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From YouTube: CQC board meeting – April 2020
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A
Meeting
so
welcome
to
the
CGC
April
board
meeting
which
yet
again
we're
having
remotely
bar
Microsoft
teams
I,
don't
even
have
any
apologies,
or
here
I,
particularly
welcome
Paul
Kirby,
who
is
our
equalities
representative
today,
Paul's
the
vice
chair
of
our
disability,
Equality
Network,
Paul,
II,
external
welcome
and
please
feel
free
to
contribute.
If
and
when
you
wish
to,
is
there
any
thing
that
anybody
needs
to
declare?
That's
not
already
declared.
A
A
Unusually,
there's
nothing
actually
on
the
action
table.
That
does
not
mean
hasn't.
The
color
of
action
of
that
has
probably
been
an
unprecedent
in
the
hunt
of
action,
but
nothing
coming
out
of
the
specifically
out
of
the
last
board
minutes.
Is
there
anything
arising?
That's
not
otherwise,
on
the
agenda
anybody
needs
to
raise,
in
which
case,
let's
move
swiftly
on
to
the
executive
team
report
and
in
command
over
to
you.
Please,
thanks.
B
Peter
I
think
those
we
have
a
substantive
item
in
a
moment
on
our
response
to
Kovan
19
and
colleagues
will
want
to
talk
about
the
detail
of
the
work
they've
been
doing
in
their
respective
areas,
but
if
I
just
just
talk
as
a
headline
level
as
I
guess
by
way
of
introduction
and
obviously
I
want
to
record
my
my
thanks
publicly
to
all
of
our
colleagues
for
the
flexible
way
in
which
people
have
responded
to
working
from
home.
I
bet
anything.
B
This
has
been
undoubtedly
a
real
challenge,
both
in
terms
of
those
those
people
who
have
if
you
like,
more
conventional
living
arrangements.
But
a
number
of
our
colleagues
have
not
they've
been
relatively
small
places,
they
don't
have
outside
spaces
and
so
forth,
and
we've
asked
them
to
to
do
their
regular
work.
We've
asked
them
to
talk
about
sensitive
and
emotionally
difficult
issues,
and
they
really
have
risen
to
the
challenge
and
we've
even
been
able
to
move
our
a
customer
service
center
to
work
remotely
as
well.
B
So
one
of
the
I
guess
relatively
huge
annotations
that
have
been
able
to
do
that
at
the
sort
of
scale
that
we've
done.
So
I'm
particularly
grateful
for
that
for
the
work
that
the
colleagues
have
done.
The
way
they've
gone
about
that
the
spirit
in
which
they've
shown
we
have
well
over
100
colleagues
now
who
are
sick
either
seconded
out
or
volunteering
elsewhere
across
the
health
and
social
care
system.
B
We've
got
colleagues
working
certifying
deaths
in
death,
certification
teams,
we've
got
colleagues
who've
been
called
up
in
the
reserve
forces
who
who
have
been
moving
PPE
about.
We've
got
colleagues
who
are
special
constables
who
are
now
working
on
a
semi-permanent
basis
as
special
as
a
police
constable,
as
well
as
more
as
well
as
roles
supporting
NHS,
England
and
public
health
England,
where
we
got
people
seconded
to
support
colleagues
there
as
well,
but
alongside
a
number
of
doctors
and
nurses
who
returned
to
frontline
practice,
we've
got
people
in
a
Andes
and
ICU,
and
so
on.
B
So
I
think
when
we
talk
about
supporting
the
overall
national
effort.
I
think
we
do
need
to
to
recognise
that
it's
it's
a
range
of
different
things
that
their
colleagues
are
doing
and
we've
tried
to
enable
that
to
happen,
whilst
at
the
same
time
being
true
to
our
purpose,
which
of
course,
we've
said
many
times
before,
is
to
give
give
public
assurance
that
the
health
and
social
care
system
is
safe
to
use
and
to
promote
improvement
and
and
knowledge
sharing
within
within
the
within
that
cohort.
B
So
in
terms
of
activity,
I
think
we've
done
a
lot
of
things.
We're
talking
detail
about
that
the
moment,
but
sort
of
headlines
are
supporting
the
set
up
of
the
various
Nightingale
hospitals.
There's
some
really
impressive
people
operating
those
Nightingale
hospitals
and
when
colleagues
are
visited,
they've
remarked
on
on
how
fantastic
the
fantastic
spirit
and
also
the
willingness
to
learn
and
improve,
which
is
which
again
has
been
a
particular
feature
of
the
nightingales.
B
And
it's
been
a
great
effort
by
a
number
of
colleagues
who
have
managed
to
book
in
over
22,000
people
now
into
appointments
to
to
have
that
how
to
have
cope
in
19
tests
done
and
and
we're
also
working
working
closely
with
public
health
England
and
the
Department
of
Health
and
Social
Care
on
the
distribution
of
postal
testing
kits
to
be
used
in
care
homes
and
potentially
else
were
I.
Think
the
important
point
really
is
that
our
technology
and
our
people
and
I
think
it
is.
This-
is
this
that
this
is
important
to
stress.
B
This
is
about
technology,
but
also
colleagues,
particularly
in
the
NCSC,
and
work
incredibly
hard
to
create
a
an
end-to-end
service
here,
which
is
which
has
been,
which
has
been
really
effective
and
to
be
able
to
do
that
from
a
standing
start
and
we're
now
offering
other
this
to
a
range
of
key
workers
as
well.
In
terms
of
upcoming
areas
of
interest.
B
I
hope
in
turn
enable
a
number
of
other
organizations
to
come
in
and
provide
support
where
that
support
is
needed.
And
that
could
be
that
that
will
be
direct,
hands-on
support
and
so
forth.
So
I
think
I
think
it
is
about
CQC,
acting
in
its
role
as
as
reporting
and
collating
information,
and
then
passing
that
on
to
to
other
agencies
for
them
to
do
the
the
hands-on
support.
B
C
In
and
so,
if
I
could
just
update
board
on
an
outcome
to
a
first
tier
Tribunal
for
which
we
received
a
decision
on
Monday,
so
it's
a
home
called
Bleak
House
I'm
up
in
Humberside,
a
home
that
currently
supports
19
adults
with
learning
disabilities
and
dementia
and
the
provider
applied
to
our
registration
teams,
to
extend
the
service
from
supporting
19
adults
to
supporting
24.
That
application
was
refused
because
it
wasn't
in
keeping
with
our
registering
the
right
support
guidance
and
wasn't
in
keeping
with
the
spirit
of
transforming
care.
C
The
provider
appealed
the
decision
it
went
to
first
tier
and
tribunal
and
the
case
was
dismissed
and
they
we
were
positively
unsupported
in
our
opposition
front
from
the
judge
around
the
need
for
services
to
small
community
focused
and
I
think
this
is
an
example,
as
we
continue
to
do.
The
refreshing
of
the
registering
the
right
support
guidance
that
we
will
be
sharing
when
we
get
through
the
kind
of
coded
period
that
we're
in
at
the
moment,
the
revised
guy.
C
A
B
D
Thank
you
in
and
so
as
you'll
see
in
the
in
the
report
of
the
board,
we're
continuing
to
publish
inspection
reports
from
the
inspections
we
did
before
the
caried
epidemic
pause
those
inspection
reports
of
enable
us
to
make
recommendations
about
special
measures
in
some
cases.
For
instance,
last
week
we
recommend
it
and/or
for
the
Norwich
hospital
should
come
out
with
special
measures
and
I've
really
very
pleased
with
the
progress
that
that
Trust
has
made
over
the
last
few
years.
D
So
we
are
continuing
to
monitor
those
trusts
that
we're
concerned
about,
in
partnership
with
NHS
England
improvement
and
other
regulators
and
I
had
a
very
successful
meeting
with
other
regulators
and
the
original
teams
from
all
over
England
furnitures
England
yesterday,
and
we
discussed
those
issues
that
we
have
of
concern.
Of
course,
a
lot
of
the
discussion
was
around
kovat,
but
we
also
discussed
the
other
issues
that
would
be
monitoring
and
coming
up
to
the
ceilidh
epidemic.
D
I
should
say
that
the
acute
sector
has
responded
really
very
well
to
the
global
epidemic
and
I
want
to
congratulate
all
my
colleagues
on
the
front
line
in
the
acute
sector.
In
the
way
they
have
raised
capacity
in
response
to
the
increasing
numbers
of
patients
with
Kovac
19
I
think
some
hospitals
have
been
under
enormous
pressure
and
I've
heard
from
doctors
and
other
staff
working
those
hospitals
of
the
difficulties
they've
faced.
