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From YouTube: CQC Board Meeting - May 2023
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A
Well,
welcome
everybody
in
the
room
got
an
afternoon:
everybody
watching,
live
or
subsequently
listening
to
this
in
a
replay
mode
for
those
who
aren't
in
the
room
and
are
listening
in
I
thought,
you
must
might
be
interested
to
know
that
you're
going
to
be
one
of
something
like
1
200
to
1
400
people
who
now
seem
to
regularly
watch
the
public
board
meetings
of
CQC
so
welcome.
A
So
this
is
the
public
board
meeting
of
CQC
on
the
24th
of
May
a
few
introductions.
Briefly,
if
I
could
Jeremy
boss,
who
is
the
interim
chair
of
our
audit
committee,
is
listening
and
online,
but
he's
not
physically
in
the
room
but
he's
observing
the
meeting
I'd
like
to
welcome
blessing
Hale
over
there
she's
the
equality
Network
representative
for
for
this
month,
so
welcome
blessing.
A
We
have
Jane
shiji,
Clark
and
Luz
Ansari
from
the
national
Guardian.
Excuse
me,
unhealth,
watch
Angela
respectively,
are
then
going
to
be
presenting
to
us
later
on
today,
but
they're
joining
us
the
whole
afternoon
so
welcome
to
both
of
you
and
then
last
by
no
means
least,
hopefully
down
to
my
far
left
I
can
see
Nina
Martin
who's.
A
Our
new
corporate
secretary,
who
will
be
helping
us
with
the
minutes
and
other
things
so
for
those
of
you
who
know
most
of
the
faces
and
regularly
watching
a
new
Facebook
Nina
Nina
welcome.
A
Let's
move
straight
on
to
the
formal
business
of
the
meeting.
Do
we
have
any
conflicts
of
interest?
New
conflicts
of
interest
to
Claire,
there
seem
to
be.
None.
I
haven't
been
notified
of
anything
urgent
that
people
probably
want
to
raise
anything
from
anybody.
No
apologize
for
the
noise
there,
okay!
So
let's
move
straight
on
to
the
the
first
item.
Those
of
you
watching
online
will
know
from
the
agenda.
You'll
have
seen
that
this
is
the
listening
learning
responding
concerns
we've
shown
on
the
agenda.
A
It's
the
the
management
response
and
action
plan.
I
thought
it
might
be
helpful
to
give
some
introductory
remarks
to
this
session,
both
from
my
perspective
of
the
wide
divorce
perspective
and
also
explain
how
we'll
use
the
next
30
minutes.
A
So
the
context
this
is
to
consider
Management's
response
to
the
reports
that
we
saw
at
the
board
meeting
last
time
so
for
them,
and
certainly
for
the
nod
Executives
on
the
board.
That
was
the
first
time
we'd
seen
those
reports.
A
We
commented
on
them
at
the
time
they
weren't
great
reading,
but
the
recommendations
at
a
high
level
were
broadly
accepted,
but
there
was
no
time
to
go
into
the
detail
lamp,
so
this
session
is
primarily
to
consider
Management's
responses
for
those
who
read
the
papers.
I
should
explain
it
does
refer
on
a
number
of
occasions
there
to
the
board
proposals.
A
I
mean
the
board
have
had
individual
board.
Members
have
had
the
opportunity
to
feed
comments
and
observations
in
over
the
course
of
the
last
couple
of
months
since
our
last
board
meeting
and
those
who
they've
been
given
or
are
reflected
in
the
paper,
so
I
think
that's
why
the
paper
says
you
know
the
board,
but
to
be
quite
clear.
A
Many
of
us
have
had
the
opportunity
over
the
course,
the
last
few
months
to
meet
and
engage
with
other
colleagues
as
well,
not
least
by
attending
some
of
the
operations
conferences
that
Tyson
has
run.
So
you
know
we
now
have
other
sources
of
information,
so
let's
stay
focused
on
the
llr,
but
recognizing
The
Wider
context
of
the
issues
that
we
are
seeking
to
to
address,
which
are
around
the
concerns
of
our
people
and
and
a
particular
the
concern
about
the
extent
to
which
one
listened
I
think
it's
right
to
say.
A
You
know
I,
think
I'm
I
know
I'm
speaking
on
behalf
of
all
my
board
colleagues,
to
say
that
you
know
we'd
rather
not
be
in
this
position,
but
we
are
and
as
a
board,
we're
sorry
for
the
impact
that
whatever
has
happened
has
had
on
on
some
of
our
staff.
So
let
me
make
that
clear.
A
So,
as
I
say,
we
look
with
eight
weeks
of
elapsed
since
we
saw
the
the
the
the
findings
and
we
were
lucky
at
the
time
to
have
in
the
room
the
people
that
worked
primarily
on
those
two
reports.
So
we
now
want
to
consider
things
a
little
bit
more
detail.
A
What
I'm
going
to
suggest
is
that
I'm
going
to
ask
Ian
tronome
as
the
chief
executive
to
introduce
the
papers
and
say
a
bit
more
about
Management's
response
on
approach
then
give
an
opportunity
for
colleagues
All,
Aboard
colleagues,
but
but
I
guess
in
particular
for
the
non-executives
that
didn't
write
the
details
of
the
paper
to
respond
or
League
of
any
questions.
They
managed
to
ask
in
relation
to
the
paper
and
blessing,
if
appropriate,
very
happy
for
you
to
comment
as
well.
A
I
would
ask
colleagues
we've
allowed
half
an
hour
for
this,
for
what
is
already
quite
a
long
meeting,
so
I
think
comments.
If
I
could
ask
people
both
the
questions
and
the
responses
to
be
to
the
point
in
brief,
if
we
could
do
and
then
once
we
finish,
those
we'll
try
to
get
through
that
within
the
half
hour
and
I'll
I'll
wrap
up
with
what
I
think
is
a
summary
from
the
points
we've
raised.
So
if
that's
okay
with
everybody
Ian
could
ask
you
to
talk
about
the
Management's
response.
B
Thanks
thanks
very
much
and,
as
you
said,
we're
here
today
to
consider
the
action
plan
arising
from
the
listening
learning
and
responding
to
concerns
review
that
was
presented
last
month.
B
I
think,
if
you
first
say
it's
a
it
was
an
upsetting
report
in
one
sense:
It's
upsetting
that
we
we
got
here
and
I
think
it's
also
fair
to
say
that
we
could
have
done
better
individually
and
collectively,
as
an
organization
and
I
think
just
to
reinforce
the
the
the
apology
that
I've
made
to
to
colleagues
internally
but
I'm.
Just
reiterate
the
point.
B
Ian's
mate
and
other
colleagues
have
made,
isn't
that
you
know
I'm,
really
sorry
about
the
impact
that
that
some
of
the
some
of
the
activities,
some
of
the
the
things
that
were
cited
in
the
report
have
had
on
colleagues
and
I.
Think
we
we're
all
Keen
to
to
do
better
and
and
improve
and
I
appreciate
the
Candor
and
honesty
with
which
everyone
has
approached
the
work.
B
The
lots
of
people
contributed
to
the
work,
and
that's
given
us
a
true
if,
if
someone
uncomfortable
picture
and
I'm
particularly
also
grateful
for
those
who
who
led
this
work
internally
and
those
people
from
outside
CQC,
who've,
supported
and
and
challenged
Us
in
equal
measure,
I
think
without
their
contribution,
the
work
would
have
been
would
have
been
the
poorer
and
it
is
a
comprehensive
piece
of
work
with
with
many
facets
to
it.
B
I
know
it
would
be
fair
to
say
that
we
are
all
absolutely
committed
to
ensuring
that
this
work
moves
forward
in
a
way
that
genuinely
makes
a
difference
and
I
think
that
generally
genuinely
making
a
difference
is
the
key
is
the
key
thing
here.
Our
strategy
is
ambitious.
We've
talked
about
our
strategy
in
many
of
these
board
meetings.
B
In
the
past,
we
are
ambitious
in
areas
such
as
safety,
Improvement
and
tackling
inequalities
in
The,
Wider,
Health
and
Care
System,
but
for
us
to
be
successful
in
in
delivering
that
strategy,
we
need
people
in
in
The
Wider
population
to
feel
that
they
can
talk
to
us
openly
and
that
we
can
be
confident
about
having
tough
conversations
about
topics
such
as
race,
be
that
internally,
with
our
own
with
our
own
colleagues
or
we
or
or
with
providers,
or
indeed
how
our
colleagues
describe
the
performance
of
individual
providers.
B
The
five
work
streams
from
the
report
made
some
80
recommendations
and
responding
to
to
these
recommendations.
These
80
recommendations
as
a
combined
package
of
activity
will
require
coordinated
and
careful
work,
but
our
mindset
must
be
focused
on
making
a
real
difference.
I
explicitly,
don't
just
want
to
quickly
tick
off
the
items
on
the
list.
I
think
we've
had
some
suggestions
that
we
should
just
go
on
with
it
and
just
get
some
get
some
things
done,
I
I
explicitly!
Don't
want
to
do
that
because
I
think
it
would
be.
B
We
may
need,
to
course
correct,
as
we
go,
it's
going
to
take
us
probably
a
fair
period
of
time,
probably
at
least
18
months
to
to
complete
some
of
these
actions,
but
complete
them
in
a
way
that
makes
a
difference.
We
may,
as
as
the
external
World
changes,
need
to
course
correct.
As
we
see
how
effective
some
of
the
early
work
is,
how
impactful
it
is.
B
We
need
we
need,
we
need
our
colleagues,
we
need
our
networks,
we
need
our
trades
unions
and
we
need
providers
to
be
with
us
on
this
journey
because
I,
don't
think,
there's
anything
in
the
report
that
everyone
isn't
absolutely
committed
to
to
taking
forward.
But
it's
a
question
of
how
we
do
that
in
the
most
effective
way.
B
Some
of
the
actions
are
already
in
trained
within
our
people
plan
or
their
or
plans
are
already
in
our
transformation
program
and
and
again
the
transformation
program
plans
have
been
reviewed
against
the
actions.
From
the
this
review,
some
things
will
be
incorporated
into
existing
programs
of
work
and
existing
activity
and,
of
course,
some
activity
is
genuinely
new
again
I
know.
Kate
Staples
is
is
happy
to
talk
about
how
she's
going
to
offer
the
leadership
to
bring
all
of
this
work
together
and
the
individual
exec
team.
B
Colleagues
stand
ready
to
to
to
to
answer
the
questions
of
Ned
colleagues
to
understand
the
detail
of
of
how
the
next
phases
of
this
will
work
so
Ian
over
to
you.
A
Thanks
Ian
Kate,
we
all
come
to
you
one
way
or
another
later
on,
but
perhaps
let's
just
pause
from
management
now
and
I've
board.
Colleagues,
I
guess
I
could
look
in,
particularly
at
my
non-executive
colleagues
any
questions
they
would
like
to
ask
Belinda.
C
Thank
you,
so
I've
got
a
couple
of
questions,
so
my
first
question
is:
it's
obviously
very
concerning
for
everybody
that
the
review
highlights
that
we
do
offer
consistent
approach
or
keep
accurate
records
when
people
raise
concerns
with
us
and
in
and
the
decision
whether
to
progress.
That
concern
is
determined
by
the
inspector,
particularly
concerning
there's
a
main
focus
on
structures
about
listening
and
learning
from
people
who
raise
concerns.
So
the
first
question
I'd
be
interested
to
learn
how
we
are
going
to
address
that
as
a
board.
C
My
second
question
is
I
recently
attended
the
CQC
conference
in
Newcastle
and
some
of
the
staff
there
expressed
concern
about
the
assessor
and
inspector
split
and
I
just
wondered
if
we
had
any
further
Clarity
on
that
for
reassurance.
A
D
Thank
you,
Belinda
I
mean
shall
I
I'll
address
the
inspector
and
assessor
split
part
of
the
question.
We've
already
launched
our
review
of
of
the
roles.
I.
Think
those
colleagues
who
attended
the
conferences
we
ran
around
England
will
have
seen
that
there
is
a.
D
There
is
a
clear
role
for
assessment
of
a
huge
amount
of
data
that
we
will
receive
going
forward
and
the
point
of
the
review,
which,
which
was
agreed
at
a
recent
acath
discussion
and
then
also
came
out
very
clearly
in
the
llr
review,
is
that
we
will
start
look
at
exactly
what
what
the
role,
what
the
roles
will
look
like
going
forward.
So
I've
already
written
out
to
all
colleagues
asking
for
10
to
12
to
become
involved
in
the
project.
D
82
have
volunteered
so
even
though
only
12
will
be
we'll
be
doing
the
really
real
heavy
lifting
on
this
I'll
make
sure
that
all
82
are
also
involved
and
we're
looking
to
start
that
now
and
then
that
will
go
through
to
October,
by
which
time
we
shall
have
a
much
clearer
idea,
but
that
that's
been
that's
been
that's
been
initiated
large,
largely
because
of
the
comics
that
we've
been
receiving
about
colleagues
views
on
the
rules.
E
Okay,
thanks
Belinda,
so
the
question
around
consistency
of
our
inspectors.
So
there
is
a
wealth
of
work
going
on
around
the
whistleblowing
led
by
one
of
our
Deputy
directors,
Haley
Moore,
and
there
will
be
outputs
from
that
generated
in
the
kind
of
coming
weeks
and
months.
I
think
it's
also
worth
flagging
that
our
new
single
assessment
framework
is
the
it's
the
structured
mechanism
which
will
support
inspectors
when
it
comes
to
consistent
decision
making
capturing.
G
To
build
on
that
and
you're
absolutely
right
about
the
importance
of
being
able
to
not
just
hear
but
to
hold
and
then
feed
back
to
people
use
Services
what
we
have,
what
we,
what
action
we've
taken
with
regards
to
their
work.
So
my
colleague,
Jim
Morel,
has
been
working
really
closely
with
colleagues
in
in
Mark's
team
to
look
at
both
how
we
capture
physically
capture
the
information
we
get
from
from
colleagues
store
it
well
and
then
can
return.
G
The
information
to
people
use
Services
indicating
what
we've
done
and
that
for
me,
that's
a
really
important
trust.
Circle
that
we're
creating
there
we've
seen
a
massive
rise,
as
you
know,
in
giffy,
back
on
care
and
the
feedback
from
from
people
in
service
about
how
they're
experiencing
it.
The
absolute
challenge
for
us
is
to
make
sure
that
we
can
be
cogent
about
how
we're
using
that
information
and
what
what
difference.
G
B
I
think
just
just
to
just
to
come
in
on
the
back
of
the
point
about
consistency,
one
of
the
things
that
Tyson
and
his
management
team
have
done
have
done
over
the
last
few
months
as
part
of
moving
to
the
new
teams,
is
they've
gone
through
all
of
our
processes
and
all
of
our
procedures
from
it,
with
a
consistency
lens
and
where
there
has
been
inconsistency.
B
They've
been
designing
that
out
and
that
process
continues,
as
as
we
started
to
expose
differences
in
in
a
range
of
different
processes,
of
which
whistleblowing
is
one
I
think
we
do
need
to
recognize,
though,
that
you
know
the
professional
Judgment
of
inspectors
is
still
important
and
and
I
think
that's
an
important
component
of
what
we
do.
D
Thank
you
and
find
a
point
for
me
on
this
blend
and
we
are
picking
up
on
what
Kate
said.
We're
also
looking
at
the
the
quality
of
how
we
respond
to
whistleblowing
and
safeguarding
just
for
some
time.
We've
been
really
good
at
the
timeliness
element
meeting
the
kpi,
but
now
we're
looking
at
system
for
how
we
can
actually
measure
the
quality
of
of
our
response
to
to
those
which
I
think
taken
in
the
round
will
will
improve
what
we're
doing
at
the
moment.
H
Thank
you,
I
guess.
Firstly,
I
mean
thank
you
very
much
to
the
executive
for
the
for
the
management
response
personally
I
think
it
is
a
good
strong
response
and,
and
we'll
pick
up
some
really
really
important
messages
from
the
llr
report.
H
H
The
second
point:
I
just
wanted
to
raise
working
with
Jane
Judy
Clark
and
with
Mark
on
the
national
Guardians
office.
There
are
some
specific
recommendations
in
the
report
about
improving
our
freedom,
speak
up
Guardian
capability,
Within
cqce,
because
that
is
one
way
in
which
it's
really
important
for
staff
to
feel
confident
that
when
they've
got
concerns
and
they've
got
worries
and
they've
got
things,
they
want
to
say,
they've
got
a
route
to
saying
it,
and
they
they
can.
H
You
know
trust
in
the
route
to
raising
their
concerns,
which
is
what
the
freedom
to
speak
up.
Guardians
are
trying
to
do
so,
just
to
note,
working
with
Jane
and
with
Mark
I
think,
there's
some
really
important
work
that
we
need
to
do,
and
we
need
to
have
some
visibility
of
at
board
level
about
a
boosting,
our
own
internal
capacity
for
freedom
to
speak
up
thanks.
E
You
thanks
Stephen,
so
I
think
our
pulse
survey
is
a
really
good
route
for
that
regular
check-in
on
where
staff
sentiments
are,
and
you
may
be
aware,
we've
currently
got
a
survey
opened
at
the
moment
focused
on
diversity
and
inclusion,
and
that
closes
in
about
a
week's
time
and
already
about
52
of
our
staff
have
completed
it.
So
we
have
a
mechanism
from
hearing
from
our
colleagues
and
also
we
have
a
really
high
response
rate.
E
So
staff
really
engage
with
that
as
a
route
to
telling
us
what
they
think,
which
is
really
valuable,
I
agree:
I,
don't
think
we
have
adequately,
on
a
regular
basis,
be
being
giving
board
enough
of
a
feel
of
what's
going
on
for
our
colleagues
outside
of
the
pulse
survey.
E
So
if
I
think
about
the
regular
transformation
updates
that
I
we
give,
you
I,
think
there's
more,
we
can
do
to
bring
to
life
for
you
what's
going
for,
for
our
colleagues
and
Quest
can
talk
to
you
you
about
that
a
bit
more
in
a
mo
I.
Think
in
addition
to
that,
I
think
there's
a
suite
of
kind
of
data
about
what
we
tell
you
about.
E
G
Yes,
I
agree
with
your
your
point:
Stephen
you'll
notice.
We've
made
some
changes
to
the
the
reporting
pack
for
the
transformation
program
in
particular,
so
we're
very
there's
more
detail
there
about
what
we're
hearing
both
from
colleagues
internally
and
also
from
people
who
services
and
and
stakeholders
externally
I
think
there's
more.
G
We
can
do
to
sort
of
get
give
a
sense
of
what
some
of
the
risks
that
sit
behind
those
issues
are,
and
also
what
we're
doing
about
those
who
are
both
practically
in
the
program,
but
also
in
terms
of
how
we
respond
to
colleagues.
I
think
this
is
a
a
case.
Sometimes
I've
been
really
clear
about
what
we
can
do,
what
we
are
doing
also
being
clear
about
what
we're
why
we're
taking
the
action
that
we're
taking
so
hopefully
you're
seeing
that
report.
A
combination
of
this
is
what
we're
hearing.
G
These
are
the
risks,
and
these
are
our
actions.
