
the
organization.
B
Helen
I
was
speaking
about
this
just
this
morning
about
how
we
make
sure
that
first
project
is
kicked
off
in
exactly
the
right
way
and
part
of
the
approach
to
this
is
to
looking
at.
How
do
we
do
this
specifically
for
a
couple
of
key
projects?
First,
rather
than
how
do
we
try
to
educate
everybody
across
the
organization?
Its
do
two
things
really
well
and
then
have
others
Shadow
and
learn
a
mentor
and
build
from
there
and
grow,
because
I
think
that's
the
only
way
to
embed
it
in
the
organization
with
evening
as.
H
So
I
think
from
an
operational
strategic
point
of
view,
we're
absolutely
aligned
with
Pete's
objectives
there,
because
they're
supporting
ours
as
well,
which
I
think
speaks
to
James
point
about.
How
does
this
fit
in
with
the
overarching
strategic
objectives
that
we
all
agreed?
Last
last
year
and
I
think
it
actually
does,
but
clearly
the
proof
of
the
pudding
is
always
in
the
eating
and
that
point
about
evaluating
as
we're
going
along
making
sure
that
we're
learning
so
that
what
we
do
in
the
first
few
projects
that
we
prioritize
we
use
so
that
we
can
improve.
C
B
But
if
you
look
as
an
agile
approach,
it's
much
more
about
testing
the
hard
things.
First,
always
do
the
thing.
That's
most
difficult
in
the
project
in
the
first
few
weeks.
Don't
do
the
things
that
look,
nice
and
shiny
and
then
wait
for
the
hard
part
at
the
end,
so
absolutely
test
those
get
the
rigor
and
from
that
you
can
get
a
much
better
estimation
on
what
to
do
next,
and
at
that
point
you
can
go
back
to
say
having
done
the
first
bit
of
work,
we
now
think
the
real
answer
is
more
like
X.
A
B
Ate
I
think
the
the
extra
piece
is
saying
that
why
we
should
have
those
additional
Gator
processes
inside
the
organization.
We
need
to
be
careful
that
we
don't
go
around
in
the
entire
loop
of
seven
or
so
approval
gates
each
time.
We
then
make
a
small
step
from
one
part
of
the
project
to
the
next,
so
we
need
an
overarching
level
commitment
in
terminal
gates
and
then
an
ability
to
to
cool
off
into
things.
If
that's
the
right
answer,
but.
C
I
think
you
just
just
say
that
a
CGC
did
look
of
talking
about
this.
We
all
remembers,
we
we
understand.
They
know
some
of
our
governance
processes
will
be
fine
in
relation
to
what
we
was
talking
about.
Some
of
them
will
not
be
quite
as
agile
enough
in
their
own
right
to
to
to
cover
what
Peters
trying
to
do
here.
The
vastus.
D
C
I
Surface
Oh,
forgive
me
a
bit
already
in
the
paper
in
a
paragraph
that
I've
already
read
and
not
totally
understood,
but
that
selecting
of
it
does
feel
a
little
bit
as
if
this
is
the
organization
looking
at
itself
and
deciding
what
it
it
needs.
And
but
this
is
a
public
organization
serving
the
public
and
overseeing
the
work
of
hundreds
of
thousands
understand.
I
So
I
just
want
to
make
sure
that
we've
got
that
part
right
and
the
priority
setting
has
reflected
that
wide
public
role
and
I
mean
it's
hard
to
be
against
top
priority,
to
develop,
cost-effective,
responsive
and
intelligence-led
registration
and
in
favor
of
all
of
those
adjectives
at
all
times.
But.
I
And
it
may
not
be
your
paper,
but
it
might
just
be
an
accompanying
discussion
and
I
just
want
to
make
sure
that
I've
understood
what
will
be
better
and
annulled.
What
would
better
staff
will
be
better
patients
and
have
we
as
a
board,
properly
discharged
our
responsibilities
to
influence
the
work
by
reflecting
the
priorities
that
we
interact?
Okay,.
A
Can
I,
just
before
you
give
a
your
part
of
the
answer,
just
come
back
to
how
we
got
here.
I
mean
this
comes
out
of
the
strategy.
The
strategy
comes
out
of
a
huge
amount
of
consultation
with
both
users
and
providers,
as
well
as
internal
debate,
so
I
think
the
top
line.
Those
do
we
know
this
is
what
is
needed.
I
I
would
say
yes
from
the
work
that
we
all
do
dead,
then
I
will
hand
over
to
Pete
as
to
how
his
paper
then
picks
up
on
on
that
sort
of
top
level.
B
Yeah
because
I
think
it's
a
sound
which
type
model
and
we're
in
the
middle
of
a
jam
at
the
middle,
and
so
at
the
moment
they
tell
you
really
to
sit
there
that
we're
working
towards
objectives
that
were
already
set
for
the
strategic
context
for
the
organization
as
a
whole,
and
this
is
how
we'll
deliver
some
of
those
in
the
right
order
to
get
them
done.
Then,
there's
a
piece
below
that
in
terms
of
the
implementation
model
for
doing
this
and
that's
very
much
about
a
user
centric
design
model.
B
B
I
Helped
the
specific
had
all
the
discussion,
then
it'd
be
even
easier
to
say
what
we
design
it
and
so
I
would
welcome
that,
and
it's
an
when
you
can
last
the
border
I
found
a
very
helpful
discussion
about
deciding
not
not
just
talking
about
the
enormous
technical
potential
design
up
there,
but
understanding
what
it
might.
What
are
the
things
that
need
to
be
better
and
trying
to
live
in
on
that
foot?
That
was
very
helpful
way
of
looking
at
it
and
I
suppose
what
I'm
saying
is
just
being
a
little
bit
clearer
about
that.
J
And
so
Paige,
more
Lewis
and
the
second
number
road
number
two
it
dis
speaks
your
points.
I
think
if
I've
understood
it,
I
think
it
does
is
about
how
the
work
that
Peters
outlined
will
help
those
people
and
share
their
experiences
about
care
and
services
that
they've
received
can
come
through
to
us
and
then
how
we
can
analyze
and
process
that
in
a
much
more
effective
way
than
we
do
hitherto,
because
what
we've
got
are
over.
J
Thirty
thousand
text-based
comments
back
about
services
which,
at
the
minute
to
being
manually,
searched
and
made
sense
of,
and
what
this
is
doing
is
giving
us
the
platforms
on
which
some
of
this
software
that
we
bought
in
Decker
can
do
some
of
this
literally
minutes
so
I
think
that's
the
outcome
from
that
work
will
be
a
significant
improvement
in
the
way
we
compared.
We
see
text,
there's
feedback
from
people
who
are
using
services
about
their
experience
of
services.
J
So
it's
not
just
that
will
receive
it,
but
will
be
a
to
analyze
it
and
process
it
in
a
way
which
is
we've
not
hitherto
been
able
to
do
because
it's.
