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From YouTube: CQC Board Meeting - September 2022
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A
Well,
good
afternoon,
everybody
Welcome
to
the
Care
Quality
commission
public
board
meeting
this
afternoon.
My
name
is
Ian
dilks
I'm,
the
chair
of
CQC,
for
those
that
I
haven't
seen
on
these
broadcasts
before
I
won't
introduce
everybody
who's
here
today,
and
many
will
be
familiar
cases
to
you.
There
is
one
I
will
introduce,
who
we
usually,
as
you
know,
have
an
equality
Network
representative.
So
today
it's
Hannah
Carson
over
in
the
corner
there.
If
the
camera's
captured
her
and
she
represents
the
gender
equality
Network.
So
welcome
Hannah.
A
We
have
World
apology,
Sean
O'kelly
can't
be
with
us
Sean.
You
recall
joined
us
a
few
months
ago,
but
he
already
had
a
long
pre-arranged
holiday
booked
for
around
this
couple
of
weeks.
So
he
sends
his
apologies.
A
I,
don't
know
if
he's
diving
him
from
vacation
to
watch
us
I
suspect
not
I
will
comment
later
on,
but
I
should
also
say
that
this
is
the
last
board
meeting
for
Mr
Robert
Francis
he'll
be
standing
down
as
the
chair
of
the
healthwatch
England
and
also
as
a
member
of
the
board,
but
I'll
mention
that
right
at
the
end
of
the
meeting
as
well.
A
I
haven't
been
notified
of
any
new
conflicts
of
interest
prior
to
the
meeting.
As
far
as
I
look
around
the
room,
I
don't
see
any
more
and
I
haven't
been
notified
of
any
urgent
business
to
put
on
the
agenda,
so
I
suggest
we
move
straight
into
the
the
topics.
Today's
agenda
is
very
much
focused
on
reporting
updates
on
what
is
going
on
in
the
organization.
We
have
no
major
strategic
discussions
today,
so
if
it's
okay
with
everybody
I
suggest,
we
just
kick
off
straight
away
with
a
report
from
the
executive
team.
A
B
Annie
good
afternoon,
everybody
as
Ian's
just
alluded
to
we,
we
normally
do
a
we've,
normally
done
a
single
report
that
talks
about
individual
sectors
in
the
in
the
chief
execs
report,
however,
I
think
reflecting
our
move
towards
looking
at
both
set
factors
and
systems
and
the
and
the
recent
internal
moves
that
we've
made
to
create
the
regulatory
leadership
function.
B
Alongside
the
operations
group,
we've
split
the
the
chief
execs
report
now
into
regulatory
matters
and
organizational
matters,
so
I
hope
that
gives
a
more
a
more
joined
up,
more
collaborative
view
of
of
what
we,
as
an
executive
team,
have
been
doing,
and
it
enables
us
I
think
to
more
coherently
reflect
the
work
that
we've
been
doing,
and
so,
as
always
I
think
I
would
I
would
I
would
ask
you
to
take
the
reporters
read
obviously
very
happy
to
ask
answer.
Any
questions.
B
I
think
the
broad
comment
I
I
would
make
is
that
the
report
report
reflects
the
the
Health
and
Social
care
system
is
under
significant
pressure
at
the
moment.
I
think
I
think
that's
something
that's
been
widely
reported
and
we
know
that
can
sometimes
translate
into
poorer
care.
For
for
individuals,
and
whilst
that
that
can
often
translate
into
a
a
regulatory
response
of
formal
regulation,
true
response,
I,
think
and
we'll
cover
that
we'll
cover
the
details
off
in
the
next
item.
B
When
we
look
at
the
performance
reporting
section,
I
think
what
we
have
also
done
is
taken
the
opportunity
to
to
look
for
where
things
are
going
well
and
looking
for
examples
were
of
good
practice
and
I.
Think
you
know.
Products
like
the
people
first
product
and
the
work
we've
been
doing
in
maternity
and
elsewhere
are
really
good.
Examples
of
that
I'll
bring
Chris
in
in
a
moment
to
to
talk
about
that.
B
The
other
thing
to
say
is:
although
we've
got
the
most
recent
performance
information
in
in
this
section
of
the
report.
I
think
the
most
sensible
way
of
dealing
with
that
is
to
talk
is
to
invite
Tyson
to
do
that
as
part
of
the
the
quarterly
performance
reporting
where
you
usually,
as
you
know,
deal
with
the
most
recent
month
in
this
section
and
then
then
quarterly
reported
I
think
just
bringing
those
together
would
probably
make
the
most
sense.
So
can
I
just
I
bring
Chris
in
to
talk
about
engagement
matters.
C
Thanks
Ian,
so
three
things
just
to
to
highlight
from
this
report.
Firstly,
as
Ian
said,
we've
been
looking
at
how
we
might
support
organizations
and
systems
in
their
planning
for
winter.
Colleagues
may
remember:
we
we
produced
a
document
working
with
clinicians
from
across
some
outstanding
organizations,
a
document
called
Patient
First,
which
was
looking
very
much
at
the
secondary
care
response
to
the
issues
in
emergency
urgency,
emergency
care
we
wanted
to,
and
and
colleagues
from
across
the
system
wanted
to
update
that
to
reference
the
relationship
between
Health
and
Care
organizations.
C
So
today
we're
launching
people
first,
which
is
a
look
at
how
organizations
work
collectively
to
support
the
the
managing
the
flow
within
urgent
rental
care,
not
just
from
within
the
secondary
care
environment
itself,
but
also
Across,
The,
Wider,
primary
care
and
adult
social
Care
Network.
What
I
think
it
does,
which
is
important
is
it.
It
obviously
highlights
the
issues,
but
it
brings
together
practical
guides
for
organizations
and
people
working
in
those
organizations
from
their
colleagues
from
other
organizations.