What
I
hopefully
also
give
you
is
a
little
bit
about
what
our
approach
is
for
the
the
next
set
of
messaging.
That's
going
to
appear,
probably
in
a
month
or
or
six
or
eight
weeks
time.
So
we
can
have
a
good
conversation
and
feel
assured
that
the
next
set
of
information
is
built
on
the
feedback
we've
received
this
time
and
also
what
we
intend
to
do
next.
I
I
Come
in
on
the
freedom
speaker,
I'm,
sorry,
thank
you.
Stephen
I
agree
with
the
the
the
need
for
us
to
to
work
on
our
freedom
to
speak
up
capability,
CQC
and
I'm.
The
exact
sponsor
for
Freedom
speak
up,
so
I
take
I.
I
Take
that
responsibility
at
the
at
the
operations,
conferences
that
we've
had
recently
I've
appealed
for
for
help
and
support
and
engagement
with
colleagues
to
to
help
share
their
experiences
and,
and
what
do
they
want
to
see,
improves
and
I've
been
absolutely
delighted
with
lots
of
offers
of
support
to
help
us
to
to
to
work
on
that
and
to
help
me
understand
what
people,
what
our
colleagues
want
from
the
freedom
to
speak
up
experience
and
to
share
their
experiences.
I
I
We
obviously
have
our
our
Guardian
Carolyn
jenkinson,
who
I'll
be
working
with
very
closely.
We've
got
a
wealth
of
experience
with
Carolyn
and
she
understands
a
lot
about
what
improvements
we
can
make
and
there's
there's
lots
of
opportunity
there
for
us
to
I.
Don't
want
to
pre-touch
that
so
I
want
to
listen
and
learn
about
what
the
what
the
opportunities
are,
but
we
we
know
we
need
to
to
boost
our
our
our
capacity
and
capability.
We
need.
I
J
I'll
be
very
quick
Ian
as
a
result
of
the
past
surveys
that
Kate
mentioned
we've
had
a
number
of
post
survey,
action
groups
within
directorates
and
across
CQC
and
one
of
the
areas
that's
been
flagged
when
we've
called
all
the
information
together
is
employee
experience
and
I
am
now
as
of
a
few
weeks
ago,
the
exec
sponsor
for
employee
experience,
so
I've
got
a
list
of
things
that
people
have
said.
J
These
are
the
things
we
want
action
on,
and
these
are
the
things
that
we
feel
will
make
a
difference
within
secrecy
and
I'll
be
working
with
our
people
team.
To
look
at
the
people
plan.
Look
at
those
actions
and
then
think
about
what
kind
of
key
things
we
can
key
interventions.
We
can
do
to
help
deliver
on
that
difference.
That
you've
talked
about.
K
You
I'm
pleased
to
see
the
acceptance
and
the
commitment
to
undertaking
all
of
the
actions
that
were
identified
within
the
review
and
I'm
pleased
to
hear
that
there
is
a
strong
commitment
to
monitoring
the
sentiment
of
our
colleagues
and
the
external
environment
to
understanding
how
these
are
vetted
in
between
the
two
of
those
aligning
there's
something
around
the
attitudes,
behaviors
and
culture
that
we
developed
that.
K
E
Great
thanks,
Ali,
so
I've
been
learning
a
lot
about
culture
recently
and
I
I.
Think
for
me,
coaches
about
how
we
do
things,
there's
a
load
of
structural
stuff.
That's
how
there's
our
policies
there's
our
Frameworks
within
which
we
work,
but
also
we
role
model
on
a
day-to-day
basis.
E
What
we
expect,
from
others
and
and
the
kind
of
time
we
set
in
the
organization
and
I,
think
things
like
publishing
this
very
transparent,
very
robust
reflection
of
where
we
could
and
should
have
done
better
in
lots
of
different
areas,
hopefully
not
coming
across
as
defensive
at
all
in
there
and
where
we've
needed
to
saying
sorry
where
we've
got
things
wrong.
E
I
hope,
that's
the
start
of
maybe
a
little
shift
in
culture
that
we
need
to
demonstrate,
which
is
as
Leaders
we're
going
to
make
mistakes
we're
going
to
get
things
wrong.
It's
really
important,
we're
transparent
about
that
and
we,
you
know,
commit
to
do
things
differently
and
are
prepared
to
be
held
to
account
for
what
those
differences
look
like
so
I
hope,
I,
hope.
E
The
publishing
of
this
report
and
the
things
that
have
followed
since
such
as
colleagues
receiving
apologies,
concrete
things
such
as
the
commitment
around
the
inspector
assessor
split
commitment
around
how
we're
going
to
you
know,
invest
in
our
speaker,
I
hope.
Those
are
concrete
things
as
well
as
a
maybe
a
little
shift
in
in
our
in,
in
how
we
work
we'll
go
some
way
to
to
build
confidence
and
kind
of
set.
The
time
we
want
to
see
through
the
organization
as
well,
which
is
you
know,
we
we
all
make
mistakes
and
it's
important.
A
L
You
none
of
us
was
pleased
to
read
the
report.
It
was
a
a
sobering
read,
but
you
know,
but
I
am
pleased
by
the
response
and
I
think
I
think
it
shows
a
real
commitment
to
change.
L
What
it
feels
like
to
work
here,
which
is
which
is
always
my
favorite
definition
of
of
culture
and
if
we're
wanting
to
create
a
truly
open
culture,
where
people
feel
free
to
raise
concerns,
suggestions,
questions,
confident
that
they'll
be
listened
to
respectfully,
confident
that
appropriate
action
will
be
taken.
That's
that's!
That's
not
an
overnight
exercise,
and
so
the
combination
of
a
real
commitment
to
to
address
the
the
80
really
constructive,
helpful,
very
directional
recommendations
in
here,
but
also
to
try
to
integrate
it
into
a
broader
program
of
work.
L
That's
not
going
to
be
delivered
overnight.
I
think
that's
I,
think
that's
tremendously
important.
So
there
was
an
observation.
The
question
you
know
one
of
the
things
that
that
obviously
a
a
rose
here
is
limited
confidence
around
the
organization
to
to
talk
about
race-
and
you
know
maybe
that
reflects
you-
know,
challenges
in
in
wider
Society.
L
It's
not
something
that
we
all
feel
tremendously
confident
about
in
our
in
our
in
our
day
lives,
but
there's
lots
that
we
can
do
to
to
to
to
change
that,
and
the
truth
is
if
we're
going
to
be
able
to
have
people
call
out
issues
when
things
just
don't
feel
right
to
address
mistakes
that
people
make
before
they
turn
into
regular
practices,
to
to
be
allies
and
and
coaches
for
each
other.
L
We've
got
to
get
good
at
this,
and
we
can't
we
certainly
cannot
have
you
know,
questions
of
of
race
in
any
way
being
a
barrier
to
to
achieving
the
the
the
culture
that
that
we
want,
because
people
just
you
know.
Sometimes
this
is
difficult
conversations
and
that's
an
extra
dimension
of
difficulty
that
can't
be
a
barrier.
So
I'd
like
to
you,
know
to
hear
a
little
bit
more
about
how
we're
how
we're
addressing
that.
B
I'll,
let
Kate
talking
a
little
bit
more
detail
about
that
in
a
moment,
but
I
think
just
a
there's
a
point.
That's
worth
a
contextual
Point,
that's
worth
making,
which
is
when
we
look
at
our
our
recruitment
activity.
At
the
moment,
a
quarter
of
our
new
starters
are
now
from
a
black
or
Asian
background
and
we
are
outstrip
and
that
that
number
of
people
is
outstripping
the
number
of
people,
the
percentage
of
people
who
are
leaving.
We
have
a
relatively
low
turnover
rate
in
in
the
scheme
of
things
and
I.
B
If
I
look
at
the
the
rate
of
employment
across
the
whole
organization,
we've
got
about
just
over
14
of
our
colleagues
are
from
a
black
or
Asian
background
at
all
levels
and
I.
B
Think
I
think
that
that
that
that
that
that
move
all
the
way
through
the
management
structure
is,
is
really
positive
and
I'm
not
going
to
sit
here
and
pretend
job
done,
but
I
think
having
a
genuinely
having
a
a
group
of
colleagues
who
are
reflective
of
the
population
which
they
serve,
takes
us
some
way
towards
what
what
you've
just
you've
just
described,
and
it
also
means
that,
in
terms
of
confidence
in
talking
about
race,
we've
got
colleagues
to
to
work
alongside
us
who
are
having
those
conversations
in
to
enable
us
to
properly
describe
what's
going
on,
because
I
think.
B
Ultimately,
you
know
the
work
that
we're
doing
around
our
new
single
assessment
framework
is
all
about
re-emphasizing,
reinforcing
the
voice
of
people
that
use
services
and
making
sure
that
those
voices
are
reflected
in
our
reporting
activity.
That's
what
the
signal
assessment
framework
re-doubles
on.
If
we've
got
people
on
staff
who
who
are
who
who've
got
some?
Who?
Who
can
make
those
connections
with
with
people
in
in
Services?
That's
going
to
make
a
huge,
a
huge
difference.
I
think
Kate
wanted
to
come
in
as
well.
Yeah.
E
Thanks
thanks
Mark,
so
it
was
interesting.
So
the
the
conversation
that
goes
along
the
lines
of
we
find
it
really.
We
know
we're
not
confident
and
confident
about
talking
about
race
or
racism.
Neither
are
most
people
in
the
country.
We
heard
a
really
strong
feedback
from
our
colleagues,
people
in
our
organization
who
say
we're
often
members
of
professional.
You
know
we're
registered
professionals.
We
should
be
holding
ourselves
to
a
higher
bar.
We
should
we
should
feel
confident
in
this
area.
So
so
there
was
a
real
pushback
from
our
people.
E
E
Had
many
many
conversations,
as
did
colleagues
with
people
who
go
out
and
inspect,
who
said,
I,
recognize
that
finding
I
often
see
things
that
feels
like
there
are
issues
going
on
around
race
or
racism,
but
I
don't
feel
like
I've
got
the
tools
to
name
it
to
describe
it
to
require
action
on
the
back
of
it.
So
our
colleagues
want
to
do
better
feel
like
they
should
be
doing.
E
You
know
that
we
should
all
be
doing
a
lot
better
in
this
area,
but
also
recognize
that
that
is
reflected
in
their
experiences,
that
for
a
number
of
our
people
there
is
that
lack
of
confidence
and
competence.
So
this
is
an
area,
a
perfect
example
where
on
Ian's
point
we
don't
want
to
rush
at
it.
So
we've
we've
started
to
do
some
thinking
about
this,
we're
going
to
work
with
our
racer
quality
Network
to
look
at
what
we
want
to
do.
It's
easy
to
think.
That's
leap
to
training,
but
actually
I
know.
E
As
we've
talked
about
this
as
an
exec
team,
our
ambition
is
to
go
further
than
it
is
in
the
report.
So
this
is
not
just
about
in
six
months
time
us
asking
everyone
in
the
organization.
Do
you
feel
more
confident
and
confident
about
talking
about
race
and
racism?
I?
Think
there
is
an
ambition
around
we
want
to
understand
structural
racism.
We
want
to
be
able
to
call
it
out.
We
want
it.
We
want
to
go
further
than
is
in
the
Rapport
and
in
order
for
to
to
do
that
in
a
really
meaningful
way.
L
F
You
Ian
I
welcome
the
Lila
review
and
its
findings.
The
equality,
Network
co-chairs
and
I
look
forward
to
working
closely
with
the
llr
sponsor
to
move
things
forward
and
help
the
board
and
ET
to
make
the
necessary
changes
and
improvements,
always
ensuring
the
colleague's
voice
is
continuously
listened
to,
thus
providing
a
better
culture
within
CQC
for
all
colleagues,
I'm,
also
looking
forward
to
help
in
shaping
the
work
on
Race
findings
and
our
confidence
in
discussing
race
to
achieve
race
fluency
at
CQC.
Thank
you.
G
M
Thank
you.
So
there
seems
to
be
a
sort
of
breakdown
in
communication
between
management
and
colleagues.
You
know
how
do
we
ensure
that
we
can
get
colleagues
to
feel
their
heard
more
often
and
actions
are
taken
quickly
rather
than
allowing
them
to
fester,
and
then
you
know,
you
know
something
that
seems
quite
small
suddenly
becomes
quite
large
and
our
colleagues
feel
stressed
and
Under
Pressure.
Are
there
any
ways
that
we
can
close
the
communication
gap
between
management
and
our
sort
of
Staff
colleagues.
G
I
think
it's
a
really
fair
point.
Jorah
two
things
I'd
say
one
is
one's
about
trust
ones,
about
speed,
so
just
to
build
on
the
trust
point
I
talked
about
it
earlier
in
response
to
Stephen's
question
been
open
and
transparent
about
what
we're
hearing,
what
risks
that
pose
is
and
what
we're
doing
about
it
is
really
really
important
and
I.
Think
we've
we've
got
better
at
interpreting
that
information
and
preventing
it
here
as
as
well
as
in
other
places,
and
that's
something
I
want
to
continue
to
do.
G
So
I
think
there's
a
there's,
a
I
think
we've
begun
to
I,
don't
as
Ian
was
saying,
this
is
a
it
doesn't
happen
overnight,
but
I
think
we've
begun
through
some
of
the
actions
we've
taken
recently
to
build
back
some
Trust
with
colleagues
that
will
enable
us
to
to
people
to
feel
confident
about
sharing
that
information
again.
I
think
the
other
part
of
this
is
giving
operational
managers
both
the
permission
and
the
requirement
to
give
us
that
information
quickly.
So
we
can
take
the
right
course
correction
just
to
get
as
a
practical
example.
G
It's
a
very
small
one,
but
there's
a
real
challenge
at
the
moment
around
Preparing
People
for
the
the
new
single
assessment
framework
and
a
training
that
goes
with
that,
and
we
had
some
conversations
about
which
came
from
the
Arts
conferences
and
we
all
met
colleagues
afterwards
talking
about
the
they.
They
supported
the
idea
of
the
new,
the
new
framework,
we're
concerned
about
whether
they
would
both
not
just
in
terms
of
the
technical
ability
to
use
the
new
the
new
system,
but
the
cultural
steps
that
that
would
that
would
create.
G
And
so
there
was
a
concern,
a
real
concern
that
they
would.
They
would
feel
ill-prepared
for
that
shift
in
October.
So
we
Joyce
chairs
the
the
regulatory
governance
group
and
we
had
a
really
good
conversation.
D
Thank
you.
The
only
point
I
was
going
to
add
is
that
I
found
leading
a
big
change
program
remotely
on
on
on
teams
or
such
other
other
such
tools
really
difficult
to
do,
because
you
can't
see
people's
Expressions.
You
can't
read
their
body
language,
the
four
conferences
we've
held
and
I
know.
We've
talked
about
a
lot
about
those
already,
but
I
kind
of
knew
that,
but
that
was
revelatory
to
me
because
I
was
actually
there
talking
to
people.
I
could
see.
I
could
see
how
they
were
reacting
and
we
designed
the
afternoons
deliberately.
D
So
there
was
time
for
colleagues
to
have
for
their
say,
and
that
was
a
risk
because
colleagues
might
not
have
done,
but
a
large
number
of
them
did
and
I
get
a
sense
that
that's
the
way
we've
got
to
work
going
forward,
of
course
we're
all
over
England.
So
we
have
to
continue
to
work
remotely,
but
I
think
we
need
to
come
together
either
with
the
whole
group
or
in
directorate
on
smaller
teams.
But
I
think
that
that
was
a
way
in
which
you
communicate
it's
much
more
impactful
than
doing
it
all
online.
A
I'm
glad
you
said
that
Tyson
in
some
extent
saves
me,
ask
the
question:
I
was
going
to
ask,
but
many
of
us
have
exposure
to
other
organizations
and
I
think
others
I
see
have
moved
more
quickly
to
away
from
holy
virtual
working
to
getting
people
together
than
perhaps
we've
done
now.
A
We
are
more
virtual
than
many
other
organizations,
so
we're
clearly
not
getting
a
position
saying
you
know
everyone's
got
media
Office
three
days
a
week
or
something
the
way
others
have,
but
nevertheless
I
think
particularly
those
of
us
that
went
to
your
operations
conference
has
just
found
how
valuable
it
was.
I
mean
I've,
been
here
a
year
as
the
chair
I
met
more
people
in
those
two
days.
I
could
animate
too,
unfortunately,
but
I
met
more
people
in
those
two
days
than
I
did
in
the
previous
year,
which
was
a
huge
benefit
Joy.
J
Yes,
because
Chris
mentioned
the
regulatory
governance
board,
I
thought
I'd
mention
it
really
quickly.
We
had
our
first
meeting,
so
this
is
part
of
transformation
and
it
was
launched
in
April,
and
we
had
our
first
meeting
on
Monday
and
the
members
are
from
across
the
organization,
including
operations
and
other
areas
like
policy
strategy,
engagement,
data
and
insight,
and
that
meeting
focused
on
you
know.
What
do
we
want
to?
J
We've
got
a
we've,
got
to
continue
to
respond
bond
to
demand
like
safeguarding
and
whistleblowing,
but
alongside
that
is
training
and
the
single
assessment
framework
and
then
some
other
areas
of
work
so
we're
trying
to
pull
away
things
that
are
necessary
to
do,
but
may
not
be
as
urgent,
and
we
want
to
give
Tyson
the
opportunity
to
say
to
his
Ops
colleagues
and
to
the
networks
and
to
the
colleagues
that
work
within
operations
that
this
training
is
really
important.
N
We've
talked
about
the
importance
of
culture
and
how
we
would
signal
a
changing
Culture
by
by
seeing
a
shift
in
how
we
work
I
think
was
a
great
way
of
putting
it
just
I'm,
aware
of
a
couple
of
examples
of
where
this
is.
We
had
the
opportunity
to
do
this.
You
know
very
soon.
Firstly,
with
primary
medical
services.
N
N
The
other
example,
I
think,
is
the
maternity
inspection
program,
where
we've
heard
clearly
from
colleagues
the
importance
of
of
ensuring
that
we
that
that
inspection
program
looks
very
closely
at
inequalities
and
the
issues
around
inequalities,
and
that
our
staff
have
the
confidence
to
discuss
those
issues,
and
that
is
something
that
we
we
we
want
to
respond
to
and
our
are
responding
to
currently.
A
Thanks
sure,
as
far
as
I'll
put
it
together
any
other
comments,
people
want
to
make
oh
and
if
not
I,
I'm
trying
to
summarize
that
with
the
possible
task,
but
I
jotted
down
a
few
things
like
I
thought,
I
heard,
and
my
colleagues
I'm
sure
will
correct
me.
If,
if
you
don't
think
this
is
right,
so
there's
a
very
comprehensive
response
on
LOL,
we
haven't
really
thanked
Kate
for
producing
her,
but
Kate
pulled
it
all
together,
and
we
said
at
a
high
level,
the
other
in
the
first
session.
A
You
know
broadly
agreed
with
it,
I
think.
If
you
look
at
that
schedule,
it
says
agreed
agreed
agreed.
We
may
need
to
discuss
further
mechanics
of
some
of
the
house,
but
all
the
points
are
agreed
so
and
I
I,
so
that
was
the
management
position.