You
know
this
from
your
research,
because
we've
got
people
going
through
manuals
manually,
going
through
tax
based
material,
which
is
pretty
tricky
quite
frankly,
so
I
think
there
are
some
very
specifics
in
here
which
will
help
the
point
that
I
think
you're,
making
and
I
think
to
Peter's
point.
J
This
is
about
how
we
take
a
big
strategy
and
start
practicing
certain
things
that
we
know
we
can
actually
make
work,
so
I
think
the
danger
is
receive.
This
has
been
the
definitive
prioritization
exercises,
of
course.
So
these
are
the
priorities
we're
going
to
begin
on
and
as
we
gain
confidence
and
experience
in
doing
this,
we'll
mature
this
as
we
go
forward
so
and
I
say
I'm
delighted
with
the
progress
we've
made
here
and
that's
not
because,
but
it's
not
exclusive.
J
J
You
know
we
we
didn't,
spend
some
capital
money
last
year
and
one
of
the
reasons
well
I,
don't
think
that
was
a
problem,
because
we
didn't
have
a
clarity
about
the
priorities
that
we
need
to
invest
on,
and
what
this
is
doing
is
helping
us
to
get
to
that
clarity
about
the
priorities
so
and
it's
the
very
last
paragraph
in
this
report
outlines
the
next
steps
are
bringing
back
two
of
the
executive
team
and
the
board
some
of
the
detail
about
the
approved
cases,
etc.
So
you
do
have
a
sense
of
momentum
now.
J
F
How
do
we
know
what
we're
doing
here?
Some
of
it
won't
be
fit
for
purpose
going
because,
but
how
do
we
know
we're
not
doing
another
big
program
in
two
three
years
time?
Are
you
building
it
in
such
a
way
and
it's
a
difficult
question,
but
it's
a
building
in
such
a
way
that
allows
us
to
bring
in
new
technologies
quite
easily
as
you've
built
your
atom
talk
about
architecture
in
here
and
so
rebuilding
a
digital
strategy,
as
well
as
helping
the
strategy
of
the
CQC
I.
B
The
text-based
answers,
as
were
the
specific
numerical
answers,
so
we're
considering
those
concepts
as
separated
concerns
at
the
beginning.
So
it's
very
separations
concerns
model
from
the
outset.
I
think
we
are
working
from
a
baseline
where
we're
only
putting
in
some
of
those
that
they're
not
particularly
advanced
answers
in
terms
of
AI
and
some
of
those
pieces.
We
need
to
get
to
that.
B
But
I
think
that
some
foundations
we
need
to
get
right
before
we
consider
those,
but
they
certainly
would
appear
on
a
roadmap
prospectively
we're
taking
away
monolithic
services
such
as
the
lower
CRM
system
and
building
opponent
services,
will
work
together
and
can
easily
be
swapped
in
and
out
as
needed.
So
that's
the
part.
It's
also
worth
noting
that
this
is
the
model
of
what's
happening
inside
CQC
and
also
have
role
HSI
and
have
a
role
in
the
national
information
board
and
we're
looking
at
these
across
the
systems.
A
K
I
think
I
can
add
to
what
Peter
just
said
in
terms
of
the
solution
that
we
put
in
place
will
not
prevent
us
or
restrict
us
in
any
ways
and
things
we
want
to
in
the
future
the
guide
to
data
science
and
AI
and
loads
of
things.
The
team
at
the
moment
are
in
the
process
of
creating
with
a
design
strategy.
A
Great,
so
I
couldn't
be
clearer
in
my
own
mind.
What
we're
trying
to
achieve
here
and
I
think
I'm
gonna
first
of
all
now,
but
it
does
get
back
to
the
strategy.
There
are
huge
benefits
for
people
who
use
services
and
been
able
to
communicate
with
us
more
effectively
and
to
be
able
to
access
our
data
much
more
effectively.
A
If
you
like
will
be
our
staff,
we
know
from
the
staff
survey
that
at
the
moment
there's
a
lot
of
pressure
on
them
to
be
able
to
do
what
they
task
to
do
and
our
systems
don't
always
support
them
as
well
as
they
they
should
or
could
so
that
will
be
the
third
big
benefit
at
the
end
of
this
process
and
the
fourth
one
is
our
own
efficiency.
We
just
won't
be
able
to
do
our
programs
on
a
reduced
budget,
and
this
we
have
this
supporter.
So
those
are
the
four
really
big
strands.
A
If
you
like
that,
I
think
we
were
trying
to
achieve
border
made
some
comments
on
governance,
David
and
I
funny
enough.
What
we're
talking
about
this
night
before
last
and
I
think
we
have
the
main
planks
of
governance
in
place
already
and
I
would
add
the
Finance
Committee
to
your
concerns
about
about
finance.
We've
got
the
audit
community,
but
I
absolutely
take
the
point,
and
it
was
what
David
and
I
were
talking
about.
A
A
But
that's
that's
what
we
will
do
and
I
think
people
your
committee
to
come
back
to
the
next
meeting
with
a
slightly
differ
is
a
look
very
different
paper
and
to
be
much
more
into
there.
This
is
what
we're
doing
at
the
moment,
and
this
is
what
we
expect
to
deliver
by
by
wind.
So
we
will
have
a
have
a
sort
of
steps
program
in
there.
So
I
think
this
is
hugely
hugely
important
and
hugely
exciting,
and
it's
anybody's
read
anything
I
would
just
say:
I,
don't
want
to
keep
you
from
getting
on
with
this.
A
So
thank
you
both
very
much
indeed
for
for
coming
today.
Thank
you
very
much
for
what
you're
doing
and
thanks
to
everybody,
does
not
in
the
room.
That's
supporting
you
both
on
the
technology
side,
but
it
has
been
said
many
times.
This
isn't
just
about
the
technology,
it's
actually
about
how
we
work
and
all
that
goes
behind
that.
So
thank
you.
Thank
you
great
good
thanks.
J
Thank
you
Peter,
so
I'm
not
going
to
present
any
performance
information
here,
because
that's
all
in
a
course
report
performance
report,
which
I
think
it's
probably
the
next
agenda.
Item
so
beginning
on.
The
second
page
numbered
item
5,
where
we've
looked
at
the
issues
around
cybersecurity
effectively.
J
What
this
is
doing,
Peter
is
just
providing
an
update
to
colleagues
on
the
board
about
the
ransomware
attack
on
the
12th
of
May
and
the
work
that
CQC
undertook
both
in
terms
of
our
own
systems,
which
are
stable
and
the
work
necessary
was
required
to
be
undertaken
had
indeed
been
undertaken.
So
we
are
a
steward
of
the
stability
of
our
own
IT
systems,
but
we
also
did
work
with
the
widest
system
and
communicated
with
them
about
some
of
the
issues
in
a
supportive
way.
J
One
of
the
key
issues
from
the
report
that
we
published
last
July
set
there
to
safe
care.