C
So
we've
we've
acted
as
a
convener
for
this,
but
it
very
much
hopefully
guides
people
early
enough
around
the
the
actions
that
they
can
take
to
support
the
organization's
planning
and
delivery
during
this
winter
period.
So
we
know
that
the
the
the
patient
first
guide
received
some
strong
support,
I'm
hoping
for
the
same
again
today
as
we
launched
people
first
alongside
that,
just
to
just
two
of
the
things
I
wanted
to
quickly
mention:
we've
been
working
for
a
number
of
months.
C
What
I
wanted
to
assure
the
board
is
that
there
was
a
strong
focus
on
inspection
activity
in
this
area
and
we
intend
in
a
similar
way,
to
to
people
first
to
talk
about
the
concerns
we
have
and
also
where
we
see
good
practice
in
return
to
Services
what
that
could?
What
lies
behind
that
good
practice.
So
there
are
a
number
of
as
an
inspection
program
for
taking
place.
Now
we
will
update
the
board
and
indeed
update
colleagues
across
Health
and
Care
with
our
findings
as
we
go.
C
Our
intention
is
to
look
at
all
organizations
that
have
not
been
inspected
since
2019
and
to
talk
about
both
ambition
where
organizations
are
improving
and
also
our
concerns
where
where
organizations
are
are
not.
And
lastly,
just
as
part
of
our
build
up
to
this
year's
state
of
care
report,
we've
we've
done
some
work
with
them.
C
An
organization
looking
at
how
people
experience
care
across
Health
and
Care,
the
the
the
project
called
four
thousand
voices
sort
of
tracks,
people's
experience
of
care
across
the
primary
care,
secondary
care
and
adult
social
Care,
Network
and
I.
Think
it's
what
it
what
it
practically
does
for
us.
It
gives
the
voice
of
people
use
services
at
the
heart
of
what
we
will
say
in
this
year's
state
of
care.
C
So
just
thank
colleagues
for
for
helping
deliver
that
it's
been
a
tremendous
undertaking
and
I
hope
that
not
only
will
it
will,
it
show
the
areas
of
concern,
but
also
again,
some
of
the
good
practice
that
we've
seen
how
systems
and
services
are
working
together
to
deliver
services
for
people
and
that's
my
thoughts
in.
D
Thanks
in
so
just
one
thing
to
draw
out
from
my
update
today,
so
in
our
commitment
to
ensuring
that
right
support
right
care,
right,
culture
is
being
delivered
so
that
people
with
learning
disabilities
and
autistic
people
receive
services
in
places
that
are
small
and
based
in
the
community,
and
we've
introduced
a
new
way
of
putting
conditions
on
new
Services
registering
with
us.
D
That
requires
them
to
come
back
to
us
if
at
a
later
date,
they
want
to
provide
services
for
people
with
learning
disabilities
and
autistic
people,
and
this
is
to
ensure
that
we
are
doing
everything
we
can
at
the
point
that
new
services
are
coming
into
the
market,
that
if
they
are
for
this
group
of
people,
they
are
meeting
the
requirements
of
right
support
right
care,
right
culture.
So
a
new
way
of
using
our
conditions.
A
A
E
Thank
you
could
I
just
say
a
quick
word
about
people
first,
because
for
a
number
of
things
about
it,
but
very
briefly.
Firstly,
it's
remarkable
as
being
a
document
which
not
only
identifies
the
very
well-known
problems
of
emergency
care,
but
also
solutions
to
some
of
those
problems
across
the
system,
even
more.
Encouragingly,
it
is
based
on
the
lived
experience
in
this
case,
one
particular
patient,
but
unfortunately,
who
had
a
journey
through
the
system
that
will
be
all
too
familiar
to
many
people
within
it.
E
But
perhaps
the
most
remarkable
piece
of
it
is
that
it's
the
use
of
the
Care
Quality
commission's
convening
Power
of
a
lot.
There
were
250
people
involved
in
putting
this
document
together,
all
of
whom
were
senior
clinicians
in
various
parts
of
the
system,
all
of
whom
were
committed
to
change
and
I.
Think
it's
really
important
to
emphasize
that,
although
we
spend
a
lot
of
time,
I,
happily
identifying
what
has
gone
wrong.
E
These
are
often
issues
for
which
there
are
solutions,
and
there
is
actually
no
need
for
people
to
despair,
I
can't
say
as
a
non-qualified
person
in
this
field
as
a
lawyer
that
these
Solutions
are
actually
the
ones
that
are
going
to
fix
the
whole
problem,
but
they
certainly
look
like
things
that
are
going
to
go
a
long
way
towards
that.
So
I
would
hope
that
this
is
a
document.
C
Just
to
Echo
that
point
particularly
around
I,
think
the
fact
that
we've
we've
managed
to
gain
support
from
such
a
wide
variety
of
people
across
the
system
to
to
make
the
report
a
practical
guide
is,
is,
is
crucial
and,
as
you
rightly
say,
Robert.
It
hopefully
gives
hope
to
those
at
the
front
line
of
delivery
of
care.
This
winter.
F
Thanks
Ian
could
I
just
come
back
to
the
maternity
report,
because
we
talk
about
The,
Wider
ambition
for
our
program
and
obviously
what
we've
detailed
here
is
quite
comprehensive
for
CQC.
But
there
are
other
bodies:
aren't
there
working
on
safety
and
maternity
under
the
guise
of
dhsc
and
obviously
the
new
body
which
will
investigate
maternity
instance.
Can
you
say
a
little
bit
more
about
what
we've
called
our
wider
ambition
for
the
program?
It's
probably
directed
at
Chris,
but
it
could
be
somewhere
else.