I
think
I
heard
from
my
ball,
colleagues
that
they
were.
They
were
agreed
with
and
pleased
to
see
that
several
people
have
used.
A
The
word
commitment,
I,
would
say
you
know
speed,
given
that
I've
spoken
to
many
of
the
executives
over
the
course
of
the
last
few
weeks,
both
those
in
the
room
and
others
I
would
say
to
my
board
colleagues
here
now
listening
I
think
that
commitment
is
genuine,
I
think
there's
a
real
desire
to
make
sure
we
get
this
right
and
I
think
that
commitment
leads
into
an
ambition
to
actually
do
better,
which
again
a
couple
of
people
have
said
and
I'd
like
to
come
back
to
in
just
a
moment.
A
This
is
in
terms
of
timing.
The
chart
may
not
show
it
there's
a
few
things
shown
as
being
completed
like
a
new
policy
on
whistleblowing,
but
quite
a
lot
of
the
work
is
underway
already
and
we
did
say
before
and
I
think
we're
doing
our
baking
it
into
the
kind
of
business
as
usual.
So
this
isn't
a
separate
project
out
there.
You
know.
Perhaps
that
was
an
issue
for
the
transformation.
A
Originally,
it
was
kind
of
separate,
but
this
is
embedded
in
the
way
we're
going
to
do
things,
so
there
will
be
some
red
and
quick
wins,
but
but
some
of
this
stuff
will
take
a
longer,
while
indeed
I
think
rather
than
saying
excited
to
18
months.
I.
Think
some
of
this
stuff
is
just
going
to
be
ongoing.
A
The
you
know
our
staff
staff
will
change.
Society
will
change
so
I
think
this
isn't
so
much
around
completing
a
project.
It's
a
new
way
of
working
of
listening
to
people
and
responding
in
a
changing
environment,
I
I
think
an
excellent
point
was
made
about
just
to
be
clear.
The
recommendations
don't
relate
just
to
the
people
around
the
table.
I
mean
it
is
for
the
organization
as
a
whole,
so
for
everybody,
our
three
thousand
past
employees,
but
let's
be
clear.
It's
responsible.
A
Let's
see
the
people
around
this
table
to
provide
the
leadership
to
enable
that
to
happen
to
make
sure
it
does
happen,
As
a
detail,
appointment,
here's
some
better
ways
of
measuring
some
stuff
so
that
we
have
a
better
side
of
what's
going
a
lot
of
the
better
listening
as
a
cultural
issue,
but
we
also
need
some
better
measurements.
There
are
things
that
that
we
don't
know
one
of
the
people
I
met.
A
There
is
I
think
a
really
important
point.
I
try
to
make
at
the
last
meeting,
but
some
of
the
more
difficult
issues
here
are
not
of
our
making
they're
societal
issues,
but
that
does
mean
so
we
can't
address
them.
Quite
the
opposite,
I
think
as
a
fundamentally
important
body
and
the
Health
and
Care
Systems
of
this
country
we're
in
a
unique
position
to
try
to
bring
about
Improvement
self-wear,
but
we
kind
of
bring
about
Improvement
self-wear
if
we're
not
better
ourselves.
A
You
know
in
a
year
or
so's
time,
20
of
our
staff
will
be
new,
so
we
need
to
find
ways
of
recruiting
the
right
people,
inducting
people
and
and
the
issues
about,
for
example,
talking
about
race,
I,
think
just
on
ongoing
challenge
for
all
of
us.
We
talked
about
some
different
ways
of
working
I.
Think
fundamental
to
that
is
is
is
listening
and
responding,
which,
with
a
no
coincidence
to
keywords,
are
for
the
name
of
the
review,
and
you
know
I
I
detect
among
my
colleagues
I.
A
Nobody
was
happy
two
months
ago.
Nobody
was
going
around
with
a
smiled
on
her
face,
I'm,
not
sure
people.
There
said
he
got
to
smile
their
face
now,
but
but
there's
I
think
a
mood
change
from
one
of
being
deeply
concerned
to
almost
a
degree
of
optimism.
Now
we
come
to
look
at
it
and
saying
this
as
an
opportunity
for
CQC
to
do
much
better
and
play
a
fundamentally
important
part
in
the
Health
and
Care
system.
A
So
nobody
likes
what
we
got
in
front
of
us,
but
I
think
pick
up
a
phrase
you
used
previously
and
yeah.
This
is
a
platform
to
do
better,
so
there's
an
opportunity.
I
think
the
role
of
this
board
is
to
make
sure
we
seize
that
opportunity.
So
we
are
being
asked
as
a
board
to
approve
a
document.
I
haven't
heard
any
objections.
What
I
have
heard
is
filed
an
agreement.
We
need
to
understand
this:
isn't
the
nads
holding
the
executive
to
account
for
something
there's
an
element
of
that?
But
this
is.
A
We
are
a
unitary
board,
Collective
responsibility.
So,
as
the
board
approves
this,
it
is
a
Board
responsibility
to
make
sure
it
happens
and
the
nads
will
have
to
play
their
their
part
in
that.
So,
but
I
also
heard
that
they
say
this
is
a
platform
part
of
a
bigger
picture,
so
we're
not
signing
off
llr
plus
in
a
formal
sense,
but
actually
what
we're
agreeing
to
is
llr
plus
so
can
I
happy
to
to
approve
the
plan
on
that
basis.
Okay,
well,
that's
excellent
and
could
I
thank
the
manager
at
the
point.
A
So
I'd
like
to
thank
all
my
colleagues
there,
just
as
a
final
note,
because
I
just
once
again
thank
some
of
the
people
that
contributed
to
all
of
this
I
mean
we
did
say
that
the
other
day,
but
perhaps
on
a
slightly
different
mood,
but
obviously
so
11
12
and
Scott
durai
Raj
led
the
two
work
streams
Ali
looking
in
the
wrong
place.
A
Sorry
Ali,
thank
you
very
much
for
on
behalf
of
this
board
for
contributing
to
that
and
overseeing
it
and
then
Jade,
Wright,
Joe,
warmington
or
Peter
dutt
and
Robin's
role
played
their
their
part.
Majority
of
those
were
with
us
the
other
day,
so
once
again
record
our
collector
thanks
for
having
me
off
okay.
Well,
thank
you
very
much,
everybody
probably
difficult
to
move
on
from
that.
Let's
move
on,
we
will
and
Ian
I
think
it's
over
to
you.
We've
got
about
15
minutes
for
a
reporting
update
of
various
things.
B
So,
as
as
usual,
we've
split
the
executive
report
into
two
halves:
one
is
around
regulatory
insight
and
one
is
around
operations
if
I
Scamper,
through
both
of
them
at
the
same
time,
I'll
assume
you've
read
the
the
detail.
First,
the
local
Authority
Assurance
we've
talked
about
that
many
times
around
this
table,
I
think
we've
been
making
good
progress.
We've
recruited,
the
team
and
three
out
of
four
pilot
sites
have
been
identified
and
we're
continuing
to
look
for
for
the
remaining
pilot
size,
but
we're
confident
we
can.
B
We
can
continue
in
terms
of
dementia.
Dementia
is
a
a
topic
that
we
spend
a
lot
of
time
on
as
an
organization
and
a
lot
of
our
providers
support
people
with
with
dementia,
we're
reviewing
our
approach
to
dementia
and
we
will
be
developing
a
new
dementia
strategy,
so
we'll
be
working
with
stakeholders
and
and
people
internally
to
do
that.
B
National
maternity
program.
We,
as
as
we've
been
talking
about,
we
have
a
program
of
inspections
inspecting
the
maternity
Services
across
the
country.
Insights
are
being
shared
as
as
we
go
with
individual
providers
and
there
have
been
some
delays
to
the
program.
It
would
be
fair
to
say,
because
of
of
trying
to
accommodate
strike
action
in
in
providers.
B
So
we're
continuing
to
also
work
towards
an
October
date
for
bringing
the
national
maternity
investigation
team
that
they're
the
team
that
currently
sit
within
hsib
into
CQC.
We're
looking
forward
to
welcoming
about
180
colleagues
into
CQC
and
and
I'm
hopeful
that
we
can.
We
can
consider
how
the
investigation
team
work,
alongside
our
current
inspection
teams,
to
maximize
the
insights
that
that
we
get
to
make
the
the
most
difference
for
for
women
and
their
families
in
as
part
of
maternity
services.
So
I
I
think
there's
some.
B
Some
real
synergies
and
I
think
it's
a
real
opportunity
for
us
to
make
it
to
make
a
difference
there.
In
terms
of
emergency
care,
we
have
recommend
scheduled
urgent
and
Emergency
Care
inspections
focused
as
ever
on
on
risk,
and
we
continue
to
look
for
ways
to
share
the
insights
from
those
inspections
and
and
we're
continuing
this,
this
process
of
developing
materials
alongside
Frontline
practitioners.
B
So
it's
material,
that's
developed
by
Frontline
practitioners
with
our
inspectors
to
be
used
by
Frontline
inspectors,
I
think
it's
a
a
good
example
of
a
very
practical
way
we're
contributing
to
to
Improvement
in
the
con
in
in
what
is
ultimized,
ultimately,
a
very
busy
context
in
terms
of
ics's.
Our
methodology
has
now
been
signed
off
by
Department
of
Health
and
Social
care,
and
the
pilot
activity
is
is
is
beginning
with
a
big
focus
on
Equity
of
access,
which
I'm
sure,
I'm
sure
the
public
will
be
will
be
pleased
about
in
terms
of
operational
matters.
B
A
couple
of
of
quick
things,
I
think
good
performance
is
the
start
of
April,
despite
despite
the
the
strike
action
that's
occurring
in
providers
and
also
the
the
work
we've
been
doing
internally,
with
with
moving
teams
into
new
moving
colleagues
into
new
teams
that
that
that
Tyson
was
alluding
to
earlier.
B
It's
also
worth
making
just
the
one
thing:
I
did
want
to
pull
out
from
this.
It's
worth
making
the
point
that
the
focus
on
risk-based
inspections
has
meant
that
we're
more
likely
to
find
breaches
of
Regulation,
which
is
in
some
respects,
an
obvious
Point,
but
over
a
third
of
our
current
inspections
are,
are
revealing.
Breaches
of
regulations
and
and
each
of
each
each
breach
of
Regulation
brings
with
it
a
a
package
of
work
as
as
inspectors,
unpack
it
and
decide
what
to
do.
B
Colleagues
who've
managed
to
continue
to
do
that
in
what
remains
a
very
challenging
challenging
environment
externally
and
then,
finally,
before
I
hand
back
to
you
in
just
on
engagement,
just
just
a
flag
that
we've
got
a
couple
of
a
couple
of
upcoming
surveys,
one
on
a
urgent
emergency
care
and
one
on
control,
drugs
management,
which
will
be
advertised
on
our
website
in
the
next
in
the
next
few
weeks.
Thanks
him.
A
A
Are
just
not
so
much
on
the
paper
itself,
I
just
want
thought
as
to
I
know,
we
only
just
started
warm
weather.
A
So
if
you
get
difficult
to
forget
last
winter,
but
I'd
be
interested
in
where
we
are
in
terms
of
thinking,
we're
about
and
working
with
others
and
planning
for
next
year,
in
particular,
as
well
as
the
context
of
the
question
is
we
we
made
some
changes
this
year
to
what
we
did
in
a
few
occasions
because
of
the
pressures
the
system
was
under,
but
can
we
to
what
extent
are
we
thinking
ahead
to
next
winter?
At
the
moment,.
N
Well,
we
we
I
think
it's
fair
to
say
we
haven't
really
stopped
working
with
other
agencies
like
nhse,
on
reviewing
the
response
to
this
winter
reviewing
what
was
what
what
worked
well
and
will
be
developing
working
alongside
them,
developing
another
plan
for
this
winter
I.
Imagine
before
too
long,
there's
no
real
Hiatus
between
the
planning
and
the
implementation
of
the
planning.
E
So
so,
as
the
board
will
know,
one
of
the
areas
of
our
Focus
for
our
operational
colleagues
from
January
through
to
March
was
going
out
and
re-rating
adult
social
care
settings,
and
we
know
where
adult
social
care
settings
have
a
rating
that
requires
Improvement
or
below
many
local
authorities
won't
buy
new
services
from
them.
E
So,
thanks
to
the
effort
of
Tyson
and
his
colleagues,
we
started
off
with
an
ambition
to
do
about
300
I
think
we
ended
up
achieving
over
a
500
and
600
inspections
during
that
time,
and
we've
also
got
a
notional
figure
about
the
number
of
beds.
We
believe
that
that
activity
opened
up
into
the
system
and
noting
Joyce's
earlier
Point
regulatory
governance
has
just
agreed
priorities
which
is
around
responding
to
risk
and
getting
training
done.
E
I
think,
as
we
get
into
Autumn
time,
there
maybe
will
be
an
opportunity
for
a
conversation
about
where
there
might
be
scope
for
such
an
approach
again,
but
we
need
to
ensure
that
we
can
manage
it
in
the
round
with
risk
being
the
priority
and
then
just
the
second
briefing
to
mention
is
we've
just
started
a
conversation
about
the
role
Intermediate
Care
can
play
in
preventing
people
from
going
into
hospital
if
they
don't
need
to,
but
also
supporting
timely
discharge
and
I've
just
been
posing
questions
to
the
team
about.
E
Do
we
know
what
really
good
quality
Intermediate
Care
looks
like
do?
We
know
where
it's
provided
across
the
country?
Is
there
an
inequality
angle
to
this,
where
you
might
be
more
likely
to
access
Intermediate
Care
and
get
better
outcomes
if
you
live
in
certain
parts
of
the
country
than
others?
So
it's
a
piece
of
work,
we're
just
initiating
now
that
I
think
body
will
be
using
the
inspection
activity,
that's
already
happening,
plus
other
intelligence
and
insight.
G
Thanksgate
Chris,
who
wanted
to
run
some
just
to
build
on
on
that.
On
that
point,
actually,
clients
may
remember.
We.
We
published
a
document
called
people
first,
which
was
a
bringing
together
of
Frontline
experience
of
Health
and
Care
Services,
particularly
urgent
Emergency,
Care
colleagues,
who
work
in
primary
care
and
and
social
care
to
look
at
what
practically
people
could
do.
So
it's
trying
to
bring
the
best
practice
from
the
from
the
best
organizations
that
rolled
out
towards
the
towards
the
end
of
last
year.
G
What
we've
been
doing,
what
the
team
have
been
doing
since
that
time
is
looking
at
how
it's
been
adopted
and
what
the
challenges
to
its
adoption
in
different
organizations
and
different
ICS
areas,
I
think
what
we'll
have
with
our
we're
doing
some
work
with
NHS
providers
and
also
with
care
England
and
others.
Looking
at
some
of
the
the
challenges
of
now
that
will
present
themselves
for
next
winter
and
I
think
what
our
aim
is
before
City
care,
there's,
certainly
in
state
of
care,
is
to
be
really
clear
about.
G
First
of
all,
what
what
we've
seen?
That's
worked
well
where,
where
have
people
taking
risks
and
where
is
that
Innovation
led
to
real
change
in
the
way
that
people
receive
services
and
also
what
potentially
are
the
are
the
current
blockers?
That
may
not
be
the
blockers
that
they
were
a
year
ago
from
both
sort
of
an
NHS
and
adult
social
care
perspective.
And
what
can
we
say
about
that?
And
how
can
we
support
those
to
be
removed,
as
we
write
this
year
said?
G
J
I'm
I
just
wanted
to
say
over
winter
we
might
start
to
see
a
winter
to
come.
We
might
start
to
see
the
impact
of
the
single
assessment
framework
because
we
made
a
decision
last
winter
that
we,
you
know,
become
risk-based,
and
so
we
would
do
less
activity
because
of
the
pressure
the
system
was
under
and
there
were
lots
of
people
speaking
to
us
at
the
time
saying
you
know
just
when
we
need
you,
you
might
not
be
there.
So
the
public
wanted
us
to
be
there
to
say.
J
Look
what
it's
like
out
here
and
also
the
staff
working
in
Services
wanted
us
to
be
there
to
say
we
we
want
a
voice.
We
want
to
be
able
to
tell
you
the
activity
that,
what's
going
on
the
single
assessment
framework,
allows
us
to
get
evidence
from
lots
of
different
sources.
Inspection
is
not
the
only
tool
that
we
will
use,
still
critical
and
important
tool
for
us
to
use,
but
we
will
be
able
to
get
data
flows.
J
A
much
faster
outcomes
from
you
know
things
from
our
partners,
so
we're
going
to
be
pulling
in
evidence
and
information
from
lots
of
different
areas
and
it
isn't
the
the
inspection
that
gives
us
the
Reliance
on
on
what's
Happening
and
we
can
make
more
insightful
decisions
about
where
we
go
and
when
and
how
we
reuse
being
on
on
site
and
how
we
get
people's
experiences.
So
there's
a
different
approach
that
we
can
use
next
winter
that
we
just
really
want
to
explore.
A
A
So
corporate
performance
report
for
Q2
I
think
we're
going
to
be
joined
by
Stephanie
Tarrant.
One
of
your
team.
O
A
Oh,
it's
a
business,
okay,
bigger
problem,
so
core
performance
support
anyway,
Kate
and
Chris
to
you.
O
Thanks
Kate
so
yeah,
so
so
we've
got
the
end
of
year
performance
report.
We've
also
got
a
couple
of
page
year
at
a
glance
as
well,
just
that
we
do
kind
of
at
the
end
of
the
year
position
just
to
pull
out
some
of
the
the
stats
and
and
things
you
can
see
that
we've
delivered
in
here.
I'll
just
pull
out
a
couple
of
areas
just
to
talk
to
and
then
I
can
open
out
for
any
comments
and
questions.
O
So
in
terms
of
regulatory
contact,
we've
nearly
20
of
locations
of
either
been
inspected
or
had
a
dma
call
in
the
year
we're
just
under
10
000
inspections
delivered
when
you
factor
in
the
public
statements
that
we
do
as
well.
Alongside
that,
that
means
about.
58
of
providers
have
had
regulatory
contact
in
you
in
terms
of
appropriate
care.
You
can
probably
see
a
slide
in
in
the
decadent
slide.
Three
on
average
86
of
registered
Services
have
a
rating
of
good
or
outstanding.
O
What
you
can
see
this
year
is
our
focused
on
risk
and
the
impact
that's
had
since
the
start
of
the
year
with
about
64
are
rated
as
good
as
a
good
or
outstanding.
So
you
can
see
that
Trend
and
how
that's
changed
in
year
in
terms
of
registration,
on
the
face
of
it,
we
we
are
below
our
targets.
We
set
ourselves
a
target
of
15
reduction
across
all
of
the
categories.
We
have
three
categories
of
registration
type
and
we
set
ourselves
a
15
reduction
in
some
areas.
O
We
haven't
hit
that
15,
but
there's
been
good,
solid
reductions
across
the
board,
so
normal
applications
we've
seen
a
two
percent
reduction,
complex
applications,
eleven
half
percent
reduction
and
simple
applications,
27
reduction
so
variability
there,
but
kind
of
a
solid
performance
across
registration
as
well.