Where
we
made
six
recommendations
was
the
recommendation
we
effectively
made
to
ourselves
about
building
into
our
assessment
that
framework
and
inspection
approach
assurance
that
the
appropriate
internal,
external
validation
against
the
new
data
standards
was
being
carried
out
as
we
undertake
our
inspections
and
that
our
inspectors
were
trained
in
that
and,
as
the
paragraphs
set
out,
that
work
has
continued
and
work
on.
Those
standards
has
continued
over
the
period
since
last
summer
and
our
plan.
J
J
We've
now
signed
memorandum
of
understanding
with
defence
medical
services.
Indeed,
I
did
that
with
a
Surgeon
General.
Only
yesterday,
where
we
carry
out
using
our
current
instructional
methodologies,
inspections
of
the
primary
medical
services
and
dental
facilities,
but
also
some
of
their
community
mental
health
and
rehabilitation
facilities
that
work
has
begun.
I
think
about
nine
inspections
have
continued
and
we're
doing
this
under
a
service
level.
Agreement
between
ourselves
and
defence,
military
services
and
I
would
like
to
commend
Steve's
team
and
the
work
that
he's
done.
J
Ruth
Rankin
in
particular,
and
Gary
Higgins,
who
I
think
have
done
some
fabulous
work
here
and
I
have
to
say
the
senior
military
clinicians
were
very,
very
happy
with
the
arrangements
they
put
in
place
as
well.
So
the
2008
Act
allows
for
us
to
help
a
provide,
providing
advice
and
assistance
to
all
the
public
authorities,
and
that,
indeed,
is
what
we're
doing
through
this
contract.
So
I
think
what
this
will
allow.
J
The
military
defense
services
benchmark
quality
of
their
services
against
of
the
NHS
services
to
ensure
that
their
personnel
are
getting
access
to
a
standard
of
health
care
which
compares
to
to
others,
and
they
are
keen
to
use
that
benchmark
in
their
internal
discussions
about
how
they
can
take
forward
the
development
of
their
services.
And
then
the
last
item.
J
Peter
and
colleagues
is
just
to
draw
attention
to
something
that
we
don't
often
do
in.
Our
board
meetings.
But
we
felt
was
important
to
do
is
just
draw
the
board's
attention
to
the
recognize,
an
outstanding
contribution
award
scheme
that
we
launched
also
last
spring,
where
this
is
a
mechanism
that
we're
using
for
staff
within
the
organization
to
nominate
their
colleagues
or
a
team
of
their
colleagues,
so
that
the
work
could
be
recognized
because
they've
made
some
particular
and
special
contribution
to
the
work
of
the
organization
and
their
teams.
J
And,
as
you
can
see
from
a
page,
four
there's
a
variety
of
different
awards
and
adult
social
care,
individual
award,
Hospital
teams,
award,
etc
and
as
I
wandered
through
Victoria.
The
other
day
you
could
see
people
returning
from
the
booking
and
palace
garden.
Parties
Theory,
the
dressed
in
military
uniforms,
are
in
their
finery,
and
one
of
the
decisions
that
was
taken
was
that
the
tickets
that
were
sent
for
the
garden
party
two
of
those
tickets
should
be
made
available
for
the
winner,
just
as
a
way
of
providing
a
special
celebration.
J
I,
don't
think
everybody
would
necessarily
value
a
trip
to
the
palace,
but
I
think
the
vast
majority
of
our
staff
would
and
I
think
it's
a
very
special
way
of
celebrating
their
achievements
and
doing
something
which
many
of
us
wouldn't
get
the
chance
to
do.
Otherwise,
so
and
again,
I
think
that's
part
of
just
building
a
culture
of
recognizing
and
acknowledging
the
contribution
that
our
staff
make
honor
on
a
daily
basis.
And
so
that's
a
report.
Pacifically.
Thank
you.
So
before
we
go
on
to
the
performance.
L
G
I
It
was
a
heroic
effort
by
the
NHS
in
response
to
this
incident
and
the
Instagram
I
think
the
staff
and
EHS
don't
think
of
these
things
as
heroic
because
they
genuinely
do
so.
If
you
talk
to
people,
this
is
just
people
doing
their
job
and
that's
not
false
modesty.
I
think
people
just
do
think
that
way,
and
yet
here
is
a
real
test
of
the
NHS
testing
it
to
the
limits
and
it
got
through
because
of
things
which
are
very
difficult
to
measure
it
got
through
because
of
clinical
skill,
but
also
people's
dedication.
I
Because
of
morale,
those
things
which
must
so
much
to
performance
and
to
the
care
that
people
get
and
there's
no
doubt
that
the
NHS
in
Manchester
will
have
saved
people's
lives.
It
will
have
improved
damaged
lives
for
years
to
come
and
I
just
think
it's
very
important.
But
when
we
assess
the
NHS,
we
remember
those
qualities
which
we
can't
always
easily
reflect,
but
actually
are
crucial
to
people's
care
and
the
performance
of
the
staff
and
I
do
have
a
more
mundane
question
at
the
end
of
this.
I
But
it
also
has
a
Manchester
connection,
which
is
some
it's
about
substance
misuse
services
because
and
there's
been
quite
an
important
concern,
growing
across
health
care
about
the
state
of
substance,
massif
services,
and
this
came
to
a
head.
A
couple
of
weeks
ago,
you
may
have
seen
a
major
provider
in
Manchester
collapsed
and
I.
I
Don't
expect
to
comment
on
that
particular
provider,
but
it
did
feed
into
a
broader
concern
about
the
skills
of
substance
misuse
such
as
the
ability
to
manage
risk,
as
well
as
in
this
case
aspects
of
financial
management,
and
there
is
there's
a
lot
of
concern
about
the
viability
and
the
suitability
and
the
relationship
with
the
NHS
in
these
services
and
and
I.
Don't
think
we
don't
you
kind
of
comprehensive
discussion
about
this
now,
but
because
of
the
nature
of
these
services,
they're,
often
quite
marginal
to
almost
everything
I.
I
Just
wonder
whether
we
could
come
back
to
it
at
a
certain
point
and
have
a
proper
discussion
about
about
that.
This
is
the
of
a
care
system
which,
for
various
reasons,
isn't
mainstream
here,
and
it's
touch
ties
with
Paul
Elliot's
presentation
not
very
long
ago,
but
but
we
never
quite
get
to
grips
with
what
we
are
doing,
an
update
on
what
we
are
doing
to
try
and
improve
care.
A
M
That's
a
very
brief
comment
on
on
the
Manchester
and
the
events
of
this
week
and
David
and
I
and
others
made
very
sure.
First
of
all
that
DC
QC
was
not
doing
any
inspections
that
will
get
in
the
way
of
people
doing
heroic
tasks,
as
you
described
to
that.
Fortunately,
we
weren't
scheduled
to
be
doing
any
of
that
week
so
with
that
was
okay.
We've
also
kept
very
closely
in
touch
with
colleagues
as
an
HS
improvement
on
the
actual
situation
in
those
those
hospitals.