D
But
having
said
that,
I
think
they
have,
they
have
risen
immensely
well
to
the
challenge
that's
been
faced
and
there
has
been
capacity
there
in
the
acute
sector
for
the
Kovac,
19
patient.
So
I
think
that
is
a
great
achievement
by
all
colleagues
in
the
NHS
across
the
board.
Nina's
already
highlighted
that
we've
worked
with
the
developing
Nightingale
hospitals
to
understand
their
model
and
to
provide
them
with
support
as
well
as
part
of
that
work.
The
one
of
the
interesting
things
is
that
there
is
spare
capacity
there
in
hospital
still
and
particularly
interesting.
D
There's
been
a
fall
in
attendances
at
emergency
departments
over
the
during
the
curve
in
epidemic
and
I
think
they
were
learning
from
that.
Bliss
I
think
it
has
identified
that
so
the
attention
is
in
emergency
departments
is,
of
course,
so
much
pressure
in
them
in
the
past
may
not
always
be
necessary.
D
But
equally
we
are
concerned
that
some
people
who
should
be
going
to
emergency
departments,
because
a
very
real
health
concerns
are
not
doing
so
because
of
fear
of
Kovac
19:00,
and
we
have
been
working
with
other
parts
of
the
of
the
system
to
ensure
the
message
goes
out
to
people
that
the
NHS
is
still
open
for
people
with
emergencies.
It's
not
just
there
for
people
with
Kovac,
19:00
and
I
think
is
very
important.
D
We
encourage
people
who
have
real
concerns
about
serious
illnesses
that
they
do
seek
the
help
that
they
need
and
what
we
have
been
raising
with
colleagues
and
the
other.
So
any
other
in
the
other
organisations
is
our
concern
about
patients
without
Kovac
and
whether
they're
getting
the
care
they
should
I
mentioned
the
the
emergency
cases
there.
D
But
of
course,
there
are
also
issues
in
say,
maternity
services,
where
it's
important
that
people
who
are
accessing
maternity
services
feel
confident
in
their
services
despite
the
carried
epidemic
and
other
alleged
services
like
cancer
services
were
we
concerned,
but
I
should
mention
it's
important.
That
providers
keep
track
of
elective
care.
D
People
with
learning,
disability
and
autism,
because
those
those
sectors
are
affected
by
the
Koval
epidemic
may
be
directly
because
staff
or
or
patients
become
infected
or
maybe
indirectly,
just
because
of
the
pressures
of
the
system
means
that
they
don't
get
the
resources
they
need
on
a
day
to
day
basis
and
is
very
important.
Those
services
get
support
as
well
and
we
are
providing
support
to
the
system
to
help
them
to
help
monitor.
E
D
It's
very
important
when
this
infectious
disease
is
prevalent,
that
hospitals
can
maintain
really
very
high
standards
of
infection
control
and
that's
acute
hospitals,
but
also,
as
they
say,
hospitals
such
as
mental
health
hospitals
and
where
patients
are,
and
that
guidance
is
coming
out.
I
hope
later
on
this
week
and
once
it
is
out,
we
will
then
be
working
with
providers
to
monitor
their
implementation
of
it
to
make
sure
they
divide
the
safest
possible
environment
for
providing
care
for
patients.
D
C
So,
just
to
let
the
board
know
that
myself
and
John
Cox
Bale
who's,
the
inspection
manager,
who
leads
the
health
and
justice
team,
appeared
before
the
Justice
Select
Committee
yesterday
to
talk
about
the
care
of
older
prisoners
and
the
what
we
asked
as
as
long
as
our
in
line
with
our
partners,
who
also
appeared
as
witnesses,
was
to
the
justice
committee
to
consider
a
recommendation
about
developing
a
national
strategy
for
older
prisoners
who
make
up
about
32%
of
the
prison
population.
So
there
is
a
real
need
for
that
coordination
and
the
national
strategy.
C
You
know,
I,
don't
know
if
you
want
me
to
talk
about
the
coded
aspects.
Now,
I'll
come
back
to
that
later.
I
think.
A
A
F
It
is
coming
just
coming
off
meat.
Thank
you.
So,
in
terms
of
the
point
I'm
gonna
hand
over
to
Chris
in
a
minute
talks
with
some
in
some
of
the
detail,
but
I
just
wants
to
pick
up
on
on
a
couple
of
issues
so
in
terms
of
our
performance
activity,
our
normal,
our
normal
routine
inspections,
have
been
suspended.
F
So
we
haven't
compiled
such
a
full
report
today,
as
we
would
normally
do,
but
just
to
focalize
some
of
things
we
wanted
to
focus
on
our
registration
activity
has
been
incredibly
busy
during
this
period
with
demands
for
registering
of
new
new
and
additional
application
services
to
support
the
covert
application.
Our
team
have
had
over
160
to
your
applications
to
date,
which
are
directly
related
to
tech,
ovid.
Nine
of
those
have
been
fast-track
applications
and
the
remainder
have
been
applications
which
increased
capacity
in
the
system.
F
What
we've
been
doing
is
prioritizing
those
fast
track
applications
and
we
are
getting
through
those
in
an
average
of
seven
days,
end-to-end
which,
given
our
normal
processes
taken
takes
of
fifty
days
plus,
that
is
quite
a
significant
focus
and
improvement
in
activity.
We're
also
for
those
applications
which
are
adding
capacity
to
the
system
which
are
not
so
urgent.
We
are
processing
those
in
an
average
of
seven
days
again
compared
to
the
50-plus
days
that
we
normally
do
so
I
think
we
are
continually
getting
applications.
F
We
are
prioritizing
those
triaging
them
and
moving
them
through
our
pace.
To
enable
us
to
do
that.
What
we're
also
doing
with
our
registrations
is
where
it's
possible
is.
We
are
enabling
registration
to
run
concurrently
with
the
application
process
so
as
not
to
cause
a
unnecessary
delay
in
the
system,
and
we
have
a
number
where,
where
we're
simply
adding
services
and
amending
registrations
where
those
are
being
done
in
parallel
to
the
application
and
off
causing
no
delays
at
all.
F
Just
in
terms
of
our
people,
we
have
seconded
a
number
of
people
out
in
to
both
other
government
departments
and
into
the
front
line
to
support
our
activity
and
also
in
terms
of
other
volunteering
activities.
We
currently
have
over
70
people
deployed
and
are
currently
and
have
a
list
of
people
who
are
have
volunteered
to
go
and
do
other
things
and
we're
working
on
supporting
those
people.
We
also
have
an
obviously
with
our
people
now
working
in
a
different
way
working
from
home
and
with
a
different
demand
on
them.
G
Thank
you.
So
this
was
this
is
our
February
update,
which
there
kind
of
last
month
before
we
we
were
heavily
impacted
by
Corvin,
seems
like
a
lifetime
ago,
and
now
so
just
a
few
headlines
for
me
really,
which
was
to
run
our
inspections
we
were,
we
were
hitting.
Some
good
numbers
here
see
were
inspecting
a
hundred
percent
of
inadequate
locations.
98%
of
requires
improvement,
PMS,
likewise,
100%
of
inadequate
90%
of
requires
improvement
and
hospitals
were
continuing,
deliver
against
high
risk
ratings,
with
91%
being
inspected
in
terms
of
safeguarding.
G
In
terms
of
our,
we
have
a
Kovac
dashboard
that
we've
set
up,
so
I
thought
it
would
be
worth
talking
to
that,
as
well
as
just
the
routing
performance,
we
have
a
corvid
dashboard,
that
is,
that
is
refreshed
daily.
So,
to
help
us
make
decisions
around
a
resource
thing
and
also
a
general
response.
Some
of
those
areas-
cursed,
he's
already
referred
to
surah
tracking
things.
There,
such
as
sir
comments
people
with
symptoms
and
the
track
and
a
variety
of
matters.
People
with
symptoms
and
understand,
understand
that
area.
G
Our
engagement
with
colleagues,
so
we
have
bulletins
coming
out
and
on
average,
is
80
percent
reading
our
opening
our
updates,
as
well
as
a
significant
number
of
colleagues
joining
the
old
or
colleague,
calls
and
separate
managers
calls
in
NCSE
and
registration
case
who's
refer
to
that
already,
but
we
were
receiving
a
lot
of
inquiries
into
into
NCSC.
I
think
the
latest
numbers
we've
had
is
about
twenty
four
and
a
half
thousand
inquiries
into
into
see
in
relation
to
culvert
system,
some
heavy
volumes
coming
in
and
we're
also
tracking
our
inspection
activity,
albeit
small.
G
So
we
announced
on
the
16th
of
March
that
we'd
stop
routine
inspections
from
that
point.