O
Just
before
I
move
on
to
some
of
the
the
the
people
and
the
money.
Just
one
point
of
clarity
in
in
the
deck
in
terms
of
representations,
there's
a
slide
in
the
deck
that
talks
about
as
the
kind
of
trend
of
reps
received.
Just
just
to
point
out.
The
graph
is
right,
but
the
narrative
below
saying
that
there
was
a
decrease
increase
in
general
increase.
O
That's
the
wrong
way
around,
so
the
graph
is
right
that
the
narrative
support
in
that
is
is
the
wrong
word
around
just
for
point
of
clarity
in
terms
of
rank
status
on
the
the
first
dashboard
you'll
see
some
areas
that
pull
out.
Maybe
we're
missing
me
not
to
mention
the
people
plan
the
the
kind
of
rated
rug,
red
rag
rooted,
so
we've
talked
pull
survey
previously
at
board.
That
does
mean
that
a
large
proportion
of
the
findings
of
that
mean
that
four
of
our
measures
are
red.
O
We've
kind
of
touched
on
this
before
in
in
the
previous
item
around
llr
and
work
is
progressing
throughout
the
organization
on
a
corresponding
action
plan,
as
well
as
focusing
on
culture
we'll
cover
both
of
those
more
in
the
next
to
gender
item
and
and
Ian
touched
on
this
in
intranome
as
well
before.
But
we
continue
monitor
diversity
of
the
workforce.
Data
shows
that
we're
making
progress
against
our
objectives,
but
we
need
to
continue
to
do
more
and
drive
that
agenda
forward
last
bit
from
me.
O
Just
in
terms
of
her
finances,
Revenue
side
end
of
the
year
with
a
five
million
surplus,
which
is
about
2.1
percent
of
budget
on
the
capital
side,
were
overspent
by
4.1
million
in
year,
which
we
we
had
tracks
throughout
the
year.
That's
the
most
we've
ever
spent
on
Capital
in
cqc's
history.
That's
largely
because
of
the
ambitious
plans
we
set
the
start
of
the
year-round
Capital
that
we
aim
to
minimize
during
the
year.
O
However,
what
we've
managed
to
deliver
in
terms
of
outcome
represents
delivering
on
those
ambitious
plans
without
any
slippage
that
we've
seen
in
previous
years,
so
I'll
pause
then
happy
to
take
any
comments
or
questions.
Okay,.
A
C
Hi,
it's
not
really
a
question
for
Chris
I.
Think
it's
more
a
question
for
Tyson,
but
it's
the
the
year
in
view
slide
and
we
talk
about
the
out
of
hours,
inspections
and
I
know.
This
morning
we've
had
a
conversation
with
private
board
about
out
of
hours
inspections
how
important
they
are,
but
I
think
we
should
mention
in
the
public
board
about
the
work
that
we
are
doing.
Regarding
increasing
the
number
of
out
of
hours
inspections,
so
I
have
a
question
for
Tyson
explained.
D
Thank
you
Belinda
and
yes,
I
mean
the
number
of
out
of
hours
number
of
out
of
hours
inspections.
We
do
at
the
moment,
which
aren't
just
an
hour
either
side
of
the
main
working
day.
It
isn't
enough.
We
have
set
up
a
project
which
we
are
now
working
with.
A
Thanks
very
much
for
mentioning
it,
Belinda
I
mean
it's
an
important
point.
Also
Bob
just
say
that
the
I
mean
it
came
up
largely
through
the
investigations
that
we
did
at
the
subcommittee
of
this
board,
the
of
the
rcg,
while
we're
looking
at
the
practicalities
of
a
number
of
things
that
we
did
so
I
think
it
was.
There
could
be
other
examples,
but
thank
you
for
raising
that
one.
It's
very
important
any
other
questions
for
Chris.
D
D
E
Okay,
so,
firstly
I
referenced
it
earlier.
We
want
to
start
producing
a
kind
of
people
pack
that
comes
to
board,
probably
every
quarter.
E
We
want
to
have
our
first
go
at
it,
for
this
July's
board
and
I
would
probably
really
value
kicking
around
what
we're
raising
to
put
in
it
with
a
couple
of
you,
but
it's
probably
going
to
look
like
the
kind
of
life
cycle
of
vacancy
Rays
new
joiners
induction
plans,
Etc
through
to
kind
of
X
interviews
Etc.
So
it
is,
it
is
something
we
have.
E
We
need
to
report
on
better
and
give
you
better
visibility
of
on
the
vacancy
rates,
so
our
average
vacancy
rates
across
CQC
is
around
9.9
in
operations
it's
slightly
higher
at
the
moment,
so
it's
about
11.5
percent,
so
slightly
higher
than
across
the
organization,
but
not
not
massively
out
and
in
terms
of
numbers.
That
equates
to
about
247
full-time
equivalents
and
then
noting,
on
top
of
that,
those
are
those
are
the
rest
of
the
organization
and
the
you
know.
E
You've
got
the
additional
things
such
as
sickness
maternity,
Etc,
but
but
over
to
Tyson.
D
So
thanks
Kate
and
I
thought
I'd
talk
a
bit
about
the
vacancies
for
for
inspectors.
D
I'll
be
great
colleagues
in
the
networks,
because
I
know,
Ian
you've
had
some
correspondence
on
that
topic
and
just
to
reiterate
what
Katie
said,
I
realize
it's
a
it's
a
challenging
time
for
colleagues
at
the
moment,
and
the
figures
I'm
talking
about
won't
include
people
who
maybe
aren't
on
full
Duty
are
a
maternity
leave
or
on
sickness.
But
these
are.
These
are
the
vacancies.
D
According
to
the
figures,
our
current
establishment
of
of
inspectors
in
the
networks
is
868
and
I
would
like
to
have
gone
into
the
financial
year
higher
than
that
on.
912,
which
is
a
gap
of
4.8
percent,
are
planned
during
the
course
of
this
year,
because
we
are
we're
still
currently
using
the
old
methodology.
Even
though
we're
in
our
new
teams
in
the
networks
is
to
go
higher
than
we
were
planning
and
to
come
at
a
thousand
and
one
a
thousand
one
inspectors
and
then
to
Glide
down
to
the
912,
which
is
our
settled.
D
Establishment
by
by
The
End
by
the
end
of
the
financial
year
and
the
gap
between
where
we
are
in
the
moment
and
where
we
want
to
get
to
in
terms
of
1001
is
13.2
percent.
So
the
Gap
is
4.8,
but
actually
the
real
Gap
is
around
13,
which
I
think
is
on
a
par
with
what
Kate
was
saying
more
generally.
But
we
have
already
recruited
some
other
people
to
work
in
our
integrated
teams,
including
23
regulatory
officers.
A
E
So
the
recruitment
activity
that's
been
happening
in
Ops
has
been
significant
and
it's
been
significant
for
HR
colleagues,
but
it's
also
been
really
significant
for
Tyson's
people
who
have
been
sitting
on
recruitment
panels.
For
you
know
chunk
of
time,
we
we
need
to
have
a
look
at
what
we
do
in
these
sorts
of
circumstances,
where
we
know
that
there
is
a
large
amount
of
recruitment
activity
that
needs
to
happen.
E
So
there's
like
how
do
we
do
the
volume
bit
but
you'll
also
know
following
the
listening
learning
responding
to
concerns
review,
we
are
really
interested
in
looking
at
how
we
might
recruit
in
a
way
that's
different.
So
how
do
we
recruit
well?
Make
it
a
positive
experience
for
people
who
are
neurodiverse,
so
how
do
we
make
sure
reasonable
adjustments
is?
Is
a
really
fantastic
offer
Etc?
E
So
there
is
a
there's,
a
piece
of
work
that
you
already
know
about
about
how
we
can
do
reasonable
adjustments
better,
but
we're
going
to
fold
that
into
actually
is
there
a
different
way?
We
want
to
go
about
recruitment
when
we've
got
large
numbers
of
Recruitment
and
automatic
recruitment
activity
to
undertake,
as
is
the
situation
at
the
moment,.
A
Okay,
thanks
I
was
reflect
early,
we'll
have
greater
visibility
in
the
future.
Stephen
I
think
you
would
excellent
blessing.
You
wanted
to
can
I
go
to
Steven.
First,
no
come
to
you.
H
Thanks
Ian
I
I
wanted
to
raise
a
different
issue
if
I
could,
which
is
page
43
and
the
trend
in
people
giving
us
feedback
on
their
care
because
in
one
sense
this
is
really
really
good
news.
More
and
more
people
are
wanting
to
give
us
feedback
on
their
care
and
that's
a
hugely
important
data
source.
H
So
there's
the
question
for
me
looking
at
that
that
Trend
rate,
if
we've
got
10
000
plus,
you
know
bits
of
feedback
every
month
and
Rising
kind
of
what
are
the.
What
are
the
consequences
for
us?
There's:
a
set
of
consequences,
I
think
for
Mark
and
Helen
and
team.
H
How
you
convert
that
then
into
reliable,
valid,
robust
evidence
about
risk
assessments
by
provider,
because
this
is
one
form
of
evidence,
I
think
and
then
there's
the
loop
back
to
the
the
llr
report,
because
the
people
giving
us
that
feedback,
many
of
them
won't
want
to
feel
well.
I,
just
put
it
into
a
black
hole
and
I
got
nothing
back
again
and
there's
a
resource
consequence
for
us,
therefore,
and
how
we
respond
so
that
people
feel
their
feedback
has
been
heard
and
listened,
and
they
understand
what
we're
going
to
do
with
it.
H
I
Go
first,
if
I
can,
on
the
technology
side
and
on
the
data
and
insight
side.
This
is
this
is
a
great
news
story.
I
mean
we've.
We've
made
a
number
of
improvements
to
the
giveaway
back
on
care
services
to
to
to
to
make
it
easy
for
people
to
contact
us
so
that
that
that's
part
of
that
good
news
story.
I
We've
got
a
number
of
improvements
that
we're
bringing
in
through
the
regulatory
platform
which
will
enable
us
to
manage
and
handle
the
information
that
comes
in
to
make
it
more
efficient
and
and
easier
for
people
to
be
able
to
to
manage
that.
One
of
the
one
of
the
things
that
we're
doing,
which
will
be
a
a
summer.
I
Provision
of
regulatory
platform
for
colleagues,
will
involve
bringing
in
all
information
that
we
gather
whether
it's
from
give
you
back
on
care,
whether
it's
contacts
directly
into
our
contact
center
or
whether
it's
through
through
other
other
mechanisms,
that
we
receive
information
all
into
one
place
for
in
for
our
inspectors
and
assessors,
so
that
it
makes
it
significantly
easier
for
them
to
see
everything
in
one
one
place.
I
So
I
think
we're
going
to
generate
a
number
of
efficiencies,
we'll
enable
us
to
to
help
us
process
this,
this
body
of
work
better
and
in
the
future.
We
will
be
developing
this
service
further,
such
that
we
can
engender
a
more
of
a
two-way
conversation,
so
that
we'll
be
able
to
not
only
receive
information
from
people,
but
also
to
have
a
a
digital
mechanism
by
which
we
can
communicate
back
to
people
as
well,
and
let
them
know
what
we
do
with
the
the
information
that
they
they
give
us.
H
G
Just
to
build
on
that,
so,
first
of
all
I
know
you
said
this,
but
this
is
a
fantastic
result
and
a
result
of
Partnerships,
including
colleagues,
in
the
room
from
from
healthwatch
and
elsewhere.
The
fact
that
people
trust
us
with
more
and
more
of
their
information
about
how
they're
receiving
Services
is
really
important.
G
One
of
the
things
that's
changed,
probably
over
the
last
three
to
four
years,
is
how
go
back
to
my
point
about
speed.
We're
able
now
to
use
this
information
alongside
other
information
to
take
take
action
on
behalf
of
people
use
services
in
in
the
in
the
inspections.
I
could
think
of
inspections
we're
doing
today
that
we
may
not
have
done
in
the
same
way,
three
or
four
years
ago,
because
of
a
the
volume
of
information.
That's
come
in
and
be
the
way
in
which
it's
coming
alongside
other
information,
so
I
think
it's
a
real.
G
It's
a
really
important
point,
I
think
there's
a
cultural
Point
here
as
well
about
how
we
have
traditionally
viewed
information
from
people
use
Services,
as
opposed
to
other
other
forms
of
data
and
I.
G
So
I
I
hear
what
you
say
about
the
I
think
this
is
a
I
think
this
is
a
tremendous
response
that
we've
generated
with
with
colleagues
from
healthwatch
and
the
other
partners
on
on
tell
us
about
your
care
and
give
feedback
on
care,
but
I,
but
I
do
think
it's
a
it's
a
it's,
the
it's
the
start
of,
or
it's
the
progression
of
a
cultural
Journey
about
valuing
a
voice
of
people
alongside
data
information
and
pushing
them
together
in
one
place
that
the
system
that
Mark
described
does
thanks.
F
Thank
you
on
the
recruitment
piece
we
do
need
more
than
we
do
need
more
independent
panel
members
apms,
so
approximately
820,
to
cover
all
grades
to
ensure
the
recruitment
process
is
bias,
free
and
considers
as
well
as
covers
all
aspects
of
protected
characteristics
for
all.
Colleagues
at
interviews,
so
having
more
in
ipms
would
actually
help
with
that
process.
E
My
to-do
list,
I
will
I
will
check
where
we
are
with
continue,
because
we
we've
all
experienced
interviewing
with
independent
panel
members
on
the
panel
and
they
add
so
much
value,
so
we're
really
committed
to
it
as
an
organization.
E
But
it
sounds
like
I
need
to
ask
the
question:
are
we
continuing
to
recruit
so
that
we've
got
good
numbers
and
the
right
mix
of
Independence
hi?
Thank
you.
A
D
Rather
cheaply
make
a
point
about
IPM,
so
I
may
also
make
a
point
to
make
good
feedback
on
care
I'm.
Looking
at
the
some
of
the
reasons
why
we
are
managing
to
recruit
a
quarter
of
people
from
ethnic
minority
backgrounds.
One
of
the
reasons
we
I've
been
given
by
by
Keith
colleague,
is
the
fact
that
we
are
using
IPM
so
absolutely
right
on
that.
D
If
I
can
go
back
to
the
give
feedback
on
care,
I
think
also
one
of
the
reasons
why
we've
created
the
assessor
role
is
so
that
we
will
have
someone
whose
role
it
is
to
absorb
all
of
this
data.
All
of
this
intelligence
and
all
of
the
all
of
this
input,
rather
than
sort
of
relying
on
on
the
person
who's
currently
doing
the
inspector
role
to
do
all
of
that
as
well.
So
I
repeat
what
everyone
else
has
said
about.
This
is
great
news,
but
I
think
part
of
our
structural
changes.
A
Okay,
thanks
Tyson,
if
there
are
no
more
comments,
Chris.
Thank
you
very
much
indeed
for
that
more
working
stuff
at
the
right
time.
One
more
session
before
we
break
we've
got
an
update
on
the
excuse.
Me
transformation
people,
so
Amy,
Pritchard
who's
been
leading.
This
work,
I
guess,
will
join
us
I'm
expecting.
A
The
so
brief
update
on
the
the
transformation,
Kate
and
or
Mark
I
think
you
were
going
to
introduce
this
usual
rules
again.
You've
read
the
paper,
but
you
might
not
have
the
high
points
and
then
let's
take
questions.
E
Thank
you.
So
this
is
a
review
of
what
we've
achieved
over
the
last
quarter.
A
couple
of
things
before
we
get
into
it.
So
Amy
is
leaving
us
for
new
for
a
new
adventure
which
we're
sad
about
so
a
massive.
Thank
you
to
Amy
for
her
work.
Amy
will
be
working
with
a
colleague
called
Kerry
dearden
who's
joining
the
organization
to
take
over
the
role
of
director
of
transformation
and
Mark,
Sutton
and
I
will
be
leaning
more
into
the
senior
responsible
officer.
E
Is
that
the
over
yeah,
the
SRO
role
for
two
of
the
programs,
so
so
Chris
will
remain
the
SRO
for
the
finance
system,
Mark's
going
to
be
stepping
in
as
SRA
for
reg
transformation
and
I
thought
Corporate
Services
very
briefly
before
I
hand
over
to
Amy
on
the
Corporate
Services
review,
as
with
all
aspects
of
our
business,
you'll
notice
a
theme
as
we
go
through
this
afternoon
session,
we
took
the
listening
learning
and
responding
to
concerns
review
as
an
opportunity
to
challenge
ourselves
about
the
approach.
E
We
were
planning
for
Corporate
Services
review
to
check
that
it
was
in
the
spirit
of
what
llr
recommendations
were
telling
us,
and
actually
we
on
the
back
of
that
decided
we
wanted
to
take.
We
wanted
to
spend
more
time
engaging
with
the
people
who
will
be
going
through
the
Corporate
Services
review.
I've
established
something
called
a
change.
E
Advisory
Group,
who
are
a
group
of
15
colleagues
across
the
directors,
are
going
to
be
affected
by
this
so
across
Corporate,
Services,
engagement
policy
strategy
and
technology,
and
they
are
a
group
of
Frontline
colleagues
who
will
be
helping
me
and
the
team
steer
the
ship
on
how
this
work
goes.
And
one
of
the
messages
that
came
out
from
that
group
is:
let's
not
just
do
a
people
change
as
we
make
these
changes.
Let's
also
look
at
opportunities
around
how
we
can
change
our
ways
of
working
to
make
them
as
effective
and
as
possible.
E
So
if
you're
happy
Mark
if
I
hand
over
to
Amy
now
and
then
I
think
she'll
bring
you
into
over
to
you
Amy.
P
Yeah,
okay,
so
we've
made
some
good
achievements
across
the
last
quarter,
so
starting
with
regulatory
transformation
program,
we
have
already
begun
implementing
our
new
regulatory
Services.
I
think
Joyce
may
have
updated
on
one
of
those
earlier
being
regulatory
governance.
Those
services
are
foundational
to
the
other
services
that
will
start
to
come
through
in
July
and
October.
We're
also
on
track
to
go,
live
with
the
first
of
our
digital
elements
in
that
program,
which
is
registration,
cancellation
and
that
will
come
live
towards
the
end
of
this
month.
P
As
I
said
a
moment
ago.
We
are
also
fully
locked
down
now
in
terms
of
all
of
the
regulatory
services
that
will
roll
out
across
July
and
October,
and
that's
really
key,
because
what
it
will
allow
is
all
of
our
operational
colleagues
to
transition
undertake
the
final
transition
to
the
new
ways
of
working
really
fully
embrace
the
new
single
assessment
framework
and
that
will
enable
them
to
undertake
their
roles
more
efficiently
and
deliver
a
much
greater
user
experience
for
colleagues
as
well
as
providers.
I
Thank
you
Amy,
so
just
to
give
a
little
bit
more
flavor
around
some
of
the
the
data
insight
and
the
technology
components.
Firstly,
data
insight.
As
you'll
be
aware,
there's
been
a
really
significant
transformation
program
which
we've
now
just
concluded
and
a
significant
part
of
that
has
been
the
the
launch
of
our
new
Enterprise
data
platform.