M
So
I
think
we've
that
caused
that
one
in
terms
of
substance
misuse
services
that
you'll
remember
that
Paul
Elliott
has
flagged
this
already.
When
we
did
a
number
of
the
early
inspections.
We
found
considerable
problems,
particularly
with
the
medical
oversight
of
detoxification,
and
on
the
basis
of
that,
we
actually
wrote
out
to
all
providers
of
substance
misuse
services
expressing
our
concerns
in
order
that
they
could
put
things
right
before
we
came
to
inspect,
and
so
we
are
now
doing
the
full
round
you
will.
A
A
D
J
So
you've
got
my
dulcet
tones
a
little
longer
and
I've
read
any
difficult
questions.
I'll
pass
off
to
my
colleagues,
but
just
on,
if
I
just
may
say
one
thing
about
Manchester
Peter.
This
has
been
very
close
to
home.
We
had
a
member
of
staff
that
was
at
the
concert
with
a
nice,
and
we
also
had
a
member
of
staff
who
had
a
son
at
the
concerts
as
well,
and
what
he's
quite
noticeable
really
speaks.
J
Much
of
the
organization
he's
just
a
sport
and
the
help
that
they've
been
given
and
that
they're
back
knowledge
as
well.
So
my
ex
point,
we
didn't
just
think
about
what
it
was
that
we
needed
to
do
in
relation
to
our
activity.
My
I
think
Steve
King.
Would
you
to
do
a
GP
inspection
in
central
Manchester
that
got
deferred
because
of
the
issues
of
people?
You
know,
understandably,
on
higher
priorities,
but
I
think
our
teams
have
been
fantastically
supportive
to
colleagues.
J
We've
been
impacted
on
this
in
quite
dramatic
way,
so
this
isn't
just
something
that's
happening
out
there.
It's
happening
in
here
and
I've.
Had
the
poem
sang
to
me
that
was
read
out
at
the
vigil
by
members
of
our
Manchester
staff,
who
thought
it
was
a
celebration
of
the
spirit
of
the
city
that
they're
living
as
well
Lewis
as
well,
so
and
I'm
sure
you
speak
for
other
of
our
colleagues
that
live
in
the
northwest
of
England
who
are
similar
feelings
and
but
on
to
performance
and
I
want
to.
J
So
it
was
an
ambitious
programme,
but
also
the
progress
we've
made
on
delivering
on
the
business
plan
and
I
think
doing
that
within
the
financial
envelope.
That
we've
sat
where
I
think
we've
demonstrated
with
burn
both
more
productive
and
more
efficient
in
the
way
that
we've
used
resources.
And
we
will
look
at
those
issues
which
we've
not
made
as
much
progress.
J
On
but
I
don't
think
they
should
diminish
from
what
has
been
a
year
of
quite
considerable
achievement
by
our
staff
and
I'd
like
to
invite
the
board
to
just
join
in
some
celebration
of
those
achievements
and
we'll
set
this
out
more
fully
in
our
annual
report,
which
will
go
to
Parliament.
But
I
do
think
it's
very,
very
important
to
to
highlight
what
we've
achieved
in
this
year.
J
So
paragraph
three
of
this
report
is
really
setting
out
the
high-level
summary
of
what
we've
managed
to
achieve
across
all
three
inspection
directorates,
but
also
in
terms
of
our
progress
in
registering
new
services
which
have
come
forward
where
I
think
there's
being
some
KY
impressive
improvement
by
registration
colleagues.
But
equally
we've
not
done
this.
By
focusing
just
on
the
acts
of
inspection,
we
have
increased
the
amount
of
enforcement
action
we've
taken.
Parliament
gave
us
powers
to
take
action
where
we
find
poor
care
and
I.
J
Think
Parliament's
and
public
would
expect
us
to
use
those
powers
and
I
think
that's
what
we're
demonstrating
in
here
I
think
this
is
part
of
us
becoming
an
effective,
incredible
regulator
in
terms
of
the
work
that
we
undertake
of
challenging
care,
which
is
unacceptable
and
poor,
where
we
find
it
I
think
the
good
news
is,
we
have
a
duty
to
encourage
improvement
in
services
and
I.
Think
the
evidence
is
that,
where
we
go
back
and
we
inspect,
there
is
evidence
of
significant
improvement
taking
place.
J
Add
to
our
numbers
from
people
who
want
to
come
and
work
with
us
and
join
us
in
our
responsibilities
of
assuring
the
course
of
care.
We
do
ask
people
that
we
regulate.
How
was
it
for
you?
Did
you
find
the
process
help
you
improve?
Did
you
find
our
staff
knowledgeable
about
the
functions
that
they
were
inspecting
and
again
we
draw
attention
in
the
report
to
the
feedback
which
again
helps
us
to
improve
what
we
do,
but
also
gives
us
some
quite
positive
feedback
on
what
we've
each
we've
under
spent
our
budgets
at
four.
J
Sixteen
seventeen
by
just
over
14
million
pounds
and
I,
think
that's
a
positive
issue,
but
the
key
issue
here
is
because
people
would
say
well,
we've
all
under
spent
our
budget,
but
we
have
got
ourselves
to
a
position
where
we're
beginning
to
actively
manage
our
budgets
and
we
find
ourselves
in
a
position
not
by
accident
but
by
design
and
by
active
management.
There
are.
J
I'm
not
going
to
go
into
the
very
fine
detail
Peter
if
I
hold
it
there,
there's
a
very,
very
dense
and
rich
set
of
slides,
which
goes
into
these
I.
Don't
want
to
look
the
issues
about
that
which
we
need
to
continue
to
improve
on
so
the
productivity
of
our
reporting
I
think
there
is
improvement,
that's
taken
place
month
on
month
throughout
the
year.
J
In
relation
to
that
that
we
still
need
to
advance
the
work
that
we're
doing
second
opinion:
doctors,
we're
not
performing
to
the
level
that
we've
set
for
ourselves
that
we
know
we
need
to
perform
to,
and
there
are
programs
of
working
respects
of
these
issues.
So
I
do
want
to
acknowledge
that
there
is
more
that
we
can
do,
but
I
think
we
should
draw
some
satisfaction
whilst
remaining
humble
about
what
we've
managed
to
achieve
and
more
to
do
so
far.
I
find
leave
it
there.
J
A
M
So
what
we
are
doing
about
it
is
to
make
the
recruitment
more
attractive
by
increasing
the
pay,
and
we
will
introduce
a
differential
so
that
there
will
be
more
for
doing
the
more
ochen
ones
and
those
in
the
parts
of
the
country
where
we
find
it
most
difficult
to
recruit.
Thank
you,
Mike
Lu
students.
If.
I
I
But
I
want
to
pick
up
the
something
which
actually
were
talking
about
earlier
in
the
prime
portions,
about
the
importance
of
driving
improvement,
because
it's
it's
quite
an
interesting
story
that
it
tells
I
think
if
you
look
at
different
parts
of
the
data-
and
this
of
course
is
I-
think
it's
going
to
become
our.