C
And
you're
quite
right,
I
think
one
of
the
important
features
of
this
work
is
that
it
quickly
disseminates
what
we
see
from
our
inspection
activity
to
partner
organizations
who
have
a
role
in
improving
and
shaping
improvements
in
a
way
women
receive
maternity
services.
So
we've
already
established
the
the
relationships
and
Our
intention
is
to
to
have
a
regular
reporting
of
that
information
through
to
other
partners,
and
indeed
there
are
some
issues
that
we
we
think
we
can
collectively
unlock.
C
One
of
the
conversations
we're
having
with
the
GMC
was
a
bit
about
the
relationship,
the
relationship
and
training
support
for
people
to
work
in
multi-disciplinary
teams
and,
of
course
this
is
a
multifaceted
issue
that
requires
support
from
other
organizations
and
they
were
very
much
they're
Keen
to
work
with
us
on
what
that
meant
in
terms
of
what
they
needed
to
say
around
their
own
support
for
for
their
members.
So
I
am
Keen
that
we've
I
believe
we've
got
the
right
mechanisms
in
place
to
bring
about
that
change.
C
What
I'm
Keen
to
make
sure
is
at
the
point
we
hear
things
as
we
go
through
that
inspection
process.
We're
sharing
information
in
real
time
with
those
other
partner
organizations
so
that
they
can
take
action.
It
isn't
just
about
building
up
to
another
report.
This
is
about
real-time
action
to
to
help
both
local
organizations
and
and
National
system
leaders
take
the
right
action.
A
Chris,
just
since
we're
on
the
subject
maternity
before
we
move
on,
Sally
asked
both
my
question,
but
also,
could
you
give
us
an
idea
of
the
timing
of
the
national
report
that
you
talk
about,
and
you
also
referred
in
your
esag
report,
the
to
the
fact
we
discussed
it
with
them.
I
just
wondered
if
there's
any
feedback
from
that
meeting,
that
would
be
worth
sharing.
Thank
you.
C
Yeah,
so
the
esac
support
for
this
was
was
quite
strong.
So
esag
is
a
group
of
people
that
that,
as
represent
both
providers,
people
use
services
and
wider
stakeholders
and
I
think
there
was.
There
was
support
for
this,
because
either
was
a
recognition
that
not
not
enough
was
changing
quickly
and
the
sense
that
this
is
a
collective
responsibility
to
do
something
about
it.
So
I
think
you
know.
The
BBC
report
today
reflects
where
we
are
at
the
moment.
I
think
the
challenge
is,
how
do
we
collectively
move
and
I?
C
C
What
we
intend
to
do
is
we
want
to
try
and
get
through
the
inspection
activity
as
quickly
as
possible,
but
we
also
want
to
make
sure
we
are
hearing
from
people
use
services
and
staff
in
service
as
we
go
so
we'll
probably
have
a
number
of
opportunities
to
update
board
a
first
one
of
those
being
in
the
early
New
Year
I'm
hopeful
by
the
end
of
this
financial
year.
A
Okay,
thank
you.
Steve
sorry,
twice
I
was
going
to
Stephen.
Had
a
question.
Are
you
going
to
add
to
that
answer
or.
G
Nothing
thank
you
and
I
was
just
going
to
add
very
briefly
that,
in
terms
of
the
timetable
for
the
inspection
program,
we're
hoping
to
complete
it
by
Spring
next
year,
which
fits
very
much
in
with
the
timetable
Chris
set
out
and
in
in
answer
to
Sally's
question.
We
see
this
is
very
much
a
contribution
to
the
National
Improvement
effort
and
we
will
obviously
work
with
with
all
Partners
involved,
to
try
and
particularly
draw
out
in
innovation
in
good
practice.
Thank
you.
A
H
Thanks
Ian,
like
Robert
I
kind
of
wanted
to
welcome
the
what
you
say
about
people
first
looks
like
a
really
really
powerful
way
of
using
CQC
sort
of
convening
power,
drawing
people
together,
getting
them
to
talk
about.
What's
working
for
them,
what
Innovations
are
they
making
sort
of
giving
some
some
solutions
to
some
serious
and
system-wide
problems?
H
Do
you
see
that
it's
a
one-off,
or
is
that
a
model
that
we
can
now
sort
of
roll
out
in
other
areas
of
sort
of
challenge
across
the
system,
because
it
it
it?
It
looks
like
a
powerful
thing
to
be
doing
and
and
I'm
just
sort
of
interested
is.
Is
this
now
a
a
model
for
the
future
that
we
could
play
out
into
other
other
parts
of
the
system.
C
A
really
important
question
and
I
absolutely
do
see
this
as
a
model
for
how
we
could
operate
I
think
to
some
extent,
cqc's
neatly
place
to
bring
what
we
know
about
the
services
across
Health
and
Care
together
and
in
this
case
we're
able
not
only
to
bring
what
we
know,
but
the
individuals
responsible
for
delivery
together
and
and
create
a
forum
where
they
can
debate
to
discuss
practical
steps
that
they
can
collectively
take
to
to
to
to
to
achieve
change.
So
I'm
I
do
see
this
very
much
as
a
model.
C
When
we
launch
status
of
care
next
month,
there
will
be
a
series
of
issues
that
come
off
the
back
of
that,
where
we
want
to
use
that
convening
power
again
to
support
conversations
with
icses
conversations
with
different
groups.
So
I
do
see
this
as
a
model
where
we
bring
our
expertise
and
our
understanding
and
and
collectively
with
with
system
partners
and
indeed
Frontline
staff.
We
we
tackle.
We
try
to
tackle
the
issues.
A
Okay,
I,
don't
say
the
others
well.
Thank
you
very
much.