I
That's
really
significant.
For
us,
it
means
that
all
of
our
analytics
products
that
all
of
our
regulatory
colleagues
use
are
now
created
by
our
new
centralized
Azure
power.
Bi-Based
data
analytics
system,
all
of
our
new
operational
and
strategic
Insight,
will
be
created
on
that
platform.
It
gives
our
data
and
insight
colleagues
the
tools
that
they
need
to
do
their
job
in
it
with
a
fast,
efficient,
centralized,
high
quality
data
tool
set,
and
we've
we've
even
started
to
begin
to
decommission
some
of
the
Legacy
infrastructure
that
we
that
we
had.
I
We've
also
spent
a
lot
of
time
with
our
with
our
colleagues
making
sure
that
they've
got
the
the
training
that
they
need.
So
we've
had
a
a
power
bi
boot
camp,
that's
run
across
the
entire
of
our
of
our
of
our
data
and
insight
unit
has
been
really
extremely
well
received
by
our
colleagues
and
that's
that's
not
the
end
of
the
story.
I
Of
course,
the
you
know
that
we're
now
into
our
onward
development
of
of
data
and
insight
capabilities
to
to
build
and
support
the
the
the
single
assessment
framework
and
our
new
way
of
working
in
regulatory
transformation
on
the
on
the
technology
side.
That
work
is
progressing
extremely
well.
Amy
mentioned
launching
next
week
is
our:
is
our
registration
cancellation
service?
So
that's
a
that's
a
really
big
deal.
It's
our
it's!
It's
an
end-to-end
service.
I
So
this
is
the
ability
for
our
providers
to
be
able
to
cancel
a
service
in
advance,
something
not
possible
at
the
moment
and
to
be
able
to
cancel
registered
manager
associations
so
that
joins
Business
Development
process
change,
underpinned
by
Technology
support.
It
allows
us
to
create
efficiency
improvements
for
us
and
for
our
providers
as
well.
It's
a
simpler
process.
I
It
frees
up
our
colleagues
to
work
on
other
activity,
which
is
something
you'll
see
repeated
as
we
as
we
continue
to
roll
out
further
further
around
changes,
and
then
our
next
big
go
live
is
on
track
for
our
summer
release
currently
being
tested
with
colleagues
Jory
you
mentioned
earlier
on
about
you
know:
how
do
we
make
sure
that
we
we're
listening
to
our
colleagues
and
we
and
we
and
we
bring
we
bring
them
into
the
work
and
I?
Think
part
of
the
work
we're
doing
here
is
is
hopefully
starting
to
help
that
process.
I
We've
got
subject
matter.
Experts
from
across
the
business
we've
got,
we've
got
colleagues
who
will
be
using
and
working
with
with
new
systems
and
new
ways
of
working
who
are
part
of
the
team
that
are
designing
and
building
the
systems
and
we're
getting
feedback
from
them
as
we
go
through
that
and
we're
iterating
as
we
as
we
go
through.
So
I
think
that
that
that
will.
I
In
the
in
the
development
and
the
build
processes
so
far,
and
that
so
so,
the
the
release
that
we've
got
coming
up
in
the
summer
that
we're
we're
actively
building
now
and
was
going
really
well
is,
is-
is
about
bringing
all
that
information
into
one
place.
That
thing
that
you
were
talking
about
earlier
on
Belinda
about
how
do
we?
I
How
do
we
get
consistency
of
the
information
that's
that's
coming
in
and
how
we
deal
with
information
that
comes
to
us
this
this
this,
this
build
of
how
we
bring
together
notifications
and
give
feedback
on
care
and
information
to
the
contact
center.
All
into
one
place
for
our
colleagues
is,
is
going
to
be
the
way
that
we
can.
We
can
systematize
that
and
make
sure
that
it's
consistent,
it'll
be
simpler,
it'll,
be
easier
for
all
of
our
stakeholders,
they're,
both
internally
and
externally
as
well,
and
then,
of
course,
later
on.
I
E
I
E
I
made
us
finish
off
with
the
people
bit
of
the
the
report,
if
that's
okay
colleague
so
a
slightly
Fuller
people's
people
section
and
and
we'll
either
continue
to
keep
it
as
part
of
transformation
or
we'll
have
it
stand
alone,
but
we
can
decide
between
now
and
July.
E
One
of
the
key
actions
that
I've
done
following
the
listening
learning
and
responding
to
concerns
review
is
to
think
about
what
that
needed
to
tell
us
in
terms
of
who
and
how
we
go
about
our
recruitment
for
our
new
people
director
job.
So
we
are
now
live
with
our
new
role.
It's
got
a
different
job
title,
a
small
but
important
change.
E
Hopefully,
so
this
is
a
director
for
people
and
culture
and
it
matters
because
they're
working
on
behalf
of
our
people,
but
also
critically,
we
are
looking
to
recruit
someone
who
has
expertise
and
a
track
record
around
cultural
change.
That
I
think
would
really
benefit
us
as
an
organization,
so
that
advert
is
live
and
closing
dates
are
first
weekend
June,
so
I'm
hopeful
that
we
will.
We
will
be
successful
in
that,
but
I
just
wanted
to
demonstrate
it's
another.
E
Another
kind
of
concrete
thing
we've
done
in
response
to
the
listening
learning,
responding
to
concerns
review
and
then
just
one
other
two
other
bits
briefly.
Cultural
works.
As
Amy
says,
a
component
of
the
cultural
activity
has,
as
is
underway
and
in
train,
and
no
longer
needing
to
have
the
kind
of
program
oversight
that
it's
had
and
Tyson
and
his
team
have
been
basically
having
a
series
of
sounds
like
very
positive
workshops
around
good
endings
and
good
Beginnings
that
we've
been
hearing
from
as
teams
about
how
they've
landed.
E
So
there
is
cultural
activity
happening
within
operations.
Very
briefly,
the
senior
leadership
team
benefited
from
a
cultural
expert
coming
along
and
spending
some
time
with
us
at
our
meeting
last
week.
Talking
about
how
you
get
a
good
cultural
change
and
what
was
really
interesting
from
that
session
was
there
was
a
wealth
of
things
that
she
was
recommending.
E
You
would
have
in
place
to
ensure
that
you
change
your
culture
and
we
actually
had
40
all
of
them
already
in
place
in
the
organization,
and
what
was
interesting
about
that
is
it
showed
me
that
we've
got
the
right
tools.
We've
got
the
right
building
blocks,
but
I
think
there's
still
more.
We
need
to
do
to
join
it
all
up
together
to
articulate
it,
but
also
to
ensure
that
we
are
able
to
evaluate
as
having
the
impact
that
we
we
need
it
to
have.
So
so
there
is.
E
There
is
some
good
work
happening
in
in
the
cultural
space,
particularly
within
Ops,
but
I
think
there's
more.
We
need
to
do
to
make
sure
it's
cross-organizational,
but
also
that
it's
all
tied
together
and
it's
having
the
impact
we
we
need
it
to
have,
and
just
just
before,
I
finish
and
had
over
to
Tyson
to
talk
to
that.
We've
already
mentioned
the
post
survey
that
is
live
at
that
moment,
with
a
focus
on
diversity
and
inclusion,
but
also
Joyce
mentioned
earlier.
E
The
the
active
pulse
survey,
Advisory
Group,
that
is,
has
honed
down
its
priorities
and
again
that's
being
distilled
into
various
actions
that
we
as
exec
teams
and
members
have
been
lined
up
to
as
well.
Tyson.
D
Thank
you,
Kate
thank
you
and
Kate
and
Amy
have
already
talked
about
our
leadership
module
the
good
good,
Beginnings,
good
endings.
The
only
point
out
is
going
to
make
is
an
email
I
got
earlier
today
with
feedback
from
module,
one
which
is
now
finished.
82
percent
of
people
who
went
on
it
agreed
or
strongly
agreed
that
it
was.
It
was
a
good
training
course.
So
I'd
like
to
thank
my
colleagues
in
the
academy
for
putting
that
together
there's
a
real
sort
of
positive
Buzz
about
it
and
a
module.
Two
is
about
to
start.
A
That's
that's
excellent
news.
We
did
talk
earlier
about
the
need
to
measure
very
quickly
how
this
is
going
so
that
that's
that's
very
good
questions
mark.
L
Just
very
quickly
to
respond
to
to
Kate
on
that
I
mean
I,
I,
I
I
think
it's
great,
that
we
are
that
we're
bringing
we're,
bringing
in
additional
expertise
and
experience
in
relation
to
to
cultural
change
and
I
and
I
applaud
the
reshaping
of
the
of
of
of
that
role,
but
I'm
also
enormously
encouraged
by
hearing
what
you
know
exactly
what
needs
to
be
happening.
This
is
not
sort
of
culture
is
not
something
that's
partialed
up
in
one
person's
role.
L
This
is
a
massive
cross-functional
exercise,
that's
needed
to
to
to
to
to
to
achieve
and
maintain
and
sustain
a
a
a
Target
culture.
If
you
don't
do
it,
cultures
form
on
their
own
and
and
it
requires
leadership
at
all
levels
in
the
organization,
so
I'm,
very
encouraged
by
by
the
approach.
A
No
okay,
well
I,
think
Amy.
Your
written
reported
the
additional
contribution
as
well.
The
colleagues
I
think
that
we
are
done.
Thank
you
very
much
indeed
can
I
just.
Thank
you
very
much
indeed,
for
your
contribution
over
the
last
couple
of
years,
I
know
you're
going
to
be
devastated.
You
don't
have
to
appear
in
front
of
this.
A
Couple
of
months,
but
I'm
sure
you'll
get
over
that
in
your
new
role.
So
good
luck.
A
A
Okay,
welcome
back
for
those
listening
on
the
video
welcome
back
colleagues,
thank
you
for
joining
us
so
promptly.
A
We've
got
a
couple
of
updates
now
from
or
as
we
said,
on,
National
Guardian,
healthwatch
England,
so
Jane
and
Louise
you've
been
here
rewarding
but
I'll.
Thank
you
again
for
joining
us.
Jane
I
think
your
first
up,
you
know
normal
rules.
We've
read
the
report,
so
don't
need
to
talk
to
the
detail.
A
However,
we
don't
see
you
that
often
so
please
do
feel
free
to
use
the
time
to
make
sure
we
do
understand
the
main
points
and
I
might
also
just
later
on
just
ask
Stephen
if
there's
anything
to
add,
given
you
up
you're
sort
of
oversight
roll
there
but
really
Jane
the
floor
is
yours.
Q
Thank
you
very
much
chair
and
thank
you
very
much
colleagues
and
six
months
since
I
was
last
here
and
the
last
two
times
has
been
virtual.
So
it's
really
lovely
to
see
you
all
in
person.
I'm
really
important
today
to
be
giving
an
update,
not
least
Because
of
You,
reflecting
on
the
the
listening
and
learning
review
and
and
I
really
welcome
that
and
and
our
work
going
forward
as
we
do
with
many
organizations
supporting
Improvement
in
speak
up
culture.
So
thank
you
for
the
invite
to
do
that.
Q
As
you've
said,
chair
take
the
the
reporters
read,
but
there
are
a
couple
of
highlights.
I
would
like
to
pull
out.
The
first
is
just
to
recognize
the
increasing
growth
of
the
Guardian
network
over
a
thousand
Guardians
now
over,
nearly
a
thousand
organizations
not
just
within
the
NHS,
definitely
obviously
all
NHS
trusts
and
Foundation
trusts,
but
also
Primary,
Care,
independent
providers
and
really
importantly
as
well.
Q
National
bodies
and
Regulatory
bodies
and
organizations
in
other
sectors
are
learning
from
from
the
model
and
that's
including
education,
financial
services
and
I've
recently
been
contacted
by
fire
and
rescue
and
also
by
the
police.
The
Met
wanting
to
take
learning
from
us,
as
well
as
since
I
last
met
you
I'm
before
Sir
Robert,
left
meeting
with
Robert,
with
the
Judiciary
around
their
scheme
for
improving
the
judiciary's
ability
to
speak
up
about
wrongdoing
within
within
the
Judiciary.
So
there's
lots
of
learning
there,
which
is
really
important
to
report
to
you.
Q
We
continue
to
collect
anonymized
data
about
speaking
up
cases
that
are
raised
with
all
the
Guardians
that
are
on
our
register
and
that
in
line
with
the
increase
in
Guardians
is
increasing.
Really
importantly,
the
point
I
make
on
page
two,
the
percentage
of
cases
where
Guardians
are
reporting
that
workers
are
saying
they're
experiencing
detriment
has
risen
again.
It
was
at
a
level
of
around
2.6
percent.
It's
now
nearly
five
percent
and
I'm
increasingly
concerned
both
by
the
high
profile
reports
that
we
see
in
the
news
of
where
people
have
spoken
up
with
blown.
Q
You
know
the
the
the
generic
term
of
speaking
up.
We
use
because
not
everyone
identifies
as
a
whistleblower,
but
they've
said
we're
really
worried
about
something,
and
then
they
suffer
adverse
consequences
for
that.
That
has
a
chilling
effect
on
the
whole
sector
and
my
message
to
you
and
last
week,
I
went
to
CQC
to
their
board
meeting
to
do
a
similar
presentation.
I
go
to
their
them
annually
to
you
twice
a
year
as
my
host
organization.
Q
But
what
is
really
really
important
is
that
my
ask
to
you
is
for
us
to
consider
that
regulatory
response
as
I'm
not
a
regulator.
What
more
can
we
do
both
to
ensure
that
detriment
is
taken
really
seriously
and
I
know?
That's
in
the
new
regulatory
framework
and
I
know
that
our
team
are
working
with
you
on
that
part
of
the
well-led
framework,
but
to
be
very
clear
about
the
responsibilities
of
NHS
in
England
yourselves
as
the
regulator
to
be
addressing
ongoing
detriment,
because
otherwise
it
will
continue
to
have
that
effect.
Q
What
also
is-
and
this
is
not
going
to
be
all
Doom
and
Gloom,
but
it
is
a
real
Stark
warning-
the
NHS
staff
survey
published
and
again
last
year,
we
small
we
saw
a
decrease
in
confidence
of
workers
in
speaking
up
both
about
clinical
safety
and
also
about
anything
that
gets
in
the
way
of
them
doing
their
role
and
their
confidence
that
their
Workforce
will
do
anything
about
it,
and
this
year
we've
seen
a
bigger
decline.
Last
year,
I
hoped
it
was
a
blip
and
I.
Q
Q
Really
really
important
want
to
talk
briefly
about
our
new
methodology,
around
learning
from
speaking
up
handling
and
we
carried
out
our
first
new
methodology
speak
up
review
of
ambulance
sector,
and
you
will
have
seen
that,
obviously,
that
had
some
very
poor,
some
poor
outcomes
in
terms
of
what
workers
were
telling
us
about
their
experience
and
we've
got
some
significant
recommendations,
including
a
wider
cultural
review
of
of
ambulance
services,
which
Minister
Quince.
Q
The
am
the
minister
responsible
for
Urgent
Emergency
Care,
has
taken
on
board
and
has
appointed
NHS
England
to
lead
an
independent
review
of
cultural
ambulance
services
wider
than
just
wider
than
just
speak
up,
but
speak
up
very
much
relating
to
that,
and
there
were
recommendations
in
there
for
the
ambulance
trusts
themselves
to
improve
their
culture.
There's
also
a
recommendation.
That's
for
The
Regulators
yourself
in
NHS
England
again
in
terms
of
how
we
work
and
you
work
to
support
improvements
in
speak
up.
Q
Q
I
also
wanted
to
mention
that
ongoing
work
with
our
partners
there's
a
whole
section
on
this
I'm
not
going
to
go
into
it.
But
what's
the
one
I
want
to
highlight
is
the
carc
review.
I've
sat
on
the
steering
group
with
NHS
England
on
implementation
of
the
carc
review
and
I
spoke
the
word
earlier.
Q
It's
about
accountability,
accountability
of
leaders
across
the
NHS,
both
executive
and
non-executive,
and
particularly
obviously,
I
was
sitting
there
in
relation
to
the
recommendation
around
serious
misconduct,
including
suppression
of
whistleblowing
or
or
detriment
happening
to
to
people
who
speak
up
so
I've
been
pleased
to
be
part
of
that
and
look
forward
to
the
launch
of
of
that
work.
There's
been
various
other
work.
That's
detailed
here
that
you're
very
happy
for
you
to
ask
me
about.
Q
It
was
in
December
time
to
the
audit
and
risk
committee
and
had
a
very
helpful
discussion
with
colleagues
who
sat
on
that
committee
regarding
our
risk
profile,
and
one
of
the
conversations
we
had
was
regarding
measuring
our
impact,
both
as
an
office
and
indeed
Freedom,
speak
up
Guardians,
and
then
that
was
followed
up
with
a
meeting
with
with
Mark
Chambers
here
and
with
David
Corner,
one
of
your
your
independent
biscuiting
members,
which
was
very
helpful
where
we
all
agreed
it
was
incredibly
difficult
and
it's
partly
why
it's
challenging
in
terms
of
in
the
well-lid
domain
assessment
of
of
those
wider
cultural
issues
such
that
I'm.
Q
I
think
it's
self-evident.
In
there
the
work
we're
doing
around
Guardian
training
and
to
support
I
want
to
mention
the
communication
section.
There's
lots
of
Engagement
and
communication
going
on,
but
I
did
want
to
thank
Ian
for
coming
to
our
annual
conference.
We
had
over
400
Guardians
present.
It
was
a
mixed
hybrid
conference
and
Ian
was
speaking
about
the
importance
of
regulation
in
the
speak
up.
Q
Space
and
Guardians
were
incredibly
welcoming
of
you
being
there
taking
the
time
and
really
recognize
and
say
and
want
you
to
hear
how
important
the
regulatory
function
is
for
them
in
their
organizations
to
increase
focus
on
improving
culture.
So
thank
you
for
that.
We
continue
to
work
externally
with
various
Partners.
The
one
I
wanted
to
mention
was
our
mental
health
roundtables.
So
following
edenfield
and
the
high
profile
case
there,
we
pulled
together
the
Guardians
who
work
in
a
mental
health
space,
along
with
the
national
Clinical
Director
for
mental
health.
Q
To
talk
about
what
more
the
Guardians
could
help
inform
her
work
and
our
work
going
forward.
But
there
are
many
other
areas
of
work
that
we're
doing
externally.
I've
highlighted
our
next
steps.
It's
very
busy
we're
a
very
small
team,
but
we
continue
to
be
absolutely
committed
to
being
part
of
the
solution
for
improving
culture,
which
the
current
evidence
from
staff
survey
and
indeed
are
soon
to
be
published.
Guardian
survey
is
that
all
is
not
well.
Q
There
are
some
areas
of
good
practice
and
if
you
look
at
the
staff
survey,
obviously
it's
an
average
across
all
organizations.
Some
will
be
improving
and
we're
doing
a
deep
dive
into
the
most
improved
organizations.
So
we
can
learn
from
those,
but
clearly
overall,
there's
a
decrease,
and
that
should
be
aware
worry
to
us
all.