You
know
what
almost
our
main
mission
to
not
just
reflect
the
quality
of
services,
but
to
help
encourage
improvement.
And
if
you
it's,
you
have
to
sort
of
link
some
of
these
and
sides
together.
I
That's
915
and
that's
the
purple
box
there,
the
care
costs
are
overall
ratings
and
some
will
certainly
improve,
but
and
onry
inspection
22%
is
feel
inadequate
of
those
that
are
requires
improvement
about
half
of
them
do
improve
and
but
the
other
half
don't
and
in
fact
a
small
number
of
them
get
worse.
So
it's
a
familiar
thing:
we've
talked
about
it
before,
but
it
is,
does
encapsulate
the
nature
of
the
problem,
so
they're
saying
yes,
it
was
really
helpful
to
hear
what
you
said
about
us.
I
We
understood
what
we
needed
to
do,
but
actually
half
of
the
organization's
are
they're,
not
improving,
and
then,
when
you
get
to
a
slide
forty,
which
is
our
strategic
risks
where
this
appears,
as
at
the
top
of
the
list
encouraging
improvement,
we
recognize
that
it
needs
a
red
rating,
but
the
hour
after
mitigation,
I,
suppose
ones.
Considering
what
we're
doing
about
it.
We
downgrade
the
risk
from
red
to
Amber
and
say
that
our
confidence
is
high,
that
we
are
able
to
address
the
issues.
I
That's
the
first
role
of
slide,
14
yep,
so
so
just
putting
those
things
together.
There's
a
response
in
the
field
which
is
yes,
we've
understood
what
you're
trying
to
tell
us
there's
a
partial
effect
as
far
as
we
find
when
we
go
back
and
but
we're
quite
confident
in
a
way
we're
recognizing
the
risk
but
and
reporting
confidence
that
this
will
this
situational
improve
Manish,
wonder
what
given
that
the
picture
is
quite
a
mixed
one.
Why
we're
so
I
we're
as
confident
as
that.
J
I
saw
the
way,
I'd
answer,
that
I
think
this
goes
to
the
heart
of
where
we
are
in
terms
of
our
development
and
maturity.
So
I
don't
want
to
make
any
big
claims
about
this
Luis
but
I.
You
know
people
say
this
to
us
we're
on
a
journey
and
we
are
so
the
fact
that
you
can
answer
that
question.
You
could
not
have
asked
that
question
12
months
ago.
You
certainly
could
have
a
stick
24
months
ago.
You
would
have
got
it
yeah.
J
A
precision
you
would
have
asked
I
wonder
what,
if
we
can
now
do
this
on
data
that
we
generated
and,
quite
frankly,
I
do
have
some
confidence
in
the
data
that
we've
got
in
front
of
us
to
allow
us
to
do
this.
I
think
this
goes
to
the
heart
of
the
issue,
about
our
role
and
how
do
we
know
we're
discharging
our
role
and
how
do
we
know
were
being
affected,
but
also
you
know,
improvement
isn't
downs.
Who
was
the
people
that
improve
services
or
the
people
that
works
in
it?
J
You
pay
tribute
to
the
people
that
did
all
that
work
in
Manchester
in
one
of
your
opening
comments,
and
it
is
true:
it's
the
people
that
work
in
services
do
it
so
I'm
not
looking
to
deflect
this
I
think
it's
usually
important
question,
but
I
think
we
are
confident.
We
do
know
that
it
took
med,
we're
what
three
years
to
get
out
of
special
measures
to
improve,
but
they
actually
got
there.
What
did
we
learn
about
that?
We
learnt
that
they
needed
help
and
support
to
get
through
that.
I
Maybe
I
should
ask
the
question
a
slightly
different
way,
which
is
that
we
say
that
we
are
in
the
in
the
middle
of
a
sort
of
natural
experiment
in
a
way,
and
we
will
have
experience
through
the
work
we
do
on
this
question
of
what
it
is
that
helps
some
organisations
improve
and
some
organizations
either
stagnate
or
sink
back
and
the
the
is
to
emphasize
the
importance
of
what
the
next
phase
here
in
understanding
the
crucial
question
of
why
organisations
recover
and
why
they
don't
so.
There's.
A
A
Are
we
confident
that
we
are
encouraging
improvement
and
I
think
you
self
said
there
is
evidence
that
in
many
places
we
are
and
the
fact
it's
not
Universal
doesn't
doesn't
mean
negate
the
point
in
the
strategic
risk
register
also
doesn't
negate
the
point
that
you
made
just
now
that
this
is
really
important
and
we
need
to
continue.
Let
me
bring
in
in
Paul
and
then
then
Mike
yeah.
N
I
think
the
the
journey
and
the
learning
is
our
responsibility
now
and
response
to
what
Lewis
has
said
is
to
is
to
use
this
data
to
encourage
and
I.
Think
in
the
past.
We
have
quite
rightly
said
improvement,
isn't
our
business
and
a
limp
back
I?
Don't
think
we
can
do
that
anymore.
I
think
we
need
to
say,
improvement
is
now
business,
but
come
on
I.
N
Look
at
this
data
and
the
our
job
is
to
produce
that
data
that
we
didn't
have
before,
and
that
this
the
incongruity
between
one
group
standing
still
and
going
back
a
bit
and
another
group
going
forward.
We
now
know
who
they
are
and
we
know
what
they
do,
and
we
therefore
have
a
responsibility,
not
just
publish
that
and
lean
back,
but
to
actually
say
we
now
expect
you
to
take
this
data
seriously
and-
and
that
is
where
we
are
today
and
work
last
year
been
in
a
year's
time.
N
N
M
J
And
I
think
just
to
pick
up
Luis
and
Paul
on
your
point,
so
we
are
planning
to
publish
document
later
in
June,
which
is
less
about
the
data,
but
is
more
about
what
is
it
that
those
trusts
have
got
outstanding
ratings
or
have
improved
their
ratings?
What
is
it
that
they've
done?
What
are
the
essential
characteristics
and
I
think
board?
Members
will
get
an
opportunity
to
look
at
some
of
that
material
later
this
afternoon.
J
Not
not
the
draft
of
the
document
that
some
of
them
I
think
the
purpose
of
that
I
think
he's
trying
to
pick
up
on
what
Paul
was
saying,
which
is
given
that
we're
a
Mike's
team,
because
it
is
about
the
NHS,
is
this
one,
but
I
think
we
need
to
do
this
for
the
other
sectors
as
well.
Given
we've
now
completed
the
comprehensive
rating
program,
what
have
we
learned
about?
What
it
is
that
makes
these
services
outstanding
or
allows
them
to
improve
at
the
rate
that
they
have
so
the
document
is
trying
to
fill
it.