Ian
Chris
Kate,
as
Ian
said
that
was
kind
of
a
very
update
of
very
recent
activities.
So
I
think
we
turn
now
to
the
corporate
performance
report
looking
back
over
a
longer
period
of
time,
Chris
ashrada.
If
you
want
to
introduce
this,
we
would
have
read
the
reports
and
I
need
to
go
through
vast
detail.
But
please
do
pick
up
highlights
for
us.
I
know
we'll
take
questions.
I
Yeah
because
just
don't
know
a
few
comments,
so
just
just
say
this.
I
Obviously,
the
first
quarter's
performance
report
against
our
new
business
plan,
We've
refreshed
the
dashboard
and
looked
at
how
we
record
the
ragstates
in
there
so
grateful
for
any
feedback
from
from
board
members
outside
of
our
board
or
now,
if
we're
just
on
the
on
the
look
and
feel
that
would
be
good
to
good
to
get
some
feedback
on
I'll
just
update
in
a
few
areas,
and
then
Tyson
might
want
to
just
talk
about
performance
right
up
today,
because
obviously
this
is
just
quarter
one
review.
I
So
just
just
pull
out
a
few
areas
slide
two
in
the
deck
just
continues
an
eye
on
on
the
activity
we're
delivering.
So
in
court,
one
nearly
10
of
locations
have
been
inspected
or
had
a
dma
call,
a
nearly
50
of
how
to
regulator
activity
when
including
our
public
statements
in
terms
of
give
give
feedback
on
care
which
is
on
slide,
six
still
receiving
High
volumes.
I
You
can
see
this
reduced
slightly
in
recent
months,
but,
interestingly,
our
positive
feedback
has
been
rising
over
the
the
last
five
months,
which
we're
doing
work
on
just
to
understand
that
in
more
detail,
some
interesting
Trends
coming
out
of
there
in
terms
of
the
following
slide
I,
can
see
one
of
the
ways
in
which
that
can
be
used,
not
the
exclusive
way,
but
one
of
the
ways
it
can
be
used
is
just
around
where
we
are
inspecting,
based
on
things
that
we've
triggered
by
risk
and
the
graph
showing
that
the
most
common
there
is
information
of
concern
which,
which
can
be
a
variety
of
things,
but
also
just
show
us
how
we're
using
the
intelligence
we're
Gathering
to
to
form
an
action
in
in
slide
13.
I
Just
on
the
report's
an
interesting
downward
Trend
there.
In
terms
of
our
time
to
publish
reports,
you
can
see
that's
come
down
by
25
over
the
last
12
months,
so
good,
good
Improvement
in
that
area
and
their
last
bit.
For
me
for
now,
just
in
terms
of
Finance.
So
on
our
Revenue
budget,
we
are,
whilst
we're
under
spent
year
to
date
largely
do
the
profile
of
income,
we're
forecasting
an
overspend
for
the
year
of
6.7
million.
I
I
Well,
overall,
I
think,
it's
fair
to
say:
we'll,
continue
to
monitor
our
financial
position
closely
and
take
remedial
action
issue
we're
in
in
on
budget
by
the
end
of
the
year,
and
that
continues
over
into
Capital,
where
we
are
forecasting
a
5.3
million
overspend
on
Capital
again.
This
also
includes
funding
we've
yet
to
get
final
confirmation
for
we're
written
that
through
shortly,
but
we'll
we'll
manage
our
overall
understand
through
the
portfolio.
I
If
you
want
to
cover
up-to-date
performance
and
that's
it
for
me,
I'll
come
back
to
risk
at
the
end
of
the
performance
conversation.
G
Thank
you,
Chris
and,
very
briefly,
I,
won't
repeat
what
what's
in
the
report.
I
just
wanted
to
thank
my
colleagues
for
what
I
think
is
a
a
strong
performance
in
August.
Despite
the
fact,
we
are
right
in
the
heart
of
our
of
our
people.
Change
now
and
colleagues
have
obviously
been
wanting
to
give
some
time
to
to
deciding
how
to
deal
with
that
I
think
there's
strong
performance
on
registration
and
in
a
number
of
places
we
are
seeing
strong
improvements.
G
The
number
of
inspections
has
increased
on
on
July
and
I'm,
hoping
that
they
will
continue
to
increase
over
September,
and
we
continue
to
show
a
strong
performance
in
terms
of
dealing
with
whistleblowing
and
safeguarding
inquiries.
So
the
only
point
I
really
wanted
to
make
was
to
thank
my
colleagues
for
what
I
thought
was
a
was
a
strong
performance
given
given
what's
going
on
in
the
organization.
A
Thanks
Tyson
questions
for
Chris
Tyson
or
the
team
mark.
J
Thank
you,
chairman
Tyson,
thanks
for
the
update
there
and
really
good
to
see
the
Improvement
in
registration
completion
times.
So
congratulations
on
that
I
mean
I
did
note
that
inspections
had
stayed
constant,
but
dmas
had
slightly
reduced.
I
just
wondered
how
this
mix
is
going
to
be
managed
going
forward.
G
Thank
you.
Thank
you.
Mark
I
think
there
are
three
reasons
why
the
dma
number
e
is
lower
than
it
has
been
over
the
last
few
months
and
the
first
one
is
obviously
we're
we're
in
the
August
was
right
at
the
heart
of
the
annual
leave
fee
and
season,
and
that
will
start
to
change
as
we
move
into
the
Autumn.
G
Secondly,
with
the
change
process
that
I
that
I
was
talking
about,
and
colleagues
in
the
DNA
team
at
grade,
A
and
Grade
B
will
have
been
going
through
very
various
people
change
processes,
and
we
will
have
ensured
that
we've
given
the
time
given
them
the
time
to
do
that
properly,
but
also
the
team
are
now
doing
dnas
on
more
on
more
complex
work.