It
should
be
a
worry
to
this
board
in
terms
of
your
work
on
inspection
of
well-led
domain
and
certainly
to
NHS,
income's
Wellness
certainly
is
to
us
and
what
we're
doing
so,
I'm
really
happy
to
take
any
questions.
I.
Q
Thank
you
very
much
for
your
time.
Next
time,
I
come
I.
Hope
I
will
have
alongside
me.
Our
new
independent
chair,
so
I'm
very
happy
to
announce.
It
was
in
the
government
section
we've
appointed
Suzanne
McCarthy
as
the
independent
chair
to
our
accountability
and
liaise
on
board
which,
from
CQC,
Stephen
and
Mark,
sit
on,
but
we
now
have
an
independent
chair
and
she
only
started
last
week,
so
her
diary
was
too
full
for
today,
so
she
sends
her
apologies
and
she's.
Looking
forward
to
meeting
you
next
time,
I
come
back.
A
Okay,
thanks
very
much
Jane
before
I
move
to
just
open
questions.
I
wondered
if
perhaps
asked
the
our
executive
colleagues
a
couple
of
things.
I
mean
personally
posited
some
challenges
out
there
for
the
us
as
a
regulator,
but
then.
Secondly,
there
was
a
very
specific
comment
in
here,
so
I
won't
use
diligent,
page
numbers,
because
anyone
listening
in
won't
see
that
but
I
think
it's
page
three
of
your
report.
You
said
the
lack
of
alignment
between
workers,
perceptions,
etc,
etc.
A
Seek
you
call
the
people
and
providers
say
they
felt
the
red
carpet
is
pulled
out
when
we
turn
up
I've
been
short
to
an
element.
It
is
I'd,
be
very
surprised
if
it
wasn't
to
a
degree
but
I'll
be
interested
in
thoughts
as
to
how
we
can
try
to
counter
that
that
view
I,
don't
know
who
would
like
to
respond
to
whether
they
will
respond
to
your
challenge
and
then
to
my
question,
sure
looks
like
your
colleagues
upon
friends
are
pointing
at
you.
N
Well,
I'm
I'm
certain
that,
yes,
when
we
inspect
a
provided
site,
they
have
prepared
for
that
inspection
and
they
are
anticipating
that
expression.
They
want
to
put
on
give
a
good
account
of
themselves
and
how
they
work
and
and
the
care
that
they
provide.
N
Having
done
a
number
of
inspections
in
the
past,
I
I
I
think
our
inspectors
I'm
also
have
a
more
sophisticated
methodology
that
allows
them
to
see
beyond
what
is
merely
presentational
and
and
superficial,
perhaps
into
into
the
the
more
deeper
aspects
of
how
performances
being
delivered
and
how
quality
is
being
manifested
in
in
in
the
in
their
in
their
care
processes.
N
I
I,
I
I.
You
know
we
have
a
lot
of
inspectors
of
a
lot
of
AIDS.
You
know
the
Chloe's.
The
key
lines
of
inquiry
are
all
designed
to
to
take
a
deeper
under
gain,
a
deeper
understanding
of
of
how
care
is
going
and
and
a
lot
of
our
methodology.
We
talk
obviously
to
patients
and
staff,
and
you
know
it
it
it
comes.
You
know
it's
consistent
or
aligned
to
what
you've
been
saying
about.
N
Speaking
up
culture,
of
course,
isn't
that
we
have
the
ability
to
speak
to
staff
in
in
a
neutral
environment
and
can
hear
what
they
want
to
tell
us
about
how
their
services
are
being
delivered
and
what
what
issues
they're
proud
of
and
what
issues
they're
concerned
about.
And
similarly
we
speak
to
patients
and
and
and
the
public
about
the
the
quality
of
services
that
patients
are
experiencing
so
yeah
the
red
carpet
might
be
in
the
front
foyer
on
in
front
hall.
N
But
you
know
we
go
beyond
the
front
foil
and
you
know
we
go
to
places
where
the
red
carpet,
perhaps
hasn't
hasn't
been
laid
out,
but
I,
don't
I.
You
know,
I
I,
don't
blame
organizations
for
wanting
to
show
the
the
good
that
they're
doing
I
mean
that
that's
that's
right,
that
they
they
they
tell
us
what
they're
proud
of,
and
we
invite
them
to
tell
us
what
they're
proud
of.
But
we
see
beyond
that
I
think
it.
N
Q
It's
much
Sean
I
mean
why
some
workers
was
was
the
feeling
that
they
were
given
scripts
and
also
that
they
were
sometimes
put
in
a
position
where
there
was
a
manager
there
overseeing
what
they
were
saying
and
I
think
that's
what
they
were
trying
to
feed
back.
That
and
I
really
methodology
is
I'm,
always
always
improving.
I
know
and
you're
working
really
hard
at
that.
N
Can
I
just
respond
to
that
briefly,
where
we
have
seen
evidence
that
you
know,
managers
have
been
close
to
where
the
conversations
are
taking
place.
We
have
very
frequently
invited
staff
to
a
neutral,
a
neutral
venue
where
they
can
speak
freely
without
the
risk
of
fearing
that
they're
being
overheard
or
observed
by
people
who
they
feel
they
are
accountable
to
in
other
ways.
A
G
G
Think
of
cases
recently
where
we've
been
people
have
offered
a
script
and
often
then
you
hear
an
expert
about
experience
and
often
then
they've
unpicked
their
script,
and
they
said
actually
no
I
don't
mean
that
I
mean
this
and
I
think
the
ability
to
to
to
to
to
help
people
tell
the
the
truth
of
the
story
of
where
they
are
and
as
an
organization
is
critical
and
I
can
there's
a
couple
of
examples
very
recently
in
in
where
we've
taken
that
exactly
that
approach
and
I
think
it
It
ultimately
helps
the
organization
understand
what
they've
got
to
do
to
change
more
quickly.
H
H
H
Personally,
I
think
there
could
be
benefits
if
it
did,
but
we're
not
there
yet,
and
so
that's
a
sort
of
discussion
for
the
future
about
what
what
do
we
see
as
the
as
the
scope
of
the
freedom
to
speak
out
model?
The
second
one
it's
alluded
to
in
in
Jane's
report
is:
there
is
a
bit
of
a
risk
of
organizations,
designating
a
freedom
to
speak
up,
Guardian
and
saying
right
job
done,
but
if
that
person
has
no
protected
time,
they've
got
no
support.
H
So
it's
important
for
us
I
think
in
the
NGO
to
to
try
to
keep
raising
awareness
of
that
point,
that
if
freedom
and
speak
up
Guardians
are
to
work
to
full
effect
in
creating
confidence
amongst
staff
in
the
ability
to
speak
up,
they
do
themselves
need
to
be
properly
supported
and
they
need
they
need
the
time
and
the
backup
and
the
support
and
the
training
to
to
carry
out
that
function.
Well.
H
Q
Thank
you
very
much
Stephen
if
I
may
come
back
chair
just
on
the
adult
social
care
front.
Thank
you
for
for
raising
that
one
of
the
many
areas
in
the
report
covered.
Q
Obviously
the
first
day
I
started
December
the
the
first
2021
it
was
announced
in
the
white
paper
that
there
would
be
funding
to
Pilot,
adult
social
care,
Freedom
speaker
models,
and
then
we've
been
working
with
the
Department
of
Social
care
for
since
then
up
until
about
six
weeks
ago,
when
there
was
a
ministerial
change
of
heart
in
terms
of
the
amount
of
investment
into
that
white
paper,
and
that
was
one
of
the
things
that
got
postponed
delayed,
hopefully
not
shelved
I've
left
an
open
door
to.
Q
We
would
like
to
work
with
with
them.
You
know,
with
the
appropriate
funding
and
I
know
from
speaking
with
Kate
and
colleagues
here
within
CPC,
that
that's
something
that
you're
you
know
very
keen
to
consider,
and
particularly
within
integrated
Care
Systems.
You
had
to
have
part
of
an
integrated
care
system
being
assessed
around
their
speak
up,
culture
and
and
another
where
that's
that's
not
not
doesn't
have
the
same.
Potentiality
is
is
disappointing,
but
something
will
certainly
keep
her
raising
the
profile
off
and
on
the
point
of
the
freedom
speaker,
Guardian
resource.
Q
That
is
absolutely
key
and
I
would
say
as
well
just
to
remind
the
board
and
I
know,
I've
said
it
on
the
two
previous
occasions:
I've
come.
This
is
not
just
about
Guardians.
This
is
about
overarching,
speak
up
culture,
and
it's
just
as
important
that
every
single
manager
in
any
organization,
CQC
or
you
know,
providers
of
care-
are
absolutely
aware
of
all
the
different
routes
where
people
can
can
have
their
voice
heard,
be
it
about
patient
safety
or
well-being.
L
Thank
you,
Jane,
and,
and
thank
you
for
the
work
that
you
and
your
team
do.
You
know
we
know
how
unbelievably
important
this
is.
Yes,
people
ought
to
have
multiple
channels
to
escalate
their
concerns,
but
you
know
you
you
you,
your
team
are
there
for
people
quite
often
for
people
who
have
no
other
channel
or
feel
they
have
no
other
channel,
and
that
and
that
the
difference
that
that
makes
is
it
is
immense.
L
Just
responding
on
the
a
few
things
responding
on
the.
How
do
you?
How
do
you
show
impact
yeah,
I?
Think
it
is,
you
know
it
is
challenging
I
think
there
are
bits
of
it
that
we
can
definitely
do
you
know
to
speak
up.
Culture
definitely
drives
trust.
There's
plenty
of
evidence
around
that,
but
you
know
perhaps,
if
you're,
if,
if
there
was
going
to
be
a
little
bit
of
a
broad
assertion,
relation
to
that
it
could
be
you
know,
one
thing
perhaps
to
explore
might
be.
L
You
know
other
elements
of
risk
management
where
you're
you
know
you're
heading
off
a
risk
of
something
really
bad
happening.
But
how
do
you
show
that
it?
Might
you
know
if
you
hadn't
been
there,
the
the
risk
would
have
been
increased,
so
risk
functions,
control,
functions,
legal
functions
or
have
that
have
much
the
same
battle
when
they're
defending
their
resources.
L
It
would
be
much
worse
if
I,
if
I
hadn't
been
there
well
prove
it
so
so
maybe
some
lateral
thinking
might
might
help
very
happy
to
help
with
some
introductions
if
that
would
be
useful,
I
I,
I
I.
This
is
not
to
undermine
your
your
point
at
all.
I
was
actually
quite
surprised
at
4.8
percent
detriment,
because
I
thought
it
was
low
that
you
know
there
are
benchmarks.
I
think
we
are
missing.
We're
not
hearing
about
an
awful
lot
and
I
I
suspect
the
position
is
is
is
worse
than
that.
L
Unless
there
are,
you
know
robust
processes
for
tracking
and
identifying
it
unless
there
are
the
most
concrete
and
and
Fail-Safe
protections
for
individuals
who
do
speak
up
this
is
this
is
going
to
undermine
everything
that
that
you're
trying
to
achieve
so
I
really
worry
about
that,
and
then
my
final
point
was
to
just
I
suppose,
building
on
Stephen's
point
about
how
do
you
support
people
in
a
role
which
is
just
which
is
a
part
of
their
of
the
role,
particularly
the
risk,
if
their
manager
thinks
you
know
not,
perhaps
surprisingly,
is
more
focused
on
delivery
of
the
day
job
than
this
other
thing,
for
you
know
as
part
of
the
NGO
Network,
you
have
a
job
description
for
a
universal
job,
description
of
a
guardian.
L
Do
you
have
a
universal
job
description
or
something
that
could
be
slipped
in
for
a
4A
to
a
manager's
role,
profile
to
to
show
what
was
expected
of
them
as
if
they
are
man?
If
they're
the
line
manager
of
a
guardian.
Q
Thank
you,
I'll
take
the
last
one
and
then,
if
I
could
comment
on
one
of
the
others
as
well
in
terms
of
that's
a
really
interesting
suggestion
and
the
one
that
I'll
take
away
as
part
of
the
carc
review
work,
we
were
discussing
it's
all
very
well
having
an
accountability
framework
if
things
go
wrong
for
for
for
senior
managers
within
the
NHS.
Q
But
what
are
we
doing
in
terms
of
training
and
support
to
make
sure
they
have
the
right,
behaviors
culture
and
knowledge
to
execute
their
jobs
and
part
of
that
I
was
contributing
saying.
Actually,
those
expectations
around
managing
people,
speaking
up
speaker
is
really
key,
so
I
hope
that
will
be
taken
on
board,
but
actually
whether
there
is
something
more
that
could
be
done.
It's
really
worth
exploring
with,
with
with
the
various
bodies
and
professional
bodies.
Q
I've
been
talking
recently
to
the
the
nursing
with
free,
Council,
the
nursing,
the
Midway
Freedom
regulator,
suggesting
that
maybe
within
the
revalidation
work
for
them
to
speak
up
and
responsibilities
around
that
for
every
nurse,
not
just
nurse
leaders
could
be
considered
and
they've
said
that
they'll
put
it
into
the
next
review
is
an
idea
as
they're
taking
that
forward,
so
that
that
sort
of
concurs
with
that.
Thank
you
in
terms
of
the
detriment
figure.
If
I
may
just
make
an
observation
on
that.
J
Q
Which
they're
at
the
point
at
which
they're
reporting
to
the
gardens,
the
Guardians
reporting
to
us,
that
the
detriment
hasn't
yet
been
become
apparent,
so
that
could
be
an
underestimation
anyway.
But
yes,
I
take
that
on
board.
It
is
not
as
high
but
as
you've
said
you
weren't
undermining
it.
You
were
just
saying
it
could
be
a
lot
worse
and,
of
course,
that's
definite
through
the
speaking
up
route.
There
could
be
a
lot
of
detriment
happening
from
speaking
up
to
your
line
manager
or
going
direct
to
you
know
your
your
board,
Senior
People,
Etc,.
L
Well
and-
and
they
that's
helpful
to
know
because
the
organizations
that
do
this
really
well
follow
with
people
on
quite
a
long
time
afterwards,
because
you
know
the
the
retaliation
is
often
quite
Insidious
and
not
timely.
It's
spread
over
the
spread
over
time,
so
tracking
how
people
do
on
subsequent
job
application,
internal
job
applications.
That
sort
of
thing
is
is
useful,
but
it
requires
a
huge
commitment
if
you're
really
going
to
track
that.
Well,
it.
Q
Does-
and
it
would
be
a
commitment
to
to
ask
you
to
think
about
as
an
organization
with
your
new
director
of
people,
culture
and
you
know
how
you
might
consider
tracking
potential
detriment
from
people
speaking
up
through
whatever
route
and
and
outcomes.
And
it's
certainly
something
that
we
encourage
boys
to
be
thinking
about.
And
it's
something
that
I
want
to
talk
with
with
you
about
in
terms
of
the
well-led
domain
and
how
you
inspect
against
this.
F
Q
Questions
for
you,
that's
okay!
Thank
you
very
much.
It's
mixed,
not
all
organizations
report
on
on
protective
characteristics
of
those
who
are
speaking
up
and
it's
something
that
we're
looking
at
this
year
as
to
whether
we
can
mandate
that
my
understanding
is
before
I
started,
that
there
was
a
reluctance
to
have
a
huge
data
Suite
that
came
to
us
from
the
guardians.
But
we
know
that
over
50
of
Guardians
report
that
internally
for
themselves.
But
that
means
you
know
it's
still,
not
all
so
I'm.
Q
Looking
as
we
do
our
data
review
this
year,
because
I
think
it's
really
important
that
we
do
ask
Guardians
to
report
on
that,
because
we
know
from
the
work
during
the
pandemic
and
a
lot
of
international
research
that
people
from
Minority
ethnic
backgrounds
and
in
other
protected
characteristic
groups
both
find
it
harder
to
speak
up
and
very
often
have
more
detriment,
more
retaliatory
referrals
to
professional
bodies.
So
it's
something
that's
really
important
for
us
to
look
at
this
year.
Thank
you
for.
F
Raising
it
thank
you,
and
also,
how
do
we
ensure
safe
safety
scene
speaking
up
whether
anonymously
or
not,.
Q
That's
the
million
dollar
question
and
that's
down
to
organizational
culture
blessing,
because
absolutely
all
routes
are
speaking
out
both
Anonymous
and
I
know.
Anonymous
is
an
important
route
and
some
people
don't
feel
safe
to
speak
up
other
than
anonymously.
Obviously,
you
have
less
opportunity
to
go
back
and
follow
up
and
find
out
more,
but
it's
still
an
important
route
so
whether
whichever
route,
whether
people,
you
know,
are
happy
for
it
to
remain
confidential
or
indeed
to
be
open
about
it.
It's
the
response.
It's
the
follow.
Q
Short
answer
is
make
it
a
priority
is
ensure
that
every
everybody
from
board
to
every
Frontline
worker
understands
individual
responsibilities,
Collective
responsibilities
and-
and
it's
a
it's
a
daily
conversation,
because
it's
not
a
strategy
paper.
Q
Yes,
it's
important
to
have
a
policy
and
and
a
guardian
and
things
like
that,
but
actually
it's
everyday
conversations
that
I
have
with
my
line
manager
that
I
have
with
my
colleagues
that
we
have
as
teams
that
that
makes
the
culture
one
where
my
ideas
are
welcome,
where
I
can
I
can
safely
say,
I
think,
there's
a
better
way
of
doing
it
or
I'm
really
worried
about
this.
Or
have
we
thought
about
it's
those
sorts
of
cultures,
that's
ones
that
I
want
to
work
in
and
I'm
sure
we
all
do
so.
Q
A
Thanks
very
much
DJ
unless
only
burning
questions,
I
suggest
we
fall
a
hold
of
that
but
Jane.
Thank
you
very
much
indeed,
no
particular
actions
exactly
but
lots
of
food
of
thought
for
us
and
for
you.
So
we
look
forward
to
seeing
again
in
six
months
time
subject
to
diaries
with
your
future
as
well:
Louise
healthwatch,
England,
usual
rules.
A
We
have
read
it,
but
we
only
get
to
see
you
every
six
months
so
feel
free
to
draw
attention
to
key
things
and
then,
as
I
did
before
since
Belinda
has
been
actually
on
an
interim
basis.
The
child
might
just
ask
her
to
comment
or
add
if
she
wishes.
R
Thank
you
chair,
and
it's
similar
to
what
Jane
said.
It's
been
great
to
be
here
for
the
whole
meeting
and
my
team
are,
are
working
with
and
supporting
colleagues
in
the
CQC
and
doing
what
we
can
to
support
the
llrc
review,
including
you
know,
really
good
relationships
between
local
Health
watch
and
the
regional
CQC
teams
and
how
we
feed
data
in
in
terms
of
things
like
give
feedback
on
care,
and
so
we'll
we'll
continue
to
try
and
work
together.
R
Well
on
that,
so
I'm
not
going
to
go
through
the
report,
but
I'm
going
to
just
mention
a
couple
of
things.
So
yesterday
our
committee
meeting
in
public
was
or
I
think
our
interim
chair
Belinda's
last
meeting
to
chair
because
we're
due
to
have
a
new
permanent
chair
soon
and
on
behalf
of
the
healthwatch
England
committee
and
the
team.