Up
to
date,
I
think
we've
done
45
inspections,
although
none
of
them
were
a
kind
of
deaths,
base
inspections
in
PMS.
We
didn't
physically
visit
the
service,
but
it
is.
It
is
an
area
we're
tracking,
so
it's
an
update
from
me.
Hopefully,
people
find
useful
were
happy
to
take
any
questions
long
as
Kirsty.
C
So
that
guidance
is
still
there
and
available.
There
is
ongoing
work
happening
Ted
mentioned
in
his
update
about
the
work
around
Mental
Health
Act
assessment
and
our
commitments
daughter
visit
in
in
scenarios
where
that
Torrance
there,
and
there
is
an
ongoing
piece
of
work,
particular
and
surveillance.
I,
know
I.
Think
we
had
potential
question
coming
from
the
public
about
where
we
are
at
with
roll
on
surveillance,
can
assure
the
board
that
we
are
currently
using
surveillance
in
our
enforcement
work
where
it
is
appropriate
and
there
was
an
active
piece
of
work.
C
Looking
at
the
moment
where
surveillance
is
gathered
through
a
provider
or
through
another
party
about
how
we
use
that
data
to
inform
any
action
that
we
may
or
may
not
take.
So
lots
of
work
happening
on
this
issue
even
more
pertinent,
as
we
are
in
a
scenario
where
we
are
not
regularly
crossing
the
threshold,
and
we
will
have
a
detailed
kind
of
prioritization
piece
to
bring
back
to
board
in
May.
Okay,.
B
We've
got
one
or
two
colleagues
have
appeared
before
select
committees
by
video
link
so
again
we're
supporting
where
that's,
where
that's
appropriate
as
well,
and
the
only
other
thing
I
just
want
to
just
pick
up
on
this
section
is
that
we've
released
our
reports
on
the
sandboxing
activity.
We
did
around
helping
digital
trio,
helping
providers
look
at
how
to
register
for
digital
triage,
although
that's
that
was
released
relatively
quietly.
B
It
is
an
important
report
and
it
sits
there
as
it
sits
there
ready
ready
to
be
used
for
those
providers
that
are
starting
to
think
about
registration
in
in
a
digital
age,
which
has
become,
as
we
can
appreciate,
much
more
popular,
very
quickly,
so
I
think
it's
important
work
which
will
have
long-term
implications,
even
if,
even
if
there
wasn't
a
short-term
big
big
amount
of
publicity
around
it.
Okay,
thank
you,
I
think
then,
and
then
finally,
we
just
wanted
just
to
touch
on
on
mark
marks
area
in
terms
of
cyber
security
and
information.
A
B
What's
going
on
within
adult
social
care
area,
feeding
that
back
into
government
we've
had
people
going
from
the
organisation
as
volunteers
to
provide
a
direct,
hands-on
support,
so
lots
of
different
ways
of
capturing
information,
both
intelligence
and
hard
data,
trying
to
summarize
that
and
pass
that
back
to
government
and
NHS,
England
and
so
forth.
I
think
the
other
area
that
we've
been
working
hard
on
is
what
I
describe
as
accelerating
so
accelerating
registration.
You've
heard
Kirsty
just
talk
at
momentarily
about
about
the
work
we've
done.
We've
done
there
we're
using
we've.
B
Had
a
net
we've
redesigned
our
entire
implement,
an
entire
inspection
methodology
to
produce
the
emergency
support
framework
and
again,
what
that
is
about
is
about
giving
us
a
tool
that
we
can
use
so
that
we
can
be
effective
in
terms
of
giving
the
public
assurance
that
that
we
are
that
they
can.
They
can
safely
use
health
and
social
care
as
a
service,
so
where
we
accelerated
that
work,
we've
done
that
work
incredibly
quickly
and
it's
the
third
area
I
think
is
around.
B
You
know
what
it
described
as
innovation,
where
we
have
we've
done
things
which
we
wouldn't
normally
do.
So
all
the
work
we've
done
around
testing,
which
colleagues
will
go
on
and
talk
about
in
a
moment
where
we've
delivered
that
we've
done
direct
delivery
of
a
booking
service
for
drive
through
testing,
to
enable
people
from
social
care
to
book
themselves
a
test
as
well
as
working
with
with
the
HSC
and
public
health
England
on
on
at
home,
at
home
testing,
at
this
idea
of
hosting
a
text
out
to
people
working
on
the
pilot.
B
Whether
these
are
things
that
we
wouldn't
normally
do.
They're
not
necessarily
core
business
for
CQC
necessarily,
but
but
we
are
uniquely
placed
because
we
have
the
information
and
the
connections
into
the
sector,
so
we've
used
those
connections
in
order
to
get
things
done
in
the
broader
system
and
then
finally,
internally,
obviously
we're
an
organization
of
three
and
a
half
thousand
people,
and
we've
gone
from
from
having
a
number
of
officers
and
and
a
large
national
customer
service
center,
and
we've
moved
all
of
that
into
into
into
home
working
mode.
B
So
none
of
our
teams
are
working
in
offices
anymore.
To
me,
just
moving
three
and
a
half
thousand
people
into
home
working
has
been
quite
an
undertaking
and
making
sure
those
people
understand
what's
going
on
and
making
sure
that
they're
fully
engaged
with
what's
going
on
alongside
enabling
them
to
to
volunteer
where
that's
appropriate.
So
so
I
guess
four
areas,
one
is
support.
One
is
accelerate.
I
wanted
to
innovate
on.
B
C
So,
thank
you
me
and
there's
been
an
enormous
amount
of
work.
So
I'll
just
pick
out
some
of
the
the
highlights
this
meeting,
because
I
think
it
would
be
here
all
day
if
we
were
talking
about
all
of
the
different
work
we
were
involved
in,
but
firstly,
I
think
the
first
thing
says
we
had
great
respect
to
working
across
the
organization
and
I.
Think
one
of
the
things
emerged
over
the
last
few
weeks,
that's
been
very
visible.
C
Is
that
sometimes
the
pathways
between
health
and
care
and
the
pathways
between
primary
care
and
secondary
care?
There's
all
sorts
of
issues
that
have
emerged,
which
we
have
been
looking
at,
how
we
can
resolve
and
support
across
the
system
and,
in
particular,
that's
been
very
visible
between
social
care
and
primary
care,
and
we
are
developing
a
set
of
statement
to
support
that
interface
and
outline
what
our
expectations
are
in
that
area.
C
We
things
we've
sent
out
to
communication
around
private
testing.
We
were
aware,
or
some
organizations
looking
at
private
testing,
sending
out
private
test
kits
and
charging
a
large
number
of
large
much
money.
So
we've
sent
out
what
our
expectations
are
in
that
area
we've
been
working
with
prisons.
There
are
whole
set
of
issues
about
cobia
in
prisons
around.
How
do
you
shield
vulnerable
people,
people
coming
in
and
out
of
prisons
and
and
a
variety
of
other
issues,
and
our
teams
have
been
working
very
closely
with
partner
agencies
such
as
HIV
and
NHS
England?
C
To
look
at?
How
do
we
really
make
sure
people
in
prison
are
are
kept
as
safe
as
possible?
In
this
current
environment,
our
dental
team
have
been
busy
looking
at
urgent,
the
urgent
treatment
centers
for
dentists
and
supporting
the
development
of
those
and
I
think
the
final
thing
I
just
under
medicines
team
have
also
been
working
to
the
cat
issues
around
controlled
drugs
in
care
homes,
to
make
sure
that
they
are
managed
safely
to
put
out
guidance
about
end-of-life
care
drugs
and
have
been
monitoring
closely
supply
chains
and
other
issues
related
to
medication.
C
I
think
p.m.
the
final
issue
I
wanted
to
raise
is
just
to
brief
the
board
about
her,
an
article
that
was
in
the
Daily
Mail
today,
which
was
contributed
to
by
a
gentleman
called
Nick
Somerton,
who
is
the
clinical
advisor
from
for
John
Newton
and
dr.
Somerton
in
his
article,
was
basically
saying
that
we
and
public
health
England
were
coming
up
with
hurdles
that
was
getting
in
the
way
of
the
rollout
of
testing
and
I
just
wanted
to
address
some
of
those
concerns
here.
C
He
said
it
was
as
simple
as
kind
of
sticking
a
swab
up
someone's
nose
in
terms
of
the
testing
and
couldn't
understand
our
why
we
would
want
training,
I
think.
The
first
thing
today
is.
We
are
all
aware.
This
is
a
very
vulnerable
group
of
people
in
care
homes
and
they're,
not
a
homogenous
group
of
people.