G
What
we
have
previously
described
as
band
C
providers,
which
is
where
there
may
be
there,
may
be
more
concerns
being
expressed
by
the
data
and
the
experiences
that
that's
taking
longer
to
do
more
thoroughly
than
maybe
some
of
the
dmas
on
on
providers
in
in
band
one
and
two.
So
certainly
the
annual
leave
point
will
will
change
as
we
move
into
September
and
October
October
and
some
of
the
people
change.
J
J
Thanks
Tyson
could
I
ask
Chris
a
question
as
well
chairman:
let's
go
ahead
Chris
just
in
terms
of
your
performance
report
and
in
turn
I
know
it's
linked
to
the
business
plan
measures
in
terms
of
people.
We
seem
to
have
lost
quite
a
bit
of
the
data
that
we've
we've
had
in
previous
performance
reports,
so
we've
lost
turnover
by
disability
and
ethnicity.
J
We've
lost
our
insight
into
our
training
performance.
We've
not
had
a
chart
on
our
reasons
for
leaving,
which
I
think
you
know
is
an
important
piece
of
information
for
us
and
no
data
on
promotions
and
acting
UPS.
So
I
just
wondered
whether
we're
going
to
see
those
again
because
they're
important
sort
of
organizational
Health
measures
and
why
we
wanted
greater
detail
in
the
in
the
past.
I
Sure
so
we'll
bring
them
into
the
an
item
and
export
in
December
which
will
bring
back
a
full
people
plan
and
include
a
host
of
metrics
there
that
such
as
the
ones
you're
talking
to
the
reason.
Unfortunately,
we
didn't
manage
to
get
it
into
this
one
and
just
vote
entirely
on
the
business
plan.
Measures
is
simply
one
around
accessibility,
so
the
data
we
need
to
get
in
accessible
format
to
ensure
it's
on
our
website.
I
A
And
Chris,
just
following
up
on
that
point
as
you
introduced,
this
is
kind
of
based
on
the
business
plan,
but
I
mean
you
are
doing
some
work
at
the
moment
which
partly
came
out
of
the
the
board
of
veterans
review
earlier
in
the
year.
I
think
looking
at
the
information
that
we
would
get
on
a
regular
basis,
so
people
metrics
I'm
assuming
will
form
a
significant
for
an
important
part,
at
least
of
that
ongoing,
regular.
A
I
I
I
could
say
more
though
I
mean
yeah.
We
are
working
on
a
new
performance
framework
in
line
with
a
new
business
plan
for
April
next
year.
So,
looking
at
really,
how
can
we
review
all
of
our
performance
measures?
How
that
links
with
our
strategy
and
how
that
works
through
the
organization
into
everyone's
deliverables
and
I?
I
Think
there's,
there's
probably
something
we
need
to
strengthen
just
in
terms
of
how
we
align
fully
with
the
strategy
and
have
a
golden
thread
of
performance
and
what
we
can
do
to
really
focus
on
the
outcomes
that
we're
delivering
on,
as
well
as
just
what
we
can
measure
and
what
activity
we're
delivering
on,
but
actually
what?
What
difference?
We're
making
from
that.
E
I
think
this
is
one
for
Chris
Davis
about
to
give
feedback
on
camps
live
at
page
20
and
what
is
noted
there,
which
is
a
very
substantial
increase
in
positive
responses,
received
and
I
wonder
you
know,
we
hear
a
lot
about
negative
responses.
Why
can
you
ascribe?
Is
there
a
change
of
methodology,
or
is
it
simply
an
up
up
to
taking
the
cheerfulness
of
the
population?
What
is
it
about
and.
C
I
think
there's
a
number
of
factors
in
play.
Firstly,
the
figures
that
we
see
that
are
only
the
online
give
feedback
on
care,
so
they
don't.
They
don't
reference
the
full
entirety
of
giffy
Puck
on
Castle,
which
comes
orbit
from
the
campaigns
through
to
the
contact
center.
So
the
the
the
normal
average
split
is
about
80
20..
So
if
you
look
at
the
Falls,
the
fallback
you
might
expect,
20
and
80
80
beans
been
being
negative,
20
being
positive,
I
think
there
are
a
number
of
things
that
are
that
play
into
that.
C
Firstly,
we've
been
trying
to
do
some
work
on
piloting
a
channel
shift
in
some
of
the
the
activities,
so
we've
actually
seen
it
with
a
net
reduction,
although
you
don't
see
it
in
the
in
these
figures
in
the
phone
element
of
this,
as
it's
moved
as
it's
moved
to
to
online
we've
also
been
piloting.
I
think
this
is
where
sustainably
this
comes
from
and
approaching
the
dma.
C
Where
we've
been
actively
asking
provide
us
to
give
us
feedback
now
you
might
say:
well,
they
would
wouldn't
they
go
to
people
that
they
know
have
experienced
a
better
level
of
care,
so
I,
don't
think
it
I,
wouldn't
really
I,
don't
think
it's
I,
don't
think
it
should
be
ruled
out,
but
I
think
it's
important
to
understand.
But
actually,
crucially,
it's
important
to
understand.
So
you
just
see
positive
negative,
actually
why
it's
positive
goes
some
way
to
describing
what
some
services
or
what
some
systems
are
doing
differently
and
actually
looking
into
the
reasons
behind.
C
Why
are
as
interested
as
looking
into
the
reasons
behind
why
Services
fail,
so
it
still
has
value
that
I
think
we're
doing
it's
fair
to
say
talking
to
Jill
and
her
team
that
we're
doing
some
both
coaching
with
with
with
college
operations
and
also
with
providers
to
make
sure
that
we're
we're
confident
that
their
their
process,
by
which
We
Gather
that
information
so,
for
example,
using
posters
that
they
can,
they
can
ascribe
to
put
up
and
put
pointy
people
towards
those.