J
Those
issues-
and
perhaps
one
of
things
we
might
need
to
do-
is
support
it
with
some
of
the
statistical
evidence
and
in
the
way
that
you've
asked
a
question.
So
it's
not
just
a
narrative
about
the
stories
that
are
being
told
but
actually
bringing
some
of
the
thing,
but
so
I
think
we
are
trying
to
get
in
the
SERP.
Also
encouraging
in
his
point,
which
is,
we
do
have
a
responsibility
to
say
what
is
it
as
defined
and
characterize
these
organisations,
which
have
been
proved
and
sat
down.
E
You
have
given
what
keep
what
given
the
noise
given
what
got
in
what
we
hear
what
we
hear
at
HealthWatch,
so
I,
just
I
just
put
that
comment
and
I'm
more
surprised
by
how
well
it
does
looking
at
the
CQC's
budget
profile
and
it's
consistent
and
amazing
ability
to
understand
and
I
am
just
looking
at
HealthWatch
ourselves.
We
have
we've
done
a
bit
of
that
ourselves.
What
lessons
have
you
learned?
Okay,
that
give
would
give
the
board
increasing
confidence
that
the
budget
profile
for
the
coming
year
is
going
to
be
more
closely
followed.
D
So
I
think
that
the
lessons
that
we've
learned
from
last
year
is
this
actually
and
that
the
staff
that
we
employ
have
really
taken
on
the
need
to
make
savings
and
they've
understood
the
message
that
we
need
to
get
to
where
we
need
to
fund
the
spending
review
to
below
217
million
by
1920,
and
that
I
should
have
done
that
for
what
the
clear
wasn't
is
the
real
to
Cepeda,
which
is
absolutely
great,
and
what
we've
done
this
year
for
the
setting
the
budget.
We
went
really
back
to
basics.
D
Almost
back
to
is
not
quite
a
zero-based
budget,
but
we
actually
ask
people
what
they
needed
rather
than
using
the
previous
year's
budget
as
the
baseline,
so
those
people
what
they
need
and
would
bill
to
the
budgets
from
that.
So
we
have
more
confidence
that
they
will
actually
spend
to
that
budget
profile
for
this
year
and
we've
also
introduced
a
key
performance
indicator
that
people
shouldn't
valiance
is
needed,
2%
on
help.
Hopefully
Thank
You.
A
H
Just
to
respond
to
James
comment
and
I
think
the
issue
that
we
need
to
remember
is
the
volume
that
we're
dealing
with
here.
So
yes,
we're
saying
that
75%
of
services
are
good.
1%
are
outstanding
and
that's
fantastic.
We
should
be
positive
about
it.
We
should
celebrate
that
and,
as
David
quite
rightly
says,
highlight
those
characteristics
which
we
can
demonstrate
to
others
that
they
need
to
adopt
and
adapt
so
that
they
can
get
to
that
level.
H
But
it's
nearly
5,000
services
that
are
designated
as
requires
improvement,
and
if
you
take
the
most
conservative
estimates
in
terms
of
the
numbers
of
people
who
might
be
using
those
services.
So
let's
just
say
we
times
that
by
30
people,
then
that's
150,000
people,
and
if
you
do
that
on
the
inadequate,
that's
nearly
20,000
people.
H
So
that's
a
headline
in
a
local
newspaper
every
day
and
it
impacts
on
people's
entire
lives
because
either
they're
living
in
an
institution
so
care
home
or
a
residential
home
or
indeed
they're
living
at
home
and
their
entire
life
is
impacted
upon
by
how
the
Damas
only
care
services
being
provided
so
I
think
you're
right
than
the
volume
of
information
that
we
get
about.
Poor
adult
social
care
services
will
be
high
because
we're
impacting
on
a
lot
of
people's
lives.
So
I
think
that
we
have
to
always
remember
that
you
know
we
make
we.
H
You
know
we
we
are
doing
well,
and
the
sector
is
doing
well
very
often,
as
you
can
see
in
the
fact
that
caring
comes
out
as
well
as
it
does.
An
awful
lot
of
that
is
down
to
staff,
doing
a
fantastic
job
by
you
know.
Despite
the
system
not
because
of
the
system-
and
you
we
get
a
lot
of
comments
back,
which
is
that
they
love
the
people
that
are
providing
the
care,
but
it's
the
reliability
of
it
say,
for
example,
in
Dhamma,
so
many
care
an
issue
so
I
think
you
kind
of
seen.
H
A
The
year
in
responding
to
people
who
contacted
the
the
contact
Scimitar
until
we
get
to
March,
and
so
many
things
have
happened
in
March,
and
so
it's
the
two
parts
of
the
question.
What
happens
in
March,
but
probably
more
important
part
of
the
question
is:
is
this
an
ongoing
whatever
it
is
or
are?
We
are
we
back
on
track
and.
E
If
you're
quite
right,
Peter,
there
has
been
a
fall-off
in
essen,
it's
not
something
that
we
take
it
too
lightly.
I.
Think
colleagues
will
remember
that
we
over
12
months
ago
began
a
program
what
we
called
modernization
across
aspects
of
CQC
and
they
included
the
contact
center,
which
is
essentially
the
front
door
of
the
organization.
E
There's
been
a
very
significant
and
continues
to
be
very
significant
program
of
change
there,
so
in
that
final
month
of
the
year
and
into
April,
essentially
them
all
the
staff
and
in
50
were
being
interviewed
for
roles
or
being
assigned
to
roles,
so
very
significant,
churn
and
change
for
them
and
that's
ongoing.
So
we
are
going
to
see
and
I
can
only
apologize
for
it,
but
they've
actually
anticipated
all
directorates
had
communications
about
services
anticipated.
We've
got
ongoing
training
of
staff
into
new
roles,
with
a
view
that
we
are
evermore
professionalizing.
E
The
way
in
which
that
front
door
CQC
is
opened
looking
very
closely
at
performance
and
I
will
be
coming
back
next
month.
I
suspect
the
following
month
to
say
that
we're
not
meeting
our
KPIs,
but
we
do
have
a
program
in
place
to
ensure
we'd
get
back
there
and
actually,
as
we're
getting
back
there.
People
who
contact
us
are
receiving
a
better
service,
I
mean.
A
E
And
gently
show
people
that
we're
not
losing
and
the
people
contact
us
urgently
are
but
they're
not
getting
lost
to
us.
It's
just
the
speed
of
dealing
with
is
being
diminished,
so
I
wouldn't
want
to
give
any
sense
that
we
are
losing
people
in
their
contacts.
They
remain.
Our
primary
focus
really
use
the
speed
of
work,
and
indeed
I
am
in
Newcastle
next
week
for
two
days
to
actually
look
at
the
program
of
getting
things
back
to
KCI
Peter,
okay,.
C
We're
here
quite
rightly,
and
focusing
on
the
time
taken
to
do
something.
What's
not
clear
to
me
and
I
suspect,
I,
don't
know
if
we
measure
it
is
actually
what
the
outcome
is
in
relation
to
the
raising
of
a
concern
or
whistleblowing
report
in
the
sense
of
was
it.