C
There
are
group
of
people
that
actually
some
will
have
learning
disabilities
and
may
have
dementia
lots
of
people
lots
of
very
different
needs,
and
we're
also
aware
from
discussions
that
we've
had
with
our
care
providers
that
there's
a
that
they're
being
expected
in
some
to
take
on
donated
tasks
which
sometimes
they're
not
feeling
supported,
to
be
able
to
do.
And
it's
really
important
that
we
make
sure
that
a
we're
protecting
feed
we're
making
sure
that
people
in
care
homes
get
the
support
and
training
that
they
need.
C
I
think
that
it
might
be
as
easy
as
putting
a
swab
up
people's
nose,
but
actually,
if
someone's
distressed,
that
is
more
difficult.
There's
consent
issues,
there's
capacity
issues
and
we
need
to
make
sure
that
people
feel
that
they
have
access
to
the
training
that
they
need.
That
doesn't
need
to
be
hugely
time-consuming.
It
might
be
a
five
or
ten
minute,
video
or
something
similar
that
people
can
access.
C
We
will
rectify
what
those
local
options
are,
but
that
is
really
important
as
well
and
finally,
I
think
it's
really
important
that
actually
people
understand
what
to
do
when
they
get
those
results
back,
so
that
end-to-end
pathway
of
actually,
if
you've,
got
a
lot
of
your
staff
who
tested
positive,
even
though
they're
asymptomatic
or
if
a
lot
of
the
residents
come
back.
We
need
to
be
really
happy
that
the
advice
and
the
support
is
there
to
those
care
hands
to
make
sure
that
they
get
the
that
they.
C
They
feel
that
they've
got
the
support
to
be
able
to
manage
that
situation.
So
those
were
the
main
things
I
wanted
to
mention
Kate.
What
may
want
to
add
further
to
the
the
Care
Homes
issue,
but
I
just
wanted
to
clarify
that
for
the
board
Thank.
C
C
And
I
think
your
chair
so
and
thank
you
to
Rosie-
and
you
know,
I
won't
reiterate
and
the
testing
point
bar
emphasis
I
think
there
were
a
number
of
different
testing
strands
here.
One
is
the
kind
of
booking
system
that
we
have
been
able
to
happen
around
testing
of
care
workers
who
can
get
myself
to
testing
centers.
C
The
other
is
what
the
role
might
be
around
home,
testing
and
testing
of
residence,
which
is
which
is
quite
a
different,
a
different
matter,
and
we
need
to
have
the
assurance
as
described
about
people's
confidence,
about
delivering
those
tests
and
to
ensure
that
it
gets
the
results
that
accurate.
So
the
testings
been
a
big
part
of
the
work
that's
gone
on
in
adult
social
care,
since
we
last
met
as
a
board.
C
Last
week,
the
Department
for
Health
and
Social
Care
and
published
it
adult
social
care,
an
action
plan
in
response
to
covert
19,
and
there
are
many
tasks
in
there
that
CQC
are
contributing
to
or
providing
a
leadership
role
of
some
of
the
stuff
would
be
areas
you'd
expect.
So
the
action
plan
talks
about
the
importance
of
our
give
feedback
on
care
and
really
encouraging
people
more
than
ever,
to
tell
us
about
the
quality
of
care,
they're
receiving
or
all
people's
experiences
as
a
worker
within
social
care.
C
C
At
the
point
of
doing
that,
we
also
made
the
decision
to
switch
off
our
provider
information
request
with
an
adult
social
care,
so
we
kept
them
going
a
little
longer
than
colleagues
in
primary
medical
services
and
hospitals,
because
that
was
our
main
route
of
visibility.
But
actually
now
we've
got.
We
will
be
having
a
daily
snapshot
about
what
that
impact
isn't
in
the
home
care
market.
C
We
made
a
change
to
how
we
asked
providers
to
report
that,
on
the
10th
of
April,
to
ensure
that
we
were
getting
the
completeness
completeness
of
data
that
we
needed,
but
also
we
were
making
it
as
easy,
as
possible
providers
to
report
to
us
if
people
were
dying
with
suspected
ANCOVA
Dorkin
confirmed
coded
so
from
the
10th
of
April
going
forward.
We
have
really
clear
data
on
that.
The
Office
for
National
Statistics
is
the
main
source
of
data
out
to
the
public.
They
produce.
C
The
data
daily
on
hospital
deaths
and
from
next
week
from
the
28th
of
April,
their
data
will
also
include
our
CQC
data
and
I
because
bear
with
me
a
second
while
I
described
the
difference,
so
so
the
officer
National
Statistics
data
is
based
on
death
certificates.
So
it's
absolutely
factual.
The
CQC
data
is
more
timely
and
it's
based
on
what
providers
are
telling
us,
but
it
hasn't
been
fully
verified.
C
So
we've
got
a
an
ons
theta,
that's
absolutely
accurate,
but
there's
a
time
lag
of
about
11
days
and
then
you've
got
the
CQC
data
that
is
more
timely
but
hasn't
been
fully
triangulated.
We
made
a
decision
between
the
Department
and
ourselves
yesterday
and
we
shared
a
joint
statement
today
on
the
back
II
guess
today's
ons
data
up
to
the
10th
of
April.
C
We
we
share
the
statement
to
describe
what
the
increase
of
deaths
are
between
the
the
11th
of
April
and
the
14th
of
April,
based
on
the
CQC
notifications,
and
it's
important
to
do
that
because
it's
it's
telling
us
a
very
clear
story
about
what
the
impact
is:
Kove.
It
is
having
on
people
in
social
care
and
what
we
said
is
the
data
that
we
have
in
front
of
us
that
hasn't
been
completely
triangulated
or
verified.
C
We've
we've
put
a
joint
statement
out
today
and
going
forward.
There
will
be
a
single
set
of
data
that
would
be
reported
on
by
ons,
but
on
this
one
of
instance,
because
we
now
have
the
most
up-to-date
data
up
to
the
14th
15th
of
April.
We
felt
it
was
really
important
to
be
talking
about
that
and
to
the
public.
C
A
D
Okay,
well,
the
just
a
couple
of
things
from
me:
one,
the
the
safety
statement
that
Rosie
talked
about
I
think
is
really
very
important,
and
we
did
that
directly
with
humility,
huge
previous
speaker,
Guardian,
because
we
think
it's
really
important
that
the
culture
out
there
should
be
a
culture
where
people
can
raise
concerns
when
in
a
very
dynamic
environment
and
people
are
facing
pressures.
That
is
just
when
you
need
that
very
open
culture,
and
that
statement
is
going
out
today
and
I
think
it
is
really
important.
There
is
a
great
opportunity.
D
We
must
not
miss
here
for
us
to
build
a
really
strong
safety
culture
coming
after
the
curve
at
19
and
I.
Think
one
of
the
encouraging
things
in
this
difficult
time
is
that
you
are
seeing
people
more
willing
to
speak
up,
and
certainly
we've
seen
more
people
raising
issues
with
us
which
we
weren't
able
to
follow
up
and
that
very
important
message.
D
The
message
is
coming
to
us,
which
we
can
follow
up
with
providers
and
other
regulators
is
something
that
is
really
very
valuable
to
us,
and
we
want
to
build
on
that
and
it's
very
important.
We
don't
get
this
sense
that
co19,
because
it's
so
difficult
there
for
safety.
Second,
it
is
a
lower
priority
than
normal.
It's
as
a
higher
priority
as
ever,
and
we've
got
to
keep
focused
on
it.
The
other
thing.
D
I've
been
doing
is
working
with
NHS
England
and
the
Academy
of
Medical
Royal
Colleges,
looking
at
clinical
guidance
to
try
and
adapt
clinical
grants
where
necessary
to
meet
the
relate.
The
pressures
of
the
current
nineteen
epidemic
and
the
very
interesting
issue
that's
coming
out
of.
That
is
that,
while
people
are
looking
at
guidance
and
refreshing
it
in
the
face
of
Kovac
19,
we're
often
recognizing
that
the
guidance
could
be
much
better
anyway
in
the
long
term,
and
so
that
there
are
in
many
ways,
there's
epidemic
his
Challenger.
D
Now
thinking
I
know,
that's
that's
gonna,
be
models
of
care
and
the
way
we
work
together,
but
is
also
in
the
way
we
clinically
manage.
Patients
and
I.
Think
it's
really
very
interesting
that
some
of
the
guidance
is
moving
forward
and
that
guidance
and
the
benefits
of
that
improvement
to
Gardens
are
going
to
be
carried
forward
into
the
future.
That's
all
I
say
for
this
happening.