C
So
it's
not
people
collecting
that
feedback
and
giving
it
to
us.
It's
still
individuals
being
prompted
to
share
their
their
feedback,
so
I
think
there's
as
I,
say,
I
think
we'll
see.
Perhaps
more
of
this
I
think
the
totals,
because
the
terms
look
like
they're
dropped
online,
but
actually
they've
risen
on
the
phone.
So
there
is
a
bit
about
looking
at
the
totals
of
this,
which
I
think
we
need
to
try
and
get
back
to
when
when
we
can
but
I'm
Keen
that
we
we
can
look
into
why
the
various
exists.
C
What
what
changes
organizations
are
bringing
about
positively
as
well,
but
it
doesn't
when
you
look
at
it
compared
to
the
to
the
to
the
phone,
the
actual
variance
is
is
quite
quite
small.
It's
much
smaller
because
it's
a
bit
of
a
translation
across
I
think
the
dma
has
a
has
a
part
to
Plano.
Definitely.
E
C
Be
a
spread
I
think
that's
really
important,
because
if
we
we
went
to
see
Newcastle
trust
recently
as
a
as
an
executive
and
indeed
some
of
the
comments
we've
had
been
from
that
that
organization
you
can
see,
you
can
point
to
things
that
individual
organizations
are
doing
that
do
do
lend
themselves
to
to
a
change
in
people's
perception.
So
I
think
you
know
going
back
to
the
points
we've
raised
earlier.
C
F
Thanks
Ian
I
had
three
questions:
if
that's
okay,
so
the
first
one
as
you'd
expect
me
to
ask
about,
is
overspend
on
both
revenue
and
capital.
So
I
appreciate,
you
talked
about
quite
a
significant
chunk
of
that
being
work
that
we're
already
doing
that
we're
awaiting
funding
on
from
the
Department
of
Health.
So
perhaps
it's
something
that
somebody
would
like
to
say
about
that.
F
I
Yeah
come
on,
I
mean
that's,
certainly
the
plan
Sally.
So
yes,
we're
working
on
that
now,
both
revenue
and
capital
to
to
bring
back
in
on
the
funding
side.
So
we
have
later
in
the
report.
You'll
see,
we've
slightly
increased
our
risk
around
funding,
and
it's
primarily
for
that
reason
we
have
we've
had
a
number
of
things
that
we
are
doing
additional
this
year
to
implement
for
future
regulation
and
we've
had
funding
for
most
of
those.
I
Okay,
such
as
local
Authority
Assurance,
been
a
recent
example,
so
it
is
probably
a
low
risk
in
the
in
in
the
grand
scheme
of
things,
but
we
are
still
as
it
as
it
stands.
At
awaiting
funding
for
ICS
integrated
care
system
regulation,
we
also
have
a
covert
inquiry
which,
as
yet
haven't
resolved
how
that
will
be
funded
for
this
year.
So
there's
a
few
risks
there
that
we
have
just
we've
just
increased
slightly
the
risk
around
our
funding.
A
I
mean
it's
probably
worth
saying:
Sally
or
Chris
I'd
just
give
you
well
I
mean
we
also
a
very
great.
We
understand
the
difficulties
the
department
has
for
the
moment
for
a
whole
bunch
of
reasons,
we're
very
grateful
for
the
money
we
have
received
and
I
think
the
discussions
are
going
well
as
a
board.
We
have
a
challenge,
we're
and
we're
trying
to
strike
a
balance
here.
You
know
we
are
supposed
to
live
in
the
financial
disciplines,
but
we
also
have
to
apply
some
common
sense
and
I.
A
Think
it'll
be
completely
wrong
with
us
just
to
stop
doing
things
when
we
have
a
good
reason
to
believe
that
in
due
course,
funding
will
be
available.
So
I
think
it's
quite
clear
the
board's
clear
that
it's
moving
a
little
bit
away
from
some
of
the
financial
disciplines,
but
it's
the
right
thing
to
do.
Conversely,
some
of
these
approvals,
which
are
under
discussion,
are
probably
taking
a
bit
longer
than
we
want.
A
I,
like
you
know,
I
think
if
I
hope,
by
the
time
we
meet
again
in
December
you'll,
be
able
to
report
that
all
of
this
is
a
result
and
the
repo
shows
that,
if
not,
then
then
obviously
you
know
one
of
the
difficult
things
the
board
will
have
to
address
is
whether
or
not
other
areas
in
which
we
have
to
curtail
our
activity
and
due
the
lack
of
funding.
But
hopefully
that
will
be
not
be
a
problem
and
sort
of
that
by
December
Ian.
So
I
don't
know.
B
Yes,
I
just
just
adding
to
that
that
point
I
think
just
I'd
just
like
to
give
everyone
assurance
that
we're
going
through
the
granting
Aid
funding
line
by
line
looking
at
at
exactly
what
we're
doing
in
terms
of
granted
funding
and
the
reason
as
you
described,
was
that
we
recognize
the
difficult
funding
position
that
that
wider
government
is
in.
It
seems
it
seems
the
right
thing
to
do
to
to
look
and
see
if
we
can
do
things
as
efficiently
as
we
can
an
awful
lot
of.
B
What
we
do
do,
though,
is
done
as
an
effectively
as
an
operational
agent
on
behalf
of
the
Department
of
Health
and
Social
care,
and
and
in
doing
that,
an
awful
lot
of
services
are,
in
fact,
volume
driven,
so
second
opinion
appointed
doctor
scheme,
for
example
under
the
mental
health
act.