What
was
some
difference?
Was
they
found?
Did
the
raising
of
it
cause
out?
C
We
see
this
all
the
time
actually
in
the
adult
social
care
reports
we
receive
and
what
they
have
done
has
made
a
difference,
and
sometimes
I
worry
that
what
we
tell
that
people
who
do
is
what
you
have
told
us
is
important
to
us
which
I'm,
sorry
Hughes
and
that's
true,
but
what
actually
happens
have
they
made
a
difference
is,
and
how
do
we
evidence
that
it
is
it
possible
disease
measuring
that?
If
we
don't
do
something
like
that,
I
wonder
whether
the
sort
of
thing
people
eventually
need
as
part
in
raising
concerns
so.
E
And
so,
if
we
go
to
the
whistleblowing
and
85,
the
sense
of
contacts
won't
surprise
you
to
hear
come
from
the
adult
social
care
area.
So
we
understand
where
they're
coming
from
and
that's
really
important.
We
understand
if
they're
clustered
around
providers,
and
that
does
allow
people
and
inspectors
in
particular,
to
understand
patterns
and
to
be
able
to
make
judgments
about
what
they
do
with
it.
E
For
10
percent
of
that
seven
and
a
half
thousand,
they
are
doing
to
be
so
serious
that
they
actually
trigger
an
immediate
responsive
inspection
or
they
bring
forward
the
date
of
a
planned
inspection.
So
I
think
it's
very
important
to
say:
do
we
know
what
we're
doing
and
does
this
information
have
an
impact?
Then?
Yes,
it
definitely
does,
and
25
percent
of
them
actually
aware
the
first
point
of
contact,
but
we're
not
the
people
who
can
do
something,
but
we
take
our
responsibility
about
passing
that
information
on
to
those
particularly
local
authorities.
E
So
we
do
that.
We
do
it
very
effectively
and
we
have
very
good
relationships
with
other
local
authorities.
So
we
always
make
clear
to
people
that
we
we're
not
the
body
that
can
actually
do
what's
required,
but
we
take
it
seriously
and
we
are
passing
things
on
so
I
hope
that
gives
you
a
sense
that
we
take
our
responsibilities
very
seriously
and
as
our
abilities
with
technology
and
being
able
to
tag
things
to
a
provider
become
ever
more
sophisticated
and
I.
E
Think
the
view
is
that
under
the
well-led
domains
that
we
look
at
but
increasingly
and
our
inspectors
under
their
dashboards
will
have
a
really
good
and
dynamic
picture
of
our
concerns
being
raised,
is
whistleblowing
coming
in
and
are
able
to
work
with
it
as
a
saying
that
very
dynamic
way,
but
for
the
most
serious
or
those
where
actually
there's
another
body.
That
is
the
responsible
Authority
and
we
need
to
get
things
to
them
quickly.
I
want
to
give
every
sense
that
we
are
doing
things
with
them.
C
Absolutely
under
understand
us
and
I
think
that's
all
world
to
be
good,
but
I
understand
also
how
difficult
it
is
to
reduce
some
of
that
to
the
quantification
that
in
any
way
meaningful,
but,
for
instance,
in
our
adult
social
care
with
ORS
and
sometimes
in
the
hospital
reports
we
will
see.
An
account
is
given
that
we
did
this,
because
whistleblowers
tells
us
about
it,
and
this
is
what
we
found
and
I
just
wonder
whether
there
might
be
some
way
of
actually
collating
that
experience.
C
E
That's
incredibly
important,
as
you
know,
it's
a
national
agenda
that
this
should
be
happening
Roberts,
so
we
will
be
publishing
every
year
a
report
on
what
we
do
with
whistleblowing
and
it
will
have
the
granular
detail
and
I'll
have
the
case.
Studies
and
I
hope
will
encourage
people
to
come
to
us
in
ever
greater
volumes.
It's
not
a
bad
signal
to
have
seven
and
a
half
thousand
people
approaching
us.
We
think
is
very
sad
that
they
feel
they
master.
That
situations
occur
that
good.
That
actually
has
a
confidence
to
come
somewhere.
H
It's
just
to
say
that,
as
you
quite
rightly
say
well,
but
there's
a
number
of
our
report
on
the
inspections
that
we've
undertaken,
because
we
have
had
information
either
for
members
of
staff
or
indeed
for
people
who
are
using
services
or
their
families
and
carers,
and
we
do
set
that
out.
It
goes
back
to
that.
H
The
second
thing,
I
think
is,
is
suppose
to
be
a
bit
more
sidious
around
and
demonstrating
that,
and
it
goes
to
Paul's
point
it's
not
just
about
using
our
information
and
demonstrate
how
people
can
improve,
but
it's
also
about
using
our
information
to
demonstrate
how
we've
been
responsive
to
people
and
the
tools
that
David
was
referring
to
earlier.
That
can
enable
those
to
do
qualitative
assessments
of
our
reports.
So
you
know
search
for
the
phrase
that
says,
and
we
undertook
this
inspection
because
of
concerns
that
were
raised
with
those
etc
etc.
H
We
can
do
that
now
using
those
tools
in
a
way
that
we
couldn't
have
done
before
it
would
have
been
a
manual
exercise
to
go
through,
although
inadequate
reports
and
kind
of
found
that
so
I
think
that
one
of
the
things
that
we
should
do
is
to
talk
to
the
analytics
team
about
whether
we
can
and
I
think
it
would
apply
across
all
three
sectors.
Whether
we
can
do
that
sort
of
analysis
and
actually
demonstrate
that
in
either
your
the
report
that
some
islands
referring
to
or
in
some
other
way
in
state
of
care.
J
Peter,
so
that
was
a
conversation
about
performance
which
is
helpful.
The
report
the
covering
report
also
goes
on
in
paragraphs
paragraph
16,
which
he
begins
on
page
11,
the
strategic
and
the
operational
risks
and
I'm
not
going
to
repeat
what
check
out
there
and
Lewis
has
already
drawn
attention
in
part
to
one
of
the
risks.
But
if
I
could
just
emphasize
something
on
annex
2
of
the
risk
register,
which
is
risk
9,
which
is
in
relation
to.
J
J
Some
further
work
has
been
done
on
this,
so
that
the
post
mitigation
risk
reads
differently
to
the
pre
mitigation
risk.
The
importance
of
this
is
otherwise
we're
saying
we're
having
no
impact
on
this
whatsoever
and
and
as
we
did
and
we
heard
from
Peter
earlier,
a
considerable
amount
of
progress
has
been
made
over
the
past
few
weeks,
a
couple
of
months.
So
in
relation
to
this.
J
So
yesterday,
through
the
Sackett
area,
we
issued
not
an
addendum
but
an
e
rotten,
so
this
performance
reports
at
risk
9,
which
actually
sets
out
what
the
original
risk
is,
but
also
sets
out
the
mitigating
action
which
is
now
but
in
place
and
as
a
consequence
of
this
I'm
asking
you
to
note
a
revision
to
the
actual
risk
rating.