H
We
we've
we've
been
able
to
reach
now
every
single
and
every
single
health,
social
care
location
in
England,
and
also
we've
now
extended
that
out
to
GP
practices
and
a
number
of
other
key
worker
groups,
as
well
as
he
and
described
so.
That's
32,000
provider
locations
and
and
as
of
the
data
of
last
night,
we've
been
able
to
facilitate
22,000
over
22,000
members
of
staff
being
tested
for
cope
in
nineteen
through
one
of
these
drive
drive
through
test
centres
and
the
other
the
Kate
mentioned.
H
There
was
around
supports
of
gathering
of
data
from
adult
social
care
and
the
domiciliary
care
organizations.
So
now,
every
single
day,
we've
got
a
very
short
but
important
survey,
that's
being
completed
across
our
10,000
domiciliary
care
organizations
that
we
were
in
here
today
and
we
are
gathering
and
reporting
that
information
back
into
the
Department
of
Health.
The
other
thing
that
we've
kind
of
done
in
tandem
as
well
or
using
the
same
underlying
technology
platform
is
to
stand
up
our
emergency
support
framework.
H
So
this
enables
us
to
have
a
desk
based
conversation
with
a
provider
and
capture
essential
information
around
safety
and
particular,
and
the
the
impact
of
nineteen
and
capture
that
with
a
central
system,
that's
yeah
and
and
that
work
will
continue
as
we
as
we
look
to
continue
to
support
the
system.
Thanks.
F
F
Talking
supporting
the
work
on
the
testing
that
we've
been
doing,
they've
been
the
ones
that
have
been
facilitating
the
emailing
out
and
the
managing
the
queries
in
addition
to
that
work,
they've
also
seen
a
rapid
rapid
increase
in
notifications
coming
through
announcing
about
a
forty
five
percent
increase
in
volume
and
we're
working
through
those
quickly
to
turn
them
around,
so
that
we
have
up-to-date
data
and
information
going
being
fed
back
into
the
system.
We're
also
seeing
a
significant
increase
in
the
number
of
calls
coming
through
to
our
call
center
and
I.
F
Think
I
just
want
to
point
out
that
some
of
those
calls
are
quite
challenging
calls
with
people
quite
often
very
distressed.
Normally,
our
colleagues
working
in
a
in
a
large
call
center,
where
they
have
that
teammates
around
them
to
provide
support
and
often
that
at
the
moment,
are
taking
quite
quite
difficult
calls.
When
they're,
when
they're
sat
at
homes,
we've
been
working
very
hard
to
ensure
that
they
are
supported
to
be
able
to
discharge
that
function
well
and
be
able
to
continue
to
do
that.
Work.
F
I
also
mentioned
the
work
we've
done
on
registration
earlier,
to
accelerate
our
process
to
ensure
that
any
applications
directly
race
to
kaiba
door
are
managed
and
through
the
system
quickly.
Our
people
we've
assisted
a
quite
a
lot
of
people
to
go
to
go
out
on
secondment
and
and
also
to
support
people
to
do
volunteering
as
part
of
their
a
day
job
so
to
add
a
few
extra
hours
here
and
there
if
they
want
to
be
able
to
support
volunteering,
local
local
initiatives.
To
do
that.
F
What
we've
done
is
we've
put
a
programme
approach
to
all
our
work
on
covered
so
that
we
are
managing
that
emerging
that
well,
so
that
we
can
track
activity,
make
sure
that
things
are
being
done
in
a
timely
fashion.
And
we
understand
what
the
interdependencies
are
between
various
activities
and
also
to
ensure
that
we
have
the
right
resources
available
to
support
the
work
at
the
right
time
to
enable
us
to
continue
this
work
at
pace
without
people
be
being
overloaded.
F
That
learning
during
this
period
to
take
us
through
a
recovery
and
out
to
the
other
side,
where
we're
able
to
re-establish
a
sort
of
business
as
usual,
a
regulatory
activity
that
will
continue
over
the
next
few
weeks,
so
that
we
are
ready
to
move
at
pace
when
we
are
able
to
move
around
freely
and
the
system
is
able
to
start
to
see
some
sense
of
normality
coming
back.
Thank
you.
Thanks.
E
We've
also
been
carrying
out
some
form
of
regular
activity,
I'm,
also
looking
for
how
providers
are
innovating
during
this
time
and
how
we've
seen
a
number
of
examples
of
how
providers
are
using
this
as
an
opportunity
to
try
and
test
new
systems
that
they
were
thinking
about
developing.
So
we're
going
to
do
with
us
to
build
that
into
what
will
become
part
of
stated
care
later
in
terms
of
the
public.
That's
already
mentioned.
E
Give
feedback
on
care
is
a
very
important
channel,
we'll
be
working
closely
with
50
organizations
that
represent
different
groups,
that
we
want
to
target
for
give
feedback
on
care
to
make
sure
we
can
maintain
the
volume
of
activity
so
that
we
understand
where,
where
there
may
be
risks
in
the
system.
When
we
can,
we
can
lose
that
to
direct
our
inspiration,
resource
and
I'm
working
with
colleagues,
so
that
they
understand
both
what's
happening
on
in
terms
of
guidance
and
commit
model
organization.
E
What
our
plans
are,
and
also
that
the
important
point
of
Costa
meant
had
been
a
link
between
the
emergency
support
framework
and
how
that
links
to
what
we
might
do
in
a
future.
The
new
strategy,
so
that
mainly
the
main
issues
arose,
is
keeping
a
track
of
what's
happening
elsewhere,
making
sure
providers
and
colleagues
feel
supported
in
us
and
making
sure
we
can
carry
on
both
how
I
want
to
support
the
system
and
our
role
as
a
regulator.
E
A
Thank
thanks,
Peter
thank
you
and
can
I
on
behalf
of
the
home
of
the
board.
Thank
you
in
and
the
whole
of
the
executive
team
and
through
you
all
our
colleagues
for
their
really
phenomenal
work.
That's
been
done
over
the
last
few
weeks,
I
mean
it's,
it's
really
impressive
and
like
if
you
could
pass
on
our
gratitude
to
Microsoft,
because
I
know
they've
been
a
a
really
key
partner
and
been
able
to
enable
some
of
this
to
happen.
So
I
mean
I.
A
I
Robert,
please
thank
you
coming,
firstly,
echo
your
thanks
and
gratitude
food
to
everyone
at
CQC
for
the
fantastic
work
they'd
be
making
place
within
the
normal
regulatory
thanks
over
to
you
and
yeah.
That's
adaptations
required
for
this
crisis.
I've
got
four
questions
and
I
just
put
them
all
Erina
you
can
decide,
he
should
answer
them.
The
first
is
about
some
capacity
and
the
fact
that
we
were
miraculously
seemed
to
have
an
excess
of
capacity
generated
by
the
remarkable
work
in
building
new
hospitals,
emptying
wards
and
so
on
and
I.
I
I
Ron
Kovic
far
as
possible,
and
while
I
appreciate
that
we
are
working
on
closed
in
environments
in
relation
to
learning,
disability
and
so
on,
I
wonder
what
immediately
we
are
doing
in
relation
to
protecting
residents
when
their
relatives
can't
go
and
see
them
and
overarching
all
of
those
things
you
might
expect
way
today.
Is
there
anything
HealthWatch,
nationally
or
locally
can
do
to
assist
your
efforts,
both
in
terms
of
information
coming
in
and
messaging,
going
out
that
you
would
like
us
to
do.
Thank.
A
You
Robert
so
I
think
the
capacity
question
probably
is
one
for
you
to
at
least
initially
and
then
as
to
for
Kate
around
testing
and
the
fact
that
as
well
but
says
care,
homes
have
effectively
become
closed
environments
and
then
the
end
of
life.
Many
medication,
Rosie
I,
suspect
that's
one,
for
you
probably
but
check.
Can
you
tick
off?
Well,.
D
I
think
everyone
recognizes
that
that
the
system
needs
to
now
focus
on
patients
who
are
not
primarily,
who
do
not
primarily
have
kovat
but
have
other
conditions
plus
or
minus
code
bitten
because
they
may
coexist,
make
sure
they're
getting
the
care
they
want
and,
as
I
said
earlier
on,
there's
an
immediate
concern
about
people
with
really
urgent
conditions,
not
seeking
the
care
they
should
care
less.
It's
thicker
and
there's
pressure
on
message
going
out
from
also
also
passed.
D
You
keep
treatment
of
all
kinds,
but
I
think
one
of
our
key
roles
is
to
make
sure
that
no
group
gets
forgotten
in
this
and
in
then
through
there
are
some
groups,
as
people
are
worried
about,
such
as
the
emergent
very,
very,
very,
very
importantly,
but
there's
there's
a
whole
host
of
other
groups,
people
long-term
conditions,
people
who
are
waiting
elective
care.