It's
a
good
example
of
that,
where
we
are,
we
arrange
for
psychiatrists
to
go
and
provide
a
second
opinion
for
people
who
are
detained
under
the
mental
health
act.
B
F
Thank
you.
Thank
you.
Yeah.
That's
really
helpful.
I
had
a
very
specific
point
around
our
disability
statistics,
so
it's
lower
than
the
general
population
by
quite
a
lot
and
I'm
interested
to
know
or
to
find
out
later.
If
you
need
to
investigate
whether
it's
because
we
are
not
recruiting
at
the
same
level,
people
who
have
a
disability
or
whether
we
are
but
staff
aren't
self-declaring,
which
is
a
problem
that
I've
seen
elsewhere
so
I,
just
wonder
whether
we've
got
an
answer
now.
F
D
So,
if
I,
if
I,
can
respond,
but
also
a
Mark
I,
don't
know
whether
a
zigzags
wants
of
the
disability,
equality
Network,
you
might
want
to
come
in
as
well
and
suddenly
we're
pretty
confident
that
we've
got
an
under
the
disclosure
issue
and
we've
been
doing
work
to
encourage
our
staff
to
accurately
capture
their
needs
that
they
have
so
that
we
can
monitor
it
appropriately.
D
K
Yeah,
thank
you.
So
we
have
a
a
comprehensive
Workforce
disability
equality
standards
action
plan.
We've
got
nine
different
work
streams
in
there
working
towards
improving
a
number
of
different
areas
to
make
this
a
great
place
to
work
for
colleagues
with
disabilities.
K
One
of
those
which
we're
launching
very
shortly
is
about
the
about
declaration,
but
part
of
the
challenge
that
we've
had
up
to
now
has
been
around
our
internal
systems
for
recording
disabilities.
We've
made
some
improvements
around
that
we're
also
doing
a
number
of
things
to
to
make
it
easier
for
colleagues
through
technology
and
accessible
ways
of
working,
but
also
about
attracting
talent
for
with
colleagues
with
disabilities
and
we're
making
great
practice
on
those.
F
Thank
you
last
one
was
about
ratings
because
there's
a
a
nice
chart
in
there
on
page
18,
which
talks
about
how
we've
changed
ratings
when
we've
responded
to
risk
and
some
of
those
ratings
have
deteriorated
and
perhaps
I'm
putting
together
a
jigsaw
that
doesn't
exist.
But
if
you,
if
you
put
that
with
some
of
the
messages
that
are
likely
to
appear
in
our
state
of
care
report
or
some
of
the
issues
that
we're
all
familiar
with
around
access
to
services,
the
ratings
are
still
quite
a
high
percentage
of
good
or
outstanding.
F
So
I
understand
there
might
be
a
slight
lag,
but
it
might
also
be
that
these
are
biased
because
we
are
triggered
by
risk
and
therefore
go
into
a
service
and
that
service
has
deteriorated.
So
I.
Don't
think,
there's
an
exact
answer,
but
I'm
just
interested
in
talking
more
in
the
future
and
at
the
next
board
ahead
of
how
the
state
of
care,
when
we
publish
that
report
and
our
ratings
fit
together
to
present
to
the
public
a
real
kind
of
honest
appreciation
of
what
services
are
like
for
them.
F
C
I
think
it's
important
to
I.
Think
you
write
in
in
a
sense
of
we
are
I.
Think
over
about
50
of
our
inspections
are
responding
to
risk
at
the
moment
and
they're,
often
going
into
services
that
are
already
inadequate
or
requires
Improvement
and
I.
Think
it's
important
that
we
can
respond
to
whistleblowers.
It's
important
that
we
can
respond
to
give
feedback
on
care
in
that
way.
C
I
think
what
we're
finding
from
our
work
in
state
of
care
and
a
wider
work
around
systems
is
that
access
to
services
is
a
is,
is
a
crucial
issue
at
the
moment
and
it
doesn't
just
affect
it
affects
all
services.
It's
not
just
about
one
sector,
so
I
would
expect
to
see
over
the
course
of
time
a
greater
reference
to
that,
both
in
our
system
work
and
indeed
in
our
individual
provider,
work.
I.
Think
what
we've
got
at
the
moment
is
an
important
response.
C
We're
making
to
risk,
which
means
that
we
are
deliberately
diverted
to
organizations
that
we
know
already
are,
are
are
inadequate
or
requirement
improvements,
because
that
they
they
pose
such
a
proportionate
risk
to
to
to
people
who
use
services.
So
it's
important
that
we
can
address
those
I
think
over
time,
particularly
with
the
new
approach.
We
will
be
able
to
offer
a
wider
perspective
on
people's
access
and
therefore
the
overall
quality
of
service.
D
So
I'm
just
talking
about
adult
social
care
Sally.
So
if,
as
Chris
says,
we've
predominantly
been
going
out
to
risk,
but
we've
also
recognized
that
when
new
Services
register
with
us
and
haven't
yet
been
rated,
that's
a
priority
area
as
well.
So
we've
been
going
out
to
Services
where
we've
been
worried
and
we've
been
broadly
finding.
D
Those
worries
to
be
there
and
have
been
that's
been
reflected
in
our
ratings,
but
also
a
chunk
of
our
activity
has
been
going
out
to
new
services
and,
as
you
know,
we
register
Services,
where
we're
confident
they
will
hit
the
good
bar
we're
rating
them
for
the
first
time
and
they're
getting
good.
So
that's
why
you've
got
that
kind
of
funny
balance
in
adult
social
care
where
you've
got
a
percentage
deteriorating
and
then
you've
got
a
percentage
getting
that
good
rating
for
the
first
time,
and
and
that's
that
high
level.
That's
broadly
the
rationale.
G
Thank
you.