I.
Think
it's
now
from
red
and
16,
which
is
a
top
rate
in
the
top
risk,
is
now
amber
and
9.
J
But
this
is
the
result
of
the
work
that
and
Mark
Edmunds
who
looks
after
the
risk
register
and
this
proposal
that
we've
just
considered
and
Peter
put
together
following
conversations
yesterday.
So
this
isn't
this
isn't
my
number.
This
is
a
number
that
has
come
out
of
the
conversation
between
the
custodian
of
the
register
if
you
wish
and
the
person
responsible
for
the
work,
so
I
don't
want
to
over
emphasize
that
point,
but
I
do
want
to
draw
your
attention
to
the
year,
art
and
the
rest.
J
The
risk
register
stares
as
it
has
been
as
polls
committee,
a
CGC
and
looked
at
this
during
16
17.
It
also
Peter.
Just
conclude.
My
battle
is
just
draw
attention
to
the
business
planning
milestones
for
the
1617
business
plan,
where
we
go
back
and
review
this,
and
we
don't
spend
a
long
time
on
this
in
our
normal
meetings.
J
We've
actually
achieved
on
and
although
some
continues
into
this
year
again,
I
think
it
reflects
well
the
work
that
has
gone
on
and
I
think
you
can
say
that
with
some
competent
Paul
chair,
the
audit
and
Corporate
Governance
Committee
this
week,
and
one
of
the
conversations
we
had
with
our
auditors
was
the
progress
that
we're
making
again
see
all
the
action
plans
which
are
also
set
out
here.
The
completeness
I
think
that's
all
I
wanted
to
draw
attention
to
outside
of
the
overall
performance
of
function.
Thank.
A
You
enlighten
my
non-scientific
way
coming
back
to
the
risk
register,
since
we
are
on
track
at
this
moment
in
time
with
where
we
thought
we
would
be
and
wanted
to
be.
As
discussed
with
these
earlier,
it
couldn't
possibly
be
right
to
say
that
the
post
mitigation
risk
was
was
read.
So
thank
you
for
whatever
happened
yesterday,
Tim
correct
the
farms,
they're
really
good.
Anything
anybody
wants
to
raise
on
any
of
the
performance
reports,
including
the
risk
register
business
plan.
Okay
from
the
board.
Is
there
any
other
business
anybody
wants
to
raise?
A
A
O
Thank
you
chairman
and
Robin
pinecone
from
that
health
on
to
armature.
It
shouldn't
actually
a
question
but
I
as
a
member.
The
public
who's
been
attending
another
public
board
meeting
since
almost
the
beginning
of
the
connections
live.
I
would
like
to
give
my
own
congratulation
to
having
completed
the
program
of
inspections
in
what
has
been
a
very
short
period
of
time
from
a
standing
start
essentially
and
with
a
background
of
the
preceding
organization
that
had
had
some
difficulties,
but
if
I
could
present
to
the
board
or
something
which
relates
to
my
question
in
April.
O
O
This
may
be
in
part
waiting
time.
I
should
say
that
this
gentleman
was
not
containing
in
any
sense
at
all
who
they
please
to
be
able
to
attend
the
husband
one
complaint
that
was
his
journey
and
the
weight
which
is
frequently
an
hour
which
again
patients
don't
generally
grumble
that
is
often
followed
by
further
weights
for
blood
tests
or
pharmacy
dispensing
and
just
to
bring
back
to
the
board.
A
So
Robert
Fussel,
thank
you
for
your
nice
words
at
the
start
on
the
completion
of
the
program
you're,
absolutely
right,
it's
a
it's
a
great
milestone
for
for
us.
Your
your
comments
about
responsiveness
of
services
to
patient
needs,
I
think
is
something
that
we
would
all
very
much
I.
Don't
if
I,
we
don't
know
whether
any
of
the
three
chief
inspectors
want
to
add
anything
like
soreness
I.
M
Only
need
to
say
that
it
is
something
that
we
do
inspect
for
that
in
the
responsiveness
key
question,
particularly
when
there's
in
this
case
by
the
sound
of
it
in
outpatients.
We
will
ask
about
waiting,
and
we
often
do
then
actually
take
action
on
that,
because
we
have
seen
people
waiting
far
too
long
in
otherwise
good
hospitals.
And
then
we
have
taken
action
and
in
some
cases
we
have
declared
that
the
outpatient
services
inadequate
on
the
basis
of
that
and.
H
H
And
but
that's
why
we
need
to
be
continual
kind
of
promoting
that
the
importance
of
it
and
being
about
the
people,
which
is
the
reason
why
I
use
the
mum
test
in
terms
of
if
this
is
a
service,
that
I
would
be
happy
for
my
mum
or
anybody,
I
love
to
use,
and
if
it
is
that's
great,
but
if
it's
not,
we
have
to
do
something
about
it.
Robin.
A
Thank
you
very
much
indeed
for
thought
for
that.
We
had
done
a
question
that
Jay
Taylor
wrote
to
me
about
jailers.
Many
people
will
know
what
use
was
a
frequenter
attended
these
meetings
and
not
able
to
be
here
herself,
but
she
asked
if
I
would
read
out
and
she
asked
that
it
was
made
clear.
The
question
was
from
her
in
a
personal
capacity:
can
the
board
provide
the
reasons
as
to
why
protecting
whistleblowers
from
suffering
detriment
is
so
vital
for
the
safety
of
service
users
and
patients?
J
J
A
P
A
P
P
P
I
can
have
a
quick
minute
of
your
time
and
it's
very
important
to
me
because
I've
seen
firsthand
as
a
campaigner
I
get
messages
daily
of
horrific
images
and
I
know
that
that
the
CQC
of
doing
a
phenomenal
job
and
I
think
more.
So
as
this
year
you
know
last
year,
I
think
you're
going
out
there
and
you're
really
trying
to
make
a
difference,
and
for
that
I'd
like
to
thank
you
and
that's
it
so
I,
don't.
A
Understand
between
you
and
meeting
love,
Lisa
David
is
nearly
as
lovely
as
the
lovely
hungry
until
done
after
the
meeting,
but
can
I
could
I
just
quickly
say
that
I
mean
this
is
a
something
that
that's
come
up
a
great
deal.
You
will
know
that
we
have
guidance
at
the
moment
on
this.
You'll
also
know
that
technology
is
changing
all
the
time
and
so
I.
A
We
will
be
updating
that
guidance
may
not
do
exactly
what
you
want,
but
I
think
it
will
I
hope
it
will
encourage
more
people
to
understand
how
to
the
sorts
of
Technology
you're
talking
about
it's,
not
just
CCTV.
There
are
the
technologies,
aren't
there
audio
technologies
and
so
on
might
provide
additional
comfort
and
security.
So
we're.