He
may
not
be
urgent,
but
they
still
have
very
important
needs
and
we
need
to
make
sure
they're
forgotten
people
in
mental
health.
D
Inpatient
settings
that
I
talked
about
earlier
on
and
making
sure
they
are
not
forgotten
in
the
priority
element
here.
So
I
think
one
of
our
roles,
Robert,
is
to
make
sure
that
no
group
gets
forgotten
and
the
risks
to
all
groups
gets
recognized
and
prioritized
appropriately,
and
we
are
working
very
much
with
with
other
partners
in
the
system
to
make
sure
that's.
That's
that
that's
important
I.
D
Talking
to
a
whole
group
of
hospitals
from
across
the
country
earlier
on
this
week
and
they're
all
starting
to
talk
about
actually
had
to
be
reset
to
deal
with
non
Kovac,
Kovac
patients-
and
we
had
some
very
interesting
discussions
and
interesting
I
think
point
was
that
he
wasn't
different
past.
The
country
are
slightly
different
points
in
this
regard.
Some
have
got
lots
of
spare
capacity
and
are
not
seeing
a
major
Kovac
surge
and
therefore
are
keen
to
to
free
up
space
for
non
carry
patients
fairly
quickly.
D
Other
other
parts,
the
country
ones
in
the
northwest-
have
seen
a
very
big
curve,
good
surge
and
they
really
need
to
develop
the
capacities,
go
to
them
a
bit
longer
to
develop
the
capacity
and
that's
not
just
physical
space.
It
is
also
the
staff
capacity
to
look
after
these
patients
and
to
do
elective
surgery,
etc.
So
so
that
needs
to
be
developed.
D
We're
also
working
I,
think
with
the
independent
healthcare
sector,
and
we've
been
working
very
closely
with
them
as
they
develop
a
new
model
of
care
under
the
auspices
of
the
NHS
to
provide
elective
care
and
I.
We've
had
a
very
good
relationship,
developing
that
so
I
think
I
think
we
are
supporting
those
parts
of
the
service
that
are
developing
extra
capacity.
D
We're
supporting
them,
develop
new
models
of
care
jointly
with
the
NHS
and
independent
healthcare,
and
we
are
encouraging
the
system
not
to
forget
any
particular
group
of
patients
who
are
in
need
of
care
going
forward.
It's
a
very
dynamic
process,
Roberts
we're
working
with
it
on
a
day-by-day
week-by-week
basis,
so
these
things
will
develop,
but
we
are
pushing
to
make
sure
that
no
grid
gets
forgotten
in
this
great
thanks.
D
C
Okay
thanks,
so,
if
I
do
the
testing
question
first,
so
we're
talking
specifically
about
the
testing
of
care
staff,
because
Rosie's
already
described
some
of
the
challenges
about
testing
of
residents
and
home
testing.
So
on
behalf
of
the
department,
as
you've
heard,
we
established
a
national
booking
system
and
since
the
system
since
this
arrangement
went
live,
I
think
market
was
on
Good
Friday.
We
went
from
having
about
nine
test
centres
available
nationally
to
twenty
five
and
those
number
of
test
centers
continue
to
rise.
C
C
There
are
particular
issues
and
pockets
of
the
country,
and
if
we've
not
got
a
test
centre,
that's
locally
available,
we
might
need
to
think
about
establishing
one,
and
while
the
work
continues
around
home
testing,
we
will
keep
an
active
eye
on
that,
because
that
is
potentially
a
way
when
clinicians
are
satisfied
that
the
right
mechanisms
are
set
up,
that's
potentially
a
way
of
reaching
care
staff
who
don't
have
the
ability
to
travel.
So
that's
a
couple
of
things
on
testing
with
regard
to
care,
homes
and
closed
environments.
C
So,
as
you
all
aware,
we
stopped
our
inspection,
our
standard
inspection
regime
at
the
start
of
this
process,
but
during
this
period
between
the
stopping
the
inspection
regime
and
the
going
live
of
our
new
emergency
support
framework,
our
interim
guidance
inspectors
have
proactively
been
having
regular
conversations
with
registers
and
managers
to
have
that
assurance
to
provide
that
support
around
how
those
services
are
supporting
people.
And
during
this
time
we
have
been
really
encouraging
get
feedback
on
care
and
because
we
really
need
to
know
what
what
people's
experiences
are.
Who
are
in
receipt
of
that
service.
C
The
other
thing,
I
would
say,
is
I
am
regularly
cited
on
instances
where,
if
there's
an
issue
or
a
challenge
with
the
care
home
sector,
a
local
response
which
often
involves
local
authorities,
CCGs
people
from
that
local
health
and
care
system
going
in
and
offering
support,
which
is
fantastic,
where
we
need
to
get
to
I
think
is
what
does
that
offer
look
like
nationally.
So
this
isn't
just
pockets
or
variability
about
that.
C
What
that
offers
for
care
homes
and
I
have
a
meeting
that
I
will
be
going
to
to
shortly
today,
which
is
looking
specifically
at
that.
What
what
is
the
concrete
support
offer
to
care
homes
that
might
have
some
local
variation?
But
is
there
a
suite
of
things
that
any
care
home
that
has
hit
this
this
level
of
issues?
This
number
of
work
absences
this
number
of
Kovach
cases.
C
Our
medicines
team
are
working
very
closely
with
partners
to
to
look
at
all
aspects
of
medication,
but
have
been
very
involved
in
this
area.
Firstly,
there
aren't
any
supply
issues
at
the
moment
with
end
of
life,
medication
that
will
wear
off,
but
I
think
one
of
the
messages
is
it's
very
important
not
to
stop
Polly's
medications,
because
that
might
cause
problems
with
the
supply
chain.
C
The
current
guidance
there
is
guidance
around
medications
for
end-of-life
care,
and
that
is
that
it
should
be
prescribed
and
supplied,
particularly
controlled
drugs
in
a
way
for
named
patients
and
care
homes.
Shouldn't
have
a
stock
of
anticipate
reMed
ins
in
their
care
homes.
We
believe
that,
with
the
local
hot
tubs
that
are
being
developed
CCG
level,
these
will
hold
anticipate
Rheem
Edison's
so
that,
if
care
homes
need
them
immediately,
they
will
have
access
to
them.
C
But
our
medicines
team
are
very
involved
in
we're
putting
out
regular
communications
and
freq.
We've
got
frequently
asked
questions
and
that
area,
so
so
the
medicines
team
are
monitoring
it
carefully,
but
just
respond
to
the
health
watch
question
as
well,
because
I
think
we've
got
some
really
great
partnership.
C
Working
going
on
with
health
watch
across
the
country
and
I've
been
encouraging
our
inspectors
to
reach
out
to
local
healthwatches,
to
have
those
discussions
to
really
understand
what
the
local
issues
are
from
that
HealthWatch
to
hearing
about
those
that
feedback
is
feeding
up
through
our
regional
escalation
and
coordination
meetings
that
we're
holding,
and
we
have
an
opportunity
to
share
that
information
through
the
regional
incident
units
that
NHS
England
have
set
up
and
also
through
our
national
channels.
So
I
think
that
relationship
is
really
really
important.
At
the
moment,
thanks
Rosie.
E
Chris,
so
yes,
as
I
rose,
you're
saying,
the
relationship
with
HealthWatch
England
is
a
very
important
one.
I
mentioned
they
give
feedback
on
care
campaign
so
give
feedback
on
care
is
our
principal
way
of
getting
the
information
from
the
public.
So,
basically,
every
since
we've
been
in
this
meeting,
six
people
have
given
their
feedback
on
our
own
care
to
us
and
we're
using
that
feedback
to
drive
our
understanding
of
what
is
happening
in
environments
where
we're
not
we're
not
going
to
have
a
routine
inspection.
E
We've
been
working
with
gippy
with
them,
HealthWatch
England
on
the
rollout
of
the
give
feedback
on
care
plan,
which
includes
both
social
media
and
partnership.
Activity
with
50
organizations
and
HealthWatch
England's
been
instrumental
in
helping
bring
that
campaign
to
fruition
so
as
well
as
those
local
relationships
with
local
HealthWatch
to
be
working
with
them
nationally.
To
make
sure
we
give
feedback
on
care,
becomes
a
food
for
group
of
people,
but
we've
already
seen
an
uptick
actually
there's
initially
a
down
over
the
first
week
of
the
trend.