We
want
to
thank
Belinda
for
absolutely
excellent
and
supportive
and
and
appropriately
challenging
time
as
interim
chair
of
healthwatch
England
and
at
that
committee.
R
It
was
an
important
one
for
us
because
it
saw
the
launch
of
our
new
strategy
2023-26
our
future
focus,
and
that
strategy
has
got
three
key
themes
in
it:
supporting
more
people
who
are
heard,
the
least,
to
feed
in
their
experience
of
Health
and
Care,
to
support
the
Health
and
Care
system
to
listen
better
and
act
on
what
they
hear
and
the
third
area
to
underpinning
that
to
be
a
stronger
organization
and
network.
It
is
very
good
bedtime
reading.
R
So,
if
you
go
onto
our
website,
you
will
see
the
full
strategy
there
we're
going
to
continue
to
build
our
focus
on
Primary
Care,
which
I
talk
about
a
little
bit
in
this
report
on
social
care
and
particularly
on
women's
health
amongst
other
areas,
and
we're
going
to
continue
to
deliver
our
statutory
duty
to
support
the
network
of
local
Health
watch.
There
are
152
of
them
across
England
and
improve
particularly
their
financial
viability,
so
I'm
going
to
leave
it
there,
but
very
happy
to
answer
any
questions
on
anything
in
the
report.
C
C
So
you
know
the
budget
is
obviously
an
ongoing
concern
for
how
to
watch
England,
because
whilst
they
didn't
receive
a
cut
this
year,
they
received
the
same
as
they
did
last
year,
which
is
which
is
essentially
a
cut,
and
so
I
know
that
funding
is
an
issue
that
keeps
Louise
and
her
team
awake
at
night.
So
that's
an
ongoing
concern
for
the
team
and
I.
Just
wonder
Louise.
R
Yes,
thanks
Belinda,
so
by
Far
and
Away
the
the
biggest
area
of
concern
biggest
area
of
feedback.
We
get
it's
about
primary
care
and
hence
that
being
a
continued
Focus
for
us
in
our
in
our
strategy
going
forwards,
I
mean
many
people.
Very
large
numbers
of
people
are
satisfied
with
GP
services,
fewer
with
dentistry
and
then
we've
we're
finding
out
much
more
about
people's
satisfaction
with
Pharmacy
and
Optometry,
and
we're
likely
to
do
more
work
in
those
areas.
R
But
you'll
see
in
the
report
that
the
British
social
attitude
survey
does
show
that
satisfaction
with
GP
services
in
particular,
is
at
an
all-time
low,
and
this
does
reflect
the
experience
that
that
people
talk
to
us
about
it's
still.
The
biggest
Trend
people
talk
to
us
about
their
frustrations
about
the
the
ATM
window
for
getting
appointments.
R
Time
spent
on
hold,
which,
of
course,
of
particular
problems
for
people
with
pay.
As
you
go.
Phones
and
we've
done
quite
a
lot
of
work
this
year
on
the
impact
of
the
cost
of
living
crisis
on
people's
access
to
healthcare,
which
I'm
happy
to
talk
more
about
only
same
day,
appointments
being
available
when
the
issue
isn't
urgent,
having
to
wait
many
weeks
for
an
appointment,
I
could
go
on
because
there's
quite
a
long
list
of
frustrations
there.
So
we
were
very
happy.
R
We
fed
all
of
these
through
to
Department
of
Health
and
to
NHS
England,
and
we
were
very
pleased
to
see
that
in
developing
the
primary
care
recovery
plan,
most
of
those
issues
had
a
response,
and
a
number
of
the
things
in
the
primary
recovery
plan
should
help
to
over
time,
if
implemented
across
the
country
alleviate
some
of
those
frustrations
and
people
do
know
that
the
system
is
under
pressure.
G
Chris,
just
a
comment
really
to
say
the
work
you
do
is
is
vital
to
our
work
in
terms
of
understanding,
not
just
how
individual
providers
work,
but
how
people
experience
care
across
an
area
across
the
system
and
as
we
go
into
this
year
and
look
at
our
work
on
particular.
G
Topics
like
access
to
services
like
the
performance
of
services,
particularly
initial
treatment
services
and
the
impact
that
has
on
adult
social
care
and
and
Urgent
moments
of
care,
I
think
there's
more
work
that
we
can
collectively
do
to
drive
the
voice
of
people
into
the
decision-making
process.
So
thank
you
for
the
work
you've
done.
They'll
know
your
team
do
a
fantastic
job.
Working
with
with
my
my
team
and
local
Health
watches.
It
will
be
a
feature
of
our
work
in
state
of
care
this
year,
as
it
always
is,
and
just
to
sort
of
formally
record.
A
A
Both
related
to
integrated,
Care
Systems,
but
probably
two-way,
round
question
one
for
you
and
then
one
from
my
colleagues
maybe
but
the
I
mean
how
what
what's
your
take
or
view
on
the
role
of
local
Health
watch.
E
A
Making
a
success
or
helping
ics's
be
successful,
there's
probably
a
theoretical
on
what
are
you
seeing
on
the
ground,
so
far
type
question
and
then
I
suppose
more
from
our
perspective,
and
maybe
ourselves,
one
of
the
CQC
colleagues
is
I
mean
you've
highlighted
things.
You
say
a
dangerous
blind
spot
in
the
NHS
understanding
the
challenges
from
people
just
getting
on
the
waiting
list.
In
the
first
place,
you
picked
up
other
things
like
only
half
of
practices
such
a
decent
Digital,
Phone
systems,
I
mean
this
is
well.
A
The
first
is
a
bit
more
subjective
but
close
to
factual.
The
second
is
just
factual,
whether
or
not
we
are
going
to
be
able
to
pick
that
sort
of
stuff
up
and
make
use
of
it
in
our
assessments.
I
know
we're
not
breaking
digital
assessments
or
general
practices,
but
if
you've
got
information
that
suggests
things
could
be
done
better
at
a
local
level.
A
You
know
how
or
to
what
extent
is
our
assessment
with
beside
I
understand
it?
We
wouldn't
be
assessing
that,
but
we
might
be
considering
whether
or
not
the
ICS
itself
was
was
looking
at
that
sort
of
information
and,
if
so,
are
they
accessing
it,
so
they
both
are
on
the
same
theme
but
I.
Think
one
is
your
your
perception
and
the
other
is
for
us.
R
So
so,
and
actually
Kate
was
there
on
the
on
the
on
the
same
day,
when
I
gave
evidence
to
the
the
Health
and
Social
care
committee
about
how
well
integrated
Care
Systems
are
doing
in
terms
of
their
accountability,
including
their
accountability
to
local
people
and
I
was
able
to
talk
about
the
good
progress
that
we
think
around
half
of
integrated
Care
Systems
have
made
in
terms
of
involving
the
groups
of
local
Health
watch
on
their
patch.
R
So
it's
it's
and
some
are
coterminous
and
what
we
are
seeing
generally
is,
as
I
say,
around
half
of
integrated
Care
Systems
are
involving
healthwatch
in
their
governance,
they're,
certainly
supporting
healthwatch
to
work
together.
So
the
Insight
flows
into
the
integrated
care
strategies
that
all
icbs,
or
rather
icps,
have
published
and
also
because
we
obviously
help
design
the
working
with
people
and
communities
guidance.
R
All
of
the
ics's
I
feel
have
taken
a
certain
step
up
from
the
world
of
ccgs
in
taking
a
community
engagement,
particularly
with
those
who
suffer
the
worst
Health
inequalities
much
more
seriously.
So
local
Health
watch
always
worked
well
with
ccgs
and
obviously
with
health
and
remove
scrutiny,
committees
and
the
other
kind
of
Frameworks
and
now
mostly
they're
working
well
with
ics's,
but
there's
still
some
way
to
go
and
in
terms
of
the
the
kind
of
how
how
this
then
feeds
into
change
locally.
R
We've
got
hundreds
of
really
good
examples
of
specific
areas
where
local
Health
watch
have
worked
with
the
service
or
it's
developing
on
an
ICS
footprint
that
they'll
identify
issues
on
a
thematic
basis
or
on
a
kind
of
population
basis,
and
really
good
change
will
be
made
and
actually
we're
feeding.
Quite
a
lot
of
some
of
those
examples
into
NHS
England
for
the
work
on
NHS
75
and
there's
lots
of
really
good
good
work
going
on
there
in
terms
of
the
relationship
between
CQC
teams
and
healthwatch
locally.
R
That's
often
on
the
basis
of
risk-based
inspection,
rather
than
kind
of
thematic
feedback,
and
when
healthwatch,
here
directly
from
people
that
they're
worried
about
a
particular
service.
The
aspiration
is
that
inspectors
will
consistently
and
always
make
sure
that
that's
it
happens
most
of
the
time
at
the
moment,
but
that
there
is
a
greater
level
of
consistency
in
terms
of
that
relationship
always
being
switched
on
and
fluid
and
inspectors
and
assessors
taking
action
when
provider
issues
are
being
flagged
via
healthwatch.
D
R
Yes,
thank
you
Tyson,
so
in
a
very
purposeful
way,
we've
we've
done
things
like
more
digital
marketing
spend
aimed
at
people
with
protective
characteristics,
but
we
have
we've
kind
of
doubled
down
on
our
previous
strategy
in
terms
of
our
commitment
to
focus
on
those
who
suffer
the
worst
Health
inequalities,
so
every
single
project
we
run,
we
have
in
mind
who
we're
targeting
so
you'll,
see
from
our
and
in
mind
the
intersectionalities
that
that
also
you
know
people
live
with.
R
So
if
you
look
at
our
work,
for
example,
on
cost
of
living
recently,
we
also
saw
that,
within
that,
some
younger
people,
people
on
benefits
and
women
were
were
suffering
more
detriment
in
terms
of
the
cost
of
living
and
the
the
impacts
on
their
ability
to
Access
healthcare
paper.
A
Okay,
can
I
just
go
back
to
my
second
part
of
my
questions.
That's
from
our
point
of
view,
so
the
dragons
right
so
I
mean
I,
would
say
we're
not
picking.
If
we
go
in
and
look
at
what
an
ICS
is
doing,
the
way
it
is
making
assessments
or
the
needs
locally.
A
Would
we
know
if
the
sort
of
the
responses
we
were
getting
were
inconsistent
with
information
held
by
healthwatch
England?
Oh.
G
Dude,
so
that
healthwatch
are
very
much
part
of
the
conversation
that
we'll
have
around
our
assessment
of
ics's.
So
there's
a
really
good
information
sharing
procedure
so
that
they
I
think,
as
you
rightly
said,
not
all
ics's
are
in
the
same
space
for
this,
but
I
think
we.
What
we
are
trying
to
do
is
collectively
capture
what
we
know
from
people.
Your
services
and
healthwatch
are
an
enormously
important
part
partner.
G
In
that
aspect,
we
also
use
it
to
gather
what's
working
well,
it's
interesting
that
the
NHS
75
information
you
push
back
is
something
that
we
requested
as
part
of
NHS
75.
But
the
idea
was
that
we
would
have
it
sounds
a
bit
cheesy.
You
would
say
about
75
cases
of
innovation
and
good
practice
that
we
could
share
at
the
event.
So
that
was
something
that
we
I
know
we're
holding
it
collectively
with
it
with
England.
G
But
that
was
something
that
we
wanted
to
to
to
to
to
promote,
partly
to
help
icscs
think
their
way
into
how
they
involve
people
who
use
services
in
the
Redevelopment
and
redesign
of
their
service,
so
so
to
20
Questions
directly.
They
are
an
important
partner
when
we
go
into
assess
they're,
also
an
important
partner
in
terms
of
spotting,
Innovation
and
good
practice,
and
we'll
use
that
together,
partly
for
our
assessment,
but
also
for
how
we're
going
to
Champion
that
work.
So
you
can
look
on
our
website
at
the
moment.
A
J
Was
just
going
to
add
that
we'd
look
at
it
from
two
aspects
within
the
assessment
framework,
both
how
we
get
the
information,
and
so
we
can
see
what's
happening
by
place
or
in
in
a
certain
geography,
but
also
within
the
ICS
assessment
we'd
be
asking
the
ISS
how
they
use
information
from
the
people
and
communities
that
are
in
their
system
and
what
action
they
have
taken
in
response
to
that
as
well.
So
there
are
two
ways
by
which
we
use
the
information
and
get
the
voices
of
people
into
our
assessment.
Yes,.
A
I
suppose
I
don't
want
to
travel
the
question,
but
I
suppose
I
was
really
thinking.
If,
if
we
do
the
second
do
we
know
to
what
extent
can
we
use
information
that
we
have
access
to
to
check
whether
or
not
it's
right,
but
but
anyway,
I
think
that
you've
answered
the
question.
Thank
you
very
much
for
no
other
questions
for
Louise.
It
doesn't
look
like
it
so
Louise.
Thank
you
very
much
indeed
for
coming.
Thank
you
for
presentation.
Thank
you
for
taking
the
time
enough
to
thank
Belinda
and
Belinda
can
I.
A
Thank
you
on
behalf
of
the
board
for
spending
and
I
think
a
subtle
amount
of
additional
time
acting
as
an
interim
chair
of
hwe
so
and
concerning
as
we
sit
here.
So.
Thank
you
very
much
indeed
for
that.
A
Let's
move
on
to
the
business
plan
after
a
false
thought,
this
time
I
think
we
are
going
to
be
joined
by
step
currently
or
team.
Chris
the
I'll
hand
over
to
you
and
to
take
us
through
the
session
just
a
word
of
explanation
to
anyone.
Listening
in
the
the
business
plan
that
was
circulated
with
the
pack
and
those
listing
end.
May
have
seen
was
the
draft
of
that
time.
A
These
sort
of
meetings
are
not
the
right
forum
for
doing
detailed
drafting,
so
we
did
say
to
board
colleagues.
If
they
had
any
comments,
could
they
feed
the
med
offline?
There
were
a
number
of
comments,
so
those
around
the
table
have
actually
got
a
slightly
revised
version
which
which
we
haven't
put
up
on
the
website.
It's
not
radically
different,
but
some
changes
have
been
made
so
Chris
I'll
hand
over
to
you,
but
I
think
between
the
two
of
you.
A
O
I
will
do
an
intro
and
then
Steph
might
be
able
to
pick
up
some
of
the
some
of
the
detailed
changes.
So
just
a
reminder,
we
bought
the
business
plan
here
in
March,
but
the
key
thing
we
want
to
reflect
on
was
the
llo
C
review,
which
was
at
the
same
session.
O
So
we've
we've
taken
that
back
and
hence
why
we're
now
back
at
board
the
plan
we've
lined
the
plan
to
our
to
our
strategy,
which
ensures
plan
of
planning
and
performance
as
a
clear
link
from
strategy
down
to
day-to-day
regulatory
activities.
O
The
plan
will
be
complemented
with
a
wider
performance
framework
in
corporate
risk
register.
So
for
the
purposes
of
our
for
this
post,
our
our
plan
focus
on
key
areas
of
delivery
and
commitment
across
the
period
the
key
bit
to
know-
and
it
kind
of
it
came
up
in
other
points
before-
is
that
we'll
have
a
catalog
of
kpis.
In
the
background,
we
can
pull
these
out
and
report
to
board
at
any
time
we
talked
before
about
some
of
the
HR
metrics
and
how
we
report
on
them.
O
So
the
the
the
introduction
does
reference
that
we
intend
to
review
the
key
results
in
the
plan,
as
as
we
deliver
on
key
pieces
of
transmission
throughout
this
year,
we
have
big
aspirations,
reports
and
delivery,
and
the
success
transformation
will
be
a
key
put
part
towards
this,
and
they
were
the
kind
of
in
brief
bits.
I
want
to
say,
Steph
I,
don't
know
if
you
want
to
touch
on
the
things
that
have
changed
since,
since
the
last
so
plan.
S
Thank
you
and
so
there's
three
main
measures
that
have
changed
since
the
last
plan
in
March,
so
the
first
was
around
the
safeguarding.
So
what
we've
done
in
this
is
we've
learned
from
the
listening
learning,
responding
review
and
we've
looked
at
how
we've
allocated
time
to
those
real
critical
measures,
those
real
critical,
safeguarding
and
whistleblowing
and
information
we
receive
where
it's
time,
critical,
that
we
respond
so
rather
than
it
being
one
day
and
then
straight
to
five
days.
We've
split
it
between
one
days,
three
days
and
five
days
in
terms
of
how
we
mitigate
action.
S
So
that's
the
first
key
change.
The
other
is:
we've
introduced,
two
measures
where
we
had
placeholders
one
for
speaking
up
and
the
other
one
about
a
cultural
Milestone
about
our
plans
for
how
we're
going
to
listen.
Why
there
is
an
organization,
since
the
draft
we
have
made
some
small
amendments
in
terms
of
out
of
hours
as
well
included
that
and
there's
also
now
an
introduction
and
a
forward
in
there
that
wasn't
in
the
plan
that
came
in
March.
S
Since
the
published
version
to
this,
the
only
changes
are
in
the
introduction.
So
there's
an
extra
paragraph
from
the
published
version
to
the
version
that
board
members
have
got,
which
has
a
bit
of
an
extra
paragraph
around
the
context
of
that
plan,
which
is
what
Chris
has
covered
in
the
introduction
about
how
this
plan
will
be
supplemented
by
the
performance
framework
and
also
our
commitment
as
we
go
through
our
transformation
and
that
we
will
revisit
these
measures.
S
So,
although
the
business
plan
runs
across
three
years,
what
we're
keen
to
do
is
over
the
6
and
12
month,
mile
Mark
really
look
at
these
key
results
as
we
deliver
on
pieces
of
transformation.
We'll
have
new
data
sets
as
a
result
of
regulatory
platform
and
be
able
to
really
hold
ourselves
to
account
to
those
new
data
sets.
A
M
A
So
can
I
turn
over
to
my
colleagues,
I
mean
we
are
being
asked
to
approve
this
we've
seen
little
bits
of
it
several
times.
Have
it
lasts
a
little
while,
but
I
think
the
the
version
of
a
circulated
with
these
papers
already
before
these
papers
was
probably
the
first
time
for
a
while
people
have
seen
the
whole
document.
So
there's
quite
a
lot,
that's
consistent
with
the
previous
year.
It's
not
radically
different,
but
there
are
changes,
and
certainly
the
the
metrics
that
we've
identifying
to
measure
our
performance
have
increased
significantly.
A
I
guess
over
that
time.
What
isn't
included
in
the
pack
but
Steph
kindly
sent
me
separately,
is
a
document
listing
where
we
are
with
the
the
metrics
that
we'll
be
using.
So
in
a
number
of
those
importantly,
we
have
got
a
baseline
So.
The
plan
does
tend
to
say
you
know
we're
going
to
improve,
but
clearly
you
could
only
measure
that
if
there's
a
baseline,
so
the
document
doesn't
have
all
of
that
in,
but
we
do
have
a
starting
point
identified.
A
So
when
performance
reports
will
be
able
to
say
Improvement
against
a
number
that
may
not
be
in
the
plan,
but
it
does
exist
and
there
are
other
cases
where
we're
still
trying
to
work
out
since
we've
expanded
the
reporting,
both
how
we
do
it
and
what
what
the
Baseline
is.