E
K
Oh
yeah,
thank
you
very
much
and
it
was
first
of
all
very
good
to
see
CQC
pulling
together
so
strongly
in
the
face
of
the
crisis
in
so
many
different
ways,
and
it
was
good
to
hear
about
give
feedback
on
on
care
and
also
we've
heard
about
the
surge
in
context
to
our
national
customer
service
center
and
to
questions
about
how
the
experience
of
the
public
and
people
using
services
is
coming
in
to
us
and
how
we're
drawing
on
it.
The
first
is:
do
we
think
there
are
any
gaps?
I
mean
I
was
just
thinking.
K
You
know
it's
more
important
than
ever,
for
example,
that
people
who
are
detained
under
the
Mental
Health
Act
are
getting
in
touch
and
telling
us.
If,
then,
if
there
are
any
keys
human
rights
issues
or
or
issues
that
they're
facing,
because
we're
not
going
in
that
moment
or
are
there
any
other
groups
of
people
that
we
feel
we're
not
hearing
from
I
mean
had
a
right.
You
had
such
a
big
focus
on
people
in
care
homes
and
now
domiciliary
care
services.
That's
all
absolutely
great.
K
I
was
just
reading
about
people
who
are
employing
their
own
personal
assistance,
so
I'm
not
using
a
domiciliary
care
agency,
but
you
know
their
issues
there
with
PPD,
for
example,
we
know
there
are
the
made
that
could
be
the
issues
of
people
who
are
facing
end-of-life
living
in
their
own
homes
rather
than
in
care
homes
or
hospitals.
This
is
just
a
general
question.
Do
we
feel
there
are
any
groups
of
people
that
we're
not
hearing
from
and
we
haven't
got
much
better
on
the
first
question.
K
Second
question:
are
we
aggregating
or
the
state
too
important
on
what
we're
getting
from
those
important
partnerships
that
we
have
to
to
really
pick
up
emerging
issues
you
know
before
they
before
they
become
bigger
problems
than
than
they
might
and
final
issues?
As
we
move
forwards,
it's
been
to
hear
some
people
talk
about
the
learning
in
different
in
different
contexts
and
I
mean
it
just
struck
me
hearing
the
discussions
about
the
data
in
social
care.
E
Chris,
so
today's
your
middle
point
first
and
we
do
aggregate
the
information
we
get
from
all
sources
I'm,
just
looking
at
a
document
which
we
share
internally
and
also
goes
part
two
as
a
part
of
an
update
nationally,
which
is
the
combination
information
received
from
both
the
partnerships
we
have
and
remove.
Motion
comes
through
the
NCSC
and
just
to
talk
to
one
of
your
points
around
personal
care
that
isn't
regulated
and
a
number
of
partners
that
we
have,
including
health
watch,
England
and
Sicily.
Other
numbers
have
given
us
feedback
on.
So
we
don't.
E
E
You
gather
that
information
I
wouldn't
be
enough
to
say
that
we
we
don't
cover
every
group,
but
I,
think
one
of
the
reasons
why
we
wants
to
learn
to
campaign
with
50
organizations
is
to
get
everybody
both
so
not
just
a
large
scale,
TV
campaign,
but
actually
working
with
local
groups
right
across
the
country,
so
that
we
can
penetrate
the
areas
that
we
wouldn't
necessarily
work
with.
That's
why
the
importance
of
the
collaboration
with
a
Veracruz
we
do.
Would
you
pull
that
information
together?
E
There
are
some
just
to
give
you
a
sense
of
some
of
the
issues
that
have
been
apparent
to
the
mine,
because
confusing
and
difficult
understand
information
from
coming
from
phe,
particularly
around
the
guns,
around
co,
vid
and
loss
of
service.
So
this
could
be
loss
of
access
to
service
from
individuals
who
have
services
withdrawn.
Are
there
are
the
biggest
issues
from
public
groups,
along
with
the
issues
around
breaches
around
human
rights,
confusing
advice
about
how
people
socially
isolate
and
a
number
of
conversations
from
particular
groups
that
don't
feel
they've
been
adequately
communicated
about
what
they?
E
The
guidance
on
social
distance?
Just
should
be
so
a
number
of
areas
that
we
that
we
gather
the
information
also
goes
to
our
inspection
teams,
and
we
use
that
as
part
of
our
both
about
what
we
call
our
silver
command
are
sort
of
main
body
for
action,
but
also
it's
a
part
Lucinda
agency,
PhD
and
NHS
England,
and
then
we
share
some
of
the
thinking
about
that
through
our
regional
forms
of
each
of
the
regional
forums
that
we
have.
E
L
Thank
you
very
much.
Something
moved
in
changed
for
20
years
or
so.
I
just
wanted
to
reiterate
how
truly
impressive
what
you
guys
did
over
the
bank
holiday
weekend
from
being
cheeky
being
charged
with
these
responsibilities
on
the
first
day
to
deliver
on
the
Monday,
not
only
in
terms
of
the
pace,
but
the
discipline.
The
in
practice
is
something
that
others
could
learn
from
in
this
crisis
and
I'm
equally
truly
impressed
with
how
we're
learning
from
that
exercise
to
apply
to
other
areas,
our
transformation.
L
So
thank
you
and,
as
a
clinician
could
I
just
support
rosy
stance
on
the
home
testing
and
care
home
testing.
The
medical
adviser
to
dr.
Newton,
in
my
view,
is
just
plain
wrong
and
you
are
absolutely
right.
She
won't
do
any
use
to
anybody
that
the
process
for
procuring
and
supplying
pban
for
rolling
out
testing
has
needed
a
bureaucratic
enema,
but
the
power
path
in
that
I
am
confident
is
completely
slick,
and
you
know
others
may
need
to
look
critically
that
the
skill
set
needed
to
undertake
the
task.
L
That's
not
a
matter
for
us,
but
my
question
is
again
a
bit
like
this.
Looking
forward
that
at
the
moment,
that
testing
is
restricted
to
niche,
not
our
know-how,
to
decision,
that's
how
it
is
and
it's
a
niche
testing
process,
any
exit
from
this
lockdown
must
have
to
include
a
more
mass
testing
contact
tracing
isolation.
That's
the
route
out!
How
are
we
doing
anything
to
help
the
system
move
to
the
recognition
that
that's
how
we
need
to
well?
C
L
Rosie
requires
the
testing
to
move
from
his
niche
to
much
more
mass
testing,
with
contact
tracing
and
relevant
isolation,
and
I
was
asking
if
we
are
taking
part
in
those
conversations
to
push
things
in
that
right
direction,
which
I
recognize
down
to
our
core
responsibilities,
but
being
back
up
and
functioning
is
depending
on
that
exit
from
lockdown.
So
in
a
sense,
it's
in
our
interest
to
pursue
that
so.
C
I'm
not
directly
involved
in
those
conversations,
I
mean
you
might
want
to
comment
in
in
a
moment,
but
essentially
I
believe
our
role
here
is
rather
a
logistical
one
in
terms
of
making
it
happen
and
we're
being
directed
by
the
central
teams
who
are
leading
this
I.
Think
our
regulatory
role
in
this
is
to
make
sure
that
whatever
happens
is
done
in
a
way
that
is,
is
safe
and
appropriate
for
the
populations
that
it's
being
rolled
out
to.
B
Thanks
Rosie
I
mean
I,
I,
think
I
think
yes,
the
the
stark
reality
there
is.
We've
got
colleagues
in
a
number
of
high-level
conversations,
a
number
of
high-level
meetings
on
a
range
of
different
topics,
so
we
are
we're
in
the
room
having
those
conversations
but,
as
you
quite
rightly
say,
John
we've
deliberately
taken
a
view
that
we're
not
going
to
start
to
step
outside
competence
in
our
on
our
on
our
core
business.
B
If
you
will,
but
we
absolutely
can
bring
the
right
people
in
so
we
frequently
will
say
we
don't
know
the
answer
to
that
question.
But
we
know
we
know
some
people
who
can
give
a
perspective
on
things
so
we're
bringing
people
together,
we're
having
having
the
conversations
where
we
got
ourselves
into
a
position
where
we
are
part
of
the
decision-making
part
of
the
advice
groups
in
a
number
of
areas,
but
I,
but
I
do
think.
We
need
to
be
really
careful
and
we've
been
very
disciplined
about
this
around
around
not
going
into
places
giving
advice.
B
L
L
If
I
may,
please
the
first
one
thank
you
for
supplying
the
people
stats
and
the
impact
on
our
people
of
kovat,
but
I,
just
wonder
whether
we
have
seen
a
spike
in
the
use
of
our
occupational
health
provider
services
by
our
people
in
this
period,
especially
as
we've
been
hearing
today
about
how
working
at
home
is
for
some
people
much
more
challenging
than
for
others.
So
that's
my
first
question
whether.
L
Services
are
working
with
us
and
being
utilized.
The
second
and
third
question
relate
to
the
executive
team
report
on
people.
It's
I'm
very
pleased
to
see
the
people
plan
adapting
effectively
in
this
period.
I
particularly
wanted
to
ask
a
question
about
the
leadership
and
line
management
capability
where
the
success
profiles
are
currently
assessed
and
tested
and
I,
just
wonder
whether
they
have
actually
been
adapted
now
with
the
coded
impact.
L
So
because
we
talked
not
much
more
about
going
forward
about
collaboration
about
adaptability,
about
coaching
about
well-being
and
whether
those
success
profiles
have
been
have
responded
to
those
future
competencies
and
capabilities
going
forward.
And
my
final
question
is
a
request.
I
suppose,
rather
than
a
question,
is
the
post
survey
I
think
it's
a
very
good
idea
to
through
the
pulse
survey
in
May,
but
could
I?
L
Please
ask
that
one
of
the
ten
questions
ask
the
questions
whether
our
people
are
seeing
action
after
the
survey,
because
that,
if
we
remember,
was
that
34%
at
the
big
survey,
I
would
just
like
to
yeah
we'll
be
able
for
us
to
look
at
that,
especially
after
everything
we've
been
doing.
Thank
you.
Thanks.
F
Sure,
if
you
can
please
yeah
okay,
so
in
terms
of
the
occupational
health
I,
don't
know
the
numbers
and
whether
we've
had
an
increase
in
in
in
uptake,
we
have
been
very
proactive
in
promoting
our
occupational
health
provider
and
making
sure
people
are
aware,
the
numbers
and
the
services
that
they
offer.
So
it's
it's,
certainly
not
a
hidden
service.
F
It's
up
there
front
and
center
in
our
response
and
I
can
find
out
whether
we've
had
an
increase
in
uptake
in
that
for
you
and
let
you
know
outside
of
the
meeting
in
terms
of
the
work
we've
been
doing
around
our
success
profiles.
Yes,
we're
out
there
now
with
refining
that
work
with
with
colleagues
and
really
just
looking
at
spent
it
to
lock
these
down.
I
think
we've
already
key.
A
Thank
You
Kirsten
Thanks
any
other
questions
from
anybody
perfect,
so
listen
I!
Just
again.
Thank
you
all
very
much
for
all
you've
been
doing,
and
please
make
sure
all
the
teams
that
have
been
busily
working
recognized
make
sure
they
understand
how
much
we
recognize
that
they
have
been
computed,
really
fabulous.
Okay,
thank
you.
Thank
you
in
if
we
could
move
on
to
the
business
plan
sign-off
and
with
one
eye
on
the
clock
and
one
eye
recognizing
that
we
have
had
a
lot
of
time
on
the
business
plan
elsewhere,
I'm
hoping
that
we
can.
A
We
can
just
agree
without
further
discussion,
the
business
plan,
but
the
risk
may
be
tempting
fate
here.
So
if
anybody
has
anything
they
need
to
raise,
please
do
so,
but
if
not
we'll
take
that
as
a
proofreader
sign.
So
thank
you
very
much
indeed,
and
again,
Chris
and
Kirstie.
Thanks
to
everybody,
that's
put
a
lot
of
work
to
get
that
this
is
coming
together,
Paul
the
ac/dc
meeting
on
the
first
of
April.
Do
you
want
to
give
a
quick
update
on
that.
I
I
We
had
a
session
with
internal
audits
on
progress
against
the
program
for
the
year
new
reports
issued
and
the
draft
audit
plan
for
2020
2021
and
finally,
a
session
short
session
with
the
NAO
updating
us
on
the
financial
statements
or
whatever
the
earth
adverse
must
2020.
Well,
they
got
a
couple
of
points
on
this
on
management
assurance.
Each
of
the
14
directorates
had
assessed
themselves
against
eight
assessment
areas,
so
a
112
different
assessments.
They
were
all
70%
of
them.
Assessments
were
good
in
kinetics
and
were
requires
improvement,
which
is
broadly
as
for
last
year.
E
I
Of
improving
the
future,
but
it
was
a
good
exercise.
The
detailed
one
carefully
conducted
and
diligently
done
a
significant
amount
of
peer
review
and
internal
audit
recorded
positivity
on
the
way
as
performed
so
the
findings
of
all
that
will
be
reflected
in
the
governance
statement.
In
the
upcoming
annual
report
on
internal
audits,
we
were
pleased
that
internal
auditor
managed
to
complete
all
the
field
work
for
their
program
to
31st
of
March
just
gone,
and
they
here
and
they're
now
working
on
finalizing
the
individual
reports
6.
I
The
committee
looked
at
the
plan
for
next
year
and
that
the
right
balance
was
in
there
between
what
public
and
businesses
usually
not
on,
show
that
there
is
business
as
usual.
No
that
also
that
between
that
in
the
transformation
program-
and
we
recognize
that
that
plan
might
need
to
be
changed
as
new
emerging
risks
came
out
from
the
current
circumstances
as
well
and
then,
finally,
on
the
NAO
update,
he
was
noted
that
they
that
there
are
networking,
is
posing
some
challenges
around
package
Ennio
working
through
with
our
party
and
had
to
come.
I
There
are
also
some
technical
issues
in
there
from
a
moral
point
of
view,
but
at
the
current
time,
CQC
are
working
on
the
original
timetable
and
are
monitoring
with
nao
any
emergency
allinger's
which,
which
should
they
wish,
would
be
out
of
our
control
and
if
those
were
to
affect
the
timetable
were
looking
for,
but
otherwise
it
was
a.
It
was
an
okay
which
means
for
any
on
that
yeah.
C
I
A
Good,
thank
you
any
questions.
Excellent.
Thank
you.
Paul.
Is
there
any
other
business
from
the
board,
so
we
had
two
questions
from
the
public
one
we
really
dealt
with
and
it
was
around
asking
for
a
commitment
that
we
would
continue
to
consider
the
use
of
covert
surveillance,
and
that
was
one
of
the
commendations
in
Guiness
Murphy's
report
to
us
last
month,
and
we
have
a
commitment
then
that
we
would
be
looking
at
all
the
recommendations.
A
E
A
Only
it
may
meeting
and
then
the
second.
The
second
question
is
from
Robin
Pike
and
it's
asking
about
the
people
who
receive
letters
from
the
NHS,
classifying
them
as
clinically
extremely
vulnerable,
because
they
have
one
of
a
number
of
conditions
and
although
the
requirements
for
negations
around
those
people,
but
some
of
the
people
who
receive
those
letters,
don't
think
they
have
one
of
those
conditions.
A
Nhs
England
has
advised
such
people
to
contact
their
GP,
but
according
to
Robin
Pike,
some
GPS
are
unwilling
to
discuss
this
with
their
patients
and
distress
has
been
caused
as
a
result.
And
what
can
they
do?
I'm,
not
sure
how
much
that's
really
a
question
for
us,
but
Rosie
I,
don't
know
whether
you
you
you,
you
have
anything
to
say
by
way
of
answer.
Yes,.
C
Certainly,
it
is
really
important
that,
as
we
know,
that
shielded
patients
are
properly
shielded
and
identified
at
the
moment
and
I
know
that
practices
have
been
working
very
hard
to
to
get
that
addressed
and
I.
Think
the
first
thing
I
would
say
is
is
I
would
encourage
people
to
go
and
see
if
they
can
have
that
discussion
with
the
GP,
because
I
think
there
may
be
conditions
that
they
have,
which
aren't
necessarily
on
the
list
but
makes
the
GP
think
that
they
are
in
a
vulnerable
group.
C
So
I
would
encourage
people
to
try
and
discuss
it
with
their
GP
and
then,
if
that's
not
forthcoming,
then
I
would
try
the
practice
manager,
because
really
this
does
need
to
be
resolved
at
a
practice
level.
If
people
are
struggling
at
that
point,
then
I
would
approach
the
local
CCG
to
have
a
discussion.
People
can
come
to
us
if
they
have
concerns
about
the
service
that
they're
getting.
C
We
can't
deal
with
the
individual
issue
and
we
won't
be
able
to
deal
with
deciding
on
an
individual
basis
whether
someone
is
in
that
shielded
group
or
not,
but
we
can
certainly
lock
that
and
and
put
it
together
with
any
other
concerns
we
have
about
the
provider
or
any
other
feedback.
So
we
can
decide
whether
we
need
to
take
any
further
steps.