So
it's
a
one
level,
not
quite
the
finished
article
but
I
think
I've.
Certainly
I
was
satisfied.
A
Looking
at
the
stuff,
you
sent
me
stuff
that
we've
done
as
much
as
we
can
now
to
be
clear
about
what
we're
going
to
measure
and
where
we
know
what
the
starting
point
is.
It's
always
helpful.
Just
say
that,
but
colleagues,
so
we're
being
asked
to
approve
it,
so
questions
comments,
blessing.
F
Your
host
the
data
that
you're
collecting
for
safeguarding
and
whistleblowing
will
there
be
any
room
to
collect
protected
characteristics
for
that
or
not.
S
Think
when
we
talk
at
the
introduction
about
wanting
to
change
the
measures
as
the
transformation
project
delivers,
that
will
be
for
me
one
of
the
key
things
that
we
look
at
and
really
looking
at
understanding
about
how
we
use
that
different
information
and
whether
there's
any
correlation
in
terms
of
our
activity,
so
certainly
not
for
the
first
bit.
But
absolutely
that
is
what
our
intentions
are.
Thank
you.
A
M
A
That
Mark
chaired
is
part
of
the
work
we
do
is
look
at
things
that
we
might
want
to
measure
on.
If
we
haven't
necessarily
got
the
data
we
want,
and
we
were
talking
about
out
of
ours
working
beforehand.
You
know
this
now
gives
us
the
option
to
get
a
better
measurement
of
data,
so
we
can
do
it
much
better.
A
So
I've
really
quite
a
lot
of
examples
like
that
in
the
market,
which
is
shows
that
the
worth
of
the
group
of
the
committee,
but
also
that,
with
the
the
new
systems,
are
going
to
be
able
to
respond.
E
So
we
we
need
to
just
ensure
there's
a
good
alignment
between
the
two
of
them
in
in
this
plan,
we
talk
about
the
need
to
deliver
on
a
cultural
plan
and
obviously
it
talks
about
how
there's
more
work
to
be
done
to
to
find
what
that
cultural
plan
is
and
to
hit
miles
staying
so
so
this
will
have
the
home
for
the
this
will
be
the
home
for
where
all
that
activity
will
sit
and
absolutely
there
will
be
alignment,
so
we're
not
going
to
be
having
two
separate
discussions
about
his
our
people,
data.
L
One
of
the
things
that
we
have
in
in
here
is
you
know,
commitment
to
develop
product
tip.
You
know
better
productivity
metrics
going
forward
given,
given
the
you
know
the
importance
of
efficiencies
as
as
part
of
the
business
case
for
trans
for
transformation.
You
know,
when
are
we
going
to
see
this
in
in
a
form
that
were
that
we
think
is
near
final.
D
I
think
I
think
that's
probably
I
mean
I
shared
I
share
your
wish
to
improve
our
efficiency
productivity
measures.
We've
got
one
at
the
moment,
but
I
don't
think
it
captures
all
the
things
we
wanted
to
capture
I.
Think
that's
an
area.
We
should
look
at
at
the
at
the
half
year
point
when
we,
when
we
look
to
refresh
the
business
business
plan,
we've
got
as
as
I've
keep
saying.
We've
got
an
awful
lot
of
training
to
be
done
amongst
a
lot
of
teams
in
operations
over
over
that
period.
A
E
Could
I
just
very
briefly
say
a
massive
thank
you
to
Steph,
so
I
think
it's
been
quite
an
epic
epic
effort
to
get
to
this
point
and
it's
not
a
finished
product.
It's
not!
You
know
it's!
It's
a
it's
our
business
plan.
As
of
now
we're
going
to
tweak
it
we're
going
to
reflect
on
it
and
and
check
in
throughout
the
year,
but
just
a
massive
thank
you
Steph
for
what
you've
done
in
capturing
many
people's
views
on
this
as
well.
A
Actually,
I
was
going
to
make
two
points.
One
was
I'd
very
similar
to
yours
and
I
think,
but
they
I.
This
is
a
major
step
forward
in
terms
of
the
quality
of
and
what
we're
trying
to
do,
and
some
of
the
insights,
so
yeah
I
think
we
have
to
accept
the
fact
that
it
may
not
be
rather
than
spending
another
two
months.
Just
looking
for
absolute
perfection,
it'd
be
great
to
have
agree
it.
A
So
the
management
know
what
they're
doing
we
don't
want
to
be
fiddling
with
it
every
month
or
every
quarter,
whatever
it's
going
to
be.
But
equally
you
know
it's
his
brother's
video.
So
we
we
have
the
opportunity
to
stand
back
six
months
or
whatever
it's
going
to
be,
but
I
think
approving.
At
that
basis.
It's
not
a
subject
too,
but
just
recognition
it
it
might
move
on.
A
I
would
like
to
make
a
few
tiny
changes
to
the
introduction,
primarily
because
we
Define
llrc
quite
extensively
in
the
context
of
external
things
at
the
top
and
then
there's
a
throwaway
line,
and
last
paragraph
about
an
internal
review,
doesn't
quite
make
the
point
that
it's
it's
joined
up,
so
I
like
to
tweak
that,
but
that's
clarification
not
in
any
way
substantive,
but
if
people
are
happy
to
approve
on
the
basis,
I'll
sort,
some
words
up
with
Ian
who's,
co-signing
and
stuff
that'd
be
great,
so
we
are
being
asked
to
approve
it
of
people
happy
to
approve
it
on
that
basis.
A
A
Right
we're
right
back
on
time,
so
we
have
some
minutes
in
the
pack
of
the
previous
meeting.
They
were
circulated
in
advance.
Any
comments
on
those
or
can
I
take
them
as
a
greed
record
of
the
meeting.
Yes,
okay,
they
are
approved.
We.
A
Mark
we've
referred
a
couple
of
times
today
to
the
rgc
had
a
meeting
the
other
day.
Could
you
give
us
a
brief
oral
update.
L
Sure
very
happy
to
a
few
of
these
points
of
of
originally
were
in
the
meeting
as
well.
So
that's
always
good
to
see
just
as
a
reminder.
L
You
know
there
are
kind
of
two
things
that
we
do
at
rgc
once
one
where
we're
developing
a
a
continuing
to
iterate
a
core
pack
which
appears
every
meeting
which
covers
you
know,
changes
to
the
design
of
our
of
of
our
regulatory
model,
proactive
improvements
that
we're
making
ourselves
responses
to
to
to
external
developments,
a
set
of
kpis
around
how
we're
delivering
against
that
model.
L
Are
we
actually
managing
to
do
what
we,
what
we
plan
to
do
and
then
a
review
of
of
of
internal
and
external
insights,
to
how
effective
it's
being
in
delivering
the
the
outcome
that
that
we
want
the
model
to
deliver.
So
a
lot
of
that's
the
the
the
the
the
the
the
the
the
core
pack
and
then,
on
top
of
that
we
do
a
a
program
of
of
of
deep
Dives,
some
of
the
things
that
came
out
of
the
the
the
call
pack
this
time.
L
Our
continued
continued
reassurance
that
our
I
think
as
as
came
back
up
earlier,
that
our
risk-based
approach
to
is
helping
us,
identify
and
and
better
Target
risk
of
harm.
We
are
we're
getting
to
that
in
a
more
targeted
and
better
way.
So
that's
good
news.
We
talked
to
Tyson
talked
earlier
about
the
work
that
we
need
to
do
on
out
of
hours
inspections.
We
need
to
make
sure
that
you
know
we
if
we're
reporting
and
commenting
on
on
and
out
of
our
inspection.
L
It
really
is
one
that
was
you
know,
designed
and
intended
and
to
to
be
conducted
outside
business
hours
and
it's
substantially
completed
with
in
in
outside
business
hours,
not
one
that
just
happens
to
roll
past
like
5,
30.
so
and
I.
Think
it's
an
indication
that
you
know
we.
We
need
to
sort
of
tighten
up
that
definition.
L
L
The
and,
of
course,
when
we
do
build
that
extra
capability
to
do
more
of
this,
which
we
really
want
to
do
and
Tyson
highlighted
some
of
the
organizational
changes
that
we
need
to
do
before
we
can
before
we
have
that
extra
capability
when
we
do
need
to
when
we
do
have
it
we'll
need
to
deploy
it
against
areas
of
greatest
risk.
L
So
we'll
be
revisiting
that
at
the
committee
in
in
Q4
we
looked
again
at
you
know,
one
of
our
regular
looks
has
has
been
the
time
taken
to
get
reports
published.
How
quickly
can
we
get
the
information
that
we're
finding
out
to
to
the
public
that
is
continuing
to
to
improve
I,
think
an
area
that
we
need
to
look
at
and
we'll
look
at
in
more
detail?
The
next
meeting
is,
is
variance
you
know.
What's
what's
the
pattern?
Averages
only
tell
you
so
much.
L
We
talked
at
a
previous
meeting.
We
looked
at
a
previous
meeting
at
something
is
in
our
toolkit,
and
we
should
pull
out
of
the
toolkit.
More
often
is
is
our
ability
to
spend
suspender
rating
for
a
provider.
We've
had
a
you
know
another
example
of
where
we've
done
that,
but
you
know
our
view
is
that
we
ought
to
do
it
more.
It
was.
It
was
a
good
response.
This
time
we
acted
very
fast,
but
it's
a
tool
that
I
think
we
should
be
more
willing
to
to
to
use.
L
You
know
we
also
looked
at
it.
You
know.
Are
we
getting
the
balance
right
in
terms
of
the
support
that
we're
providing
to
assistance
to
other
organizations?
I
think
we?
L
We
need
to
make
sure
that
we,
where
it's
it's
all
helpful
and
it's
all
well
received,
but
we
need
to
make
sure
that
there's
a
you
know
that
we
that
we
probably
ever
try
and
seek
to
see
shrink
that
rather
than
grow
that
and
make
sure
that
there's
a
clear
linkage
to
our
to
our
core
purpose
when,
when
we're
doing
that
our
deep
dive,
this
time
was
on
registration
and
looking
you
know.
L
Obviously
our
registration
process
is
intended
to
identify
and
and
only
let
through
providers
that
were
confident
will
receive
the
stand
to
achieve
the
standards
required
for
a
good
rating.
Now
we
can't
guarantee
that
because
a
lot
of
time,
of
course
that's
where
these
are
plans
rather
than
practices
that
people
are
describing
for
us.
L
But
a
a
you
know,
a
significant
number
of
of
providers
when
they
are
first
time
inspected
by
us
subsequently
do
not
achieve
those
standards.
So
we've
had
a
good
look
at
that
to
learn
what
we
can
use,
what
we
can
learn
from
that
to
you
know
to
to
to
tailor
and
focus
our
registration
process.
L
It
proved
to
be
quite
a
difficult
question
and
one
that
we
don't
have
all
the
answers
to
yet
you
know
there
are
definitely
some
factors
about
things
that
change
contributory
factors
about
things
that
change
between
registration
of
first
inspection,
but
we
we
need
to
do
a
a
more
in-depth
study
on
that
which
we
will
come
back
to
possibly
later
this
later
this
year.
L
The
you
know
the
the
our
next
meeting
our
next
deep
dive
is,
is
is
going
to
be
on
in
in
you
know,
on
complaints,
and
will
you
know
that's
something
that
we
we
do
look
at
at
a
board
level,
but
yeah
I
think
it
will
be
useful
for
us
to
have
more
time
to
to
dig
into
that
deep,
deeper
A
Day
committee
level,
but
it
was
another
good
meeting
and
thank
you,
everyone
for
the
effort
put
in
to
produce
some
very
high
quality
papers.
L
Thank
you
to
George
for
his
support
for
the
committee
and,
and
you
know
thank
you
to
members
for
what
was
a
contributors.
We
thought
was
I.
Think
a
pretty
good
discussion.
A
Good
thanks
very
much
indeed
Mark
anything
to
add
from
fellow
committee
members
or
management
or
any
questions
for
Mark.
A
Okay,
I
think
that
almost
brings
us
the
end
of
formal
business,
any
other
business
or
a
couple.
Something
I
want
to
mention,
but
let
me
start
with
others
any
other
business
people
want
to
raise.
No,
the
two
things
for
me:
one
is
just
simply
animation.
I'm
casting
my
back
over
the
notes.
I
was
making
during
the
meeting
and
my
apologies
for
those
the
transformation,
but
you
did
mention
some
significant
steps
forwards
on
the
technology
side,
so
I
think
we
should
have
congratulated
you
on
that.
A
It's
very
useful
to
see
that
everyone's
come
through,
so
I'll.
Do
it
now
and
apologize
that
I
didn't
do
it
earlier.
The
main
aob
I
just
wanted
to
make
sure
everyone's
aware
that
this
will
be
jorah's
last
board.
Meeting
Jor
is
by
a
significant
margin,
the
longest
standing
a
member
of
this
board.
He
served
two
full-time
as
a
non-executive
director
and
that
expired
in
the
Autumn.
A
He
very
kindly
agreed
to
stay
on
for
another
couple
of
three
month
terms
as
an
associate
non-executive
director
or
something
that
we're
able
to
do
ourselves,
but
he
is
looking
at
other
things
indeed,
as
being
asked
to
take
on
other
things,
and
we've
agreed
that
it
would
simply
be
unfair
to
ask
him
to
to
extend
again
he
has,
as
I
mentioned
one
two
people
agreed
to
be
available.
Should
there
be
any
ongoing
questions
and
and
you've
got
another
week
with
us.
A
It's
just
it's
your
last
board
meeting
so
I
think
on
behalf
of
everybody
just
like
thank
you
for
I
know
from
the
management
point
of
view,
been
very
grateful
for
your
insights
and
support
I've
only
been
here
a
year,
but
maybe
the
value
member
of
the
board
so
can
I.
Just
thank
you
formerly
and
very
much
indeed,
for
your
very
significant
contribution
to
CQC.
So
thank
you
very
much
indeed.
Jorah.
A
In
terms
of
the
formal
business
that
concludes
it,
but
we
do
have
questions
from
the
public,
so
we
will
just
quickly
take
those.
We
have
three
questions
for
Mr
Pike,
two
I'm
going
to
Hunter
Joyce
a
1-2
to
Sean
I'm
hoping
the
system
has
worked,
and
you
know
about
these.
A
J
Thank
you,
discussion
with
Louise
and
healthwatch,
so
we
use
the
term
people's
experiences
throughout
our
assessment
framework,
and
this
covers
people's
needs.
Expectations,
lived
experience
and
their
satisfaction
with
access
to
service
care,
support
and
treatment,
and
our
assessment
framework
has
uniquely
been
built
involving
people
to
say
what
good
looks
like
from
the
services
that
they
would
expect.
So
our
assessment
framework
is
built
on
those
standards
and
it
then
becomes
it's
actually
linked,
Into
the
Heart
of
how
we
collect
evidence
and
make
our
judgments
as
well.
J
We
will
use
a
variety
of
methods
to
collect
information
through
surveys,
information
from
Partners
from
healthwatch,
like
we
said
from
the
ICS
themselves,
from
the
integrated
Care
Systems
of
self.
How
do
they
get
feedback
from
people
they
receive?
We
will
also
get
information
from
providers
and
then
we'll
also
do
our
own
work
talking
to
people
and
communities
and
pathway
track
within
local
systems.
J
We
are
committed
to
ensure
that
we
get
the
experiences
for
people
most
likely
to
receive
poor
access,
experience
and
outcomes,
and
we
also
want
to
Chris
talked
earlier
about
give
feedback
of
care
which
is
increasing
Rising
as
a
number
of
people
contact
us.
We
also
want
to
be
able
to
use
that
information
analyze
that
information
to
provide
even
further
information
across
systems
and
where
people
are
at
place
where
they
have
a
local
Authority
and
their
Neighborhood
Services.
A
Thanks
so
much
Joyce
and
another
question
for
you,
excuse
me:
what
process
does
CQC
currently
have
in
place?
Reviewing
the
classifications
of
outstanding
good
requires
Improvement
and
an
adequate.
J
So
I
think
that's
another
good
question
as
well.
We
keep
our
Frameworks
under
constant
review
review
through
engagement
and
through
consultation
and
where
necessary,
we
have
updated
sections
like
our
rating
characteristics,
to
keep
Pace
with
best
practice,
Rising
public
expectations
and
recommendations
from
over
at
other
agencies.
That's
previously
been
on
a
cycle
of
about
every
five
years,
but
with
the
introduction
of
our
new
single
assessment
framework
will
be
far
more
responsive,
particularly
in
relation
to
best
practice
and
standards.
J
So
our
new
approach
will
be
able
to
use
evidence
and
scoring
and
we'll
make
quality
judgments
to
produce
ratings
and
we'd
be
quite
transparent
exactly
in
terms
of
how
we
reduce
the
ratings
I
just
wanted
to
know
if
the
question
is
asked
about
the
classification
itself,
the
fact
that
we
use
a
four
point
scale:
that's
not
our
decision.
That
would
be
with
the
Department
of
Health.
A
I
wasn't
entirely
sure
of
the
question,
but
thank
you
for
making
that
absolutely
clear
and
then
finally
Sean
a
question
for
you
during
Hospital
inspections,
how
does
CQC
assess
the
quality
of
a
Hospital's
Communications
with
patients.
N
Thank
you
yes.
Well,
when
we
assess
the
quality
of
communication
with
patients,
there's
a
number
of
things
in
particular
that
we're
interested
in.
So
this
would
include
how
well
staff
communicate
with
patients
directly
how
well
the
hospital
shares
important
information
with
patients,
especially
patient
safety
information,
and
whether
they
share
that
in
a
way
that
is
accessible
and
then
also
how
well
hospitals
engage
with
patient
interest
groups
when
we
perform
inspections.
Clearly,
we
have
a
number
of
approaches.
We
we
we
we
do
direct
observation
of
of
all
of
those
things.
N
We
talk
to
patients
and
staff
and
we
review
documentation
that
will
provide
us
with
evidence
to
help
guide
inspectors
when
they're
doing
inspections
and
looking
at
this
particular
function
of
trust.
There
are
a
number
of
key
lines
of
inquiry
in
in
our
in
our
guidance,
especially
in
the
caring
and
well-led
domains,
and,
for
example,
you
know
there
are
numerous.
N
There
are
numerous
questions,
but
a
couple
of
examples
would
be
an
undercaring
2.1:
do
staff
communicate
with
patients
so
that
they
understand
their
condition,
their
treatment
and
their
care,
and
under
well-led,
for
example,
well
that
Chloe
7.2
our
patients,
carers
and
families
actively
engaged
in
decision
making
around
care
and
treatment.
So
those
are
just
a
couple
of
examples
of
the
guidance
that
we
have
for
inspectors
when
they're
when
they're
looking
at
communications
with
patients.
A
Okay,
well,
thank
you
very
much
for
sure
that
answers
the
questions
so
I
think
to
anyone
listening
we
have
finished.
Thank
you
very
much
for
listening
in
to
my
board.
Colleagues,
thank
you
for
your
time.
It's
been
another
long
session
this
afternoon
and
blessing.
Thank
you
very
much
indeed
for
joining
us.
Thank
you.