The
only
thing
I
would
add
to
that
is
that
quite
a
lot
of
our
risk
activity
will
involve
going
to
the
same
provider
a
number
of
times
as
we
monitor
whether
or
not
they've
improved
over
a
period
of
time
and
therefore
the
static
ratings
might
not
give
a
completely
accurate
picture
of
of
how
many
providers
in
what
category
we're
we're.
Actually
we're
actually
inspecting.
So
that's
another
bit
of
the
context.
I
think.
A
Thanks
Tyson
any
other
questions
or
comments
on
this
report,
I
mean
just
to
close
the
loop
a
little
bit
on
a
discussion.
We
had
earlier
Chris
on
performance
reporting
on
Sunday's
question
that
Ian's
response
pointing
out
that,
for
example,
some
of
the
services
we
provide
are
about
volume,
driven,
I,
think
one
of
the
things
we've
discussed
and
usual
just
to
confirm.
Is
that
then,
that
the
reporting,
drawing
distinction
between
our
internal
performance
on
things
where
we
know
we
have
an
outcome
to
achieve
for
patients
and
users
of
care?
A
A
No,
you
know
we
neither
set
the
terms
conditions
in
which
we
do
it
or
the
the
volumes
of
throughput
so
it'll
be
helpful
to
draw
a
distinction
that
in
the
future
reporting
as
to
those
things
we
can
influence
on
those
things
we
can't,
but
I
think
that's
picked
up
in
the
current
project.
A
Okay,
well,
if
there
are
no
further
questions
Chris.
Thank
you
very
much
indeed,
for
that
and
very
helpful
summary.
A
Let's
move
on
to
one
of
the
most
important
issues
we
always
have
on
the
agenda,
which
the
quarterly
transformation
update,
Kate
and
Mark
I
think
you'll
lead
on
this,
but
we
should
also
be
enjoined
by
Amy,
Pritchard,
I.
Think.
D
Okay,
you're
going
to
lead
on
this
I
will
do
yeah.
Thank
you.
So
this
is
the
update
of
the
first
quarter
of
this
year
for
transformation,
I'm
just
going
to
pick
out
a
couple
of
highlights
from
each
of
the
programs
and
then
I'm
going
to
talk
a
little
bit
about
what
next,
if
that's,
okay,
so
firstly
on
the
first
pillar,
our
first
program
around
our
regulatory
framework.
D
As
you
know,
this
is
our
new
single
assessment
framework
based
on
what
matters
to
people
a
kind
of
key
achievement
that
has
been
delivered
in
the
first
quarter
of
this
year
running
a
bit
into
summer,
is
our
four
test
and
learn
Pilots
for
another
another
phrase
of
two
local
authorities
and
two
integrated
Care
Systems,
where
we've
gone
out
with
our
new
methodology,
our
new
single
assessment
framework
to
test
whether
we've
got
the
right
method
for
capturing
evidence
and
forming
a
effective
view
about
how
that
local
Authority
and
how
that
integrated
care
system
is
delivering
for
people.
D
So
that's
landed.
It's
produced
a
huge
amount
of
important
feedback
for
us
that
will
continue
to
shape
our
methodology
as
we
get
ready
for
go
live
into
next
financial
year.
So
that's
just
one
thing
to
celebrate
with
the
first
pillar
with
the
second
pillar,
which
is
around
organizational
design.
D
Progress
continues
to
happen
around
our
people
changes.
So
we
are
continuing
to
support
colleagues
to
move
into
deputy
director
roles
within
regulatory
leadership,
deputy
director
roles
within
the
operations
group,
and
to
follow
through
the
implications
for
people
at
manager
level
and
for
our
inspectors
Etc.
So
those
people
changes
are
continuing.
Our
preference
exercise
closed
yesterday
for
our
inspectors,
and
that
is
making
that's
making
progress
as
expected
and
then
on
the
final
pillar.
D
We've
gone
live
with
our
new
data
and
insight
unit,
which
is
really
important
that
we
kind
of
pause
and
celebrate
as
well,
because
this
is
a
key
key
foundation
for
enabling
us
to
be
that
Insight,
driven
organization
where
data
is
is
helping
us
shape
our
regulatory
efforts.
So
that's
gone
now
and
then
we
also
went
live
in
the
beginning
of
August
with
our
first.
D
We
call
it
early
adopter,
which
is
where
we
have
tested
out
our
new
technology,
to
enable
hospices
to
provide
death
notifications
for
us
as
a
regulator,
but
also
for
a
small
number
of
Home
Care
Providers
to
register
with
us
on
the
portal.
So
the
reason
why
I
say
that
is,
there
has
been
a
lot
of
good
stuff.
D
That's
been
delivered
in
the
first
quarter
of
this
year,
but
as
we
move
between
phases,
it's
a
really
good
opportunity
as
well
to
check
in
on
whether
our
plan
is
still
the
right
plan
as
we
move
ahead
and
the
reason
why
I
mentioned
that
is
for
a
couple
of
reasons,
going
live
with
new
technology
incredibly
complex,
and
we
need
to
make
sure
that
our
plan
for
How
We
Roll
that
technology
app
makes
sense.
D
D
So
we
need
to
reflect
on
all
of
that
when
we
think
about
what
should
the
rollout
look
like
for
the
next
six
to
12
months
and
I
would
ask
board
for
your
support
in
enabling
Amy
and
I
and
Mark
and
other
colleagues
Tyson
and
our
teams
to
think
about.
Have
we
still
got
the
right
timings
around
that
roll-up
plan,
noting
the
kind
of
complexity
of
the
technology
are
people
changes
internally,
but
also
what's
happening
out
there
for
Health
and
Social
care
providers
as
well?
Thank
you.
Thank
you.
K
That
was
very
comprehensive,
so
I
think
I
I
could
just
highlight
again
the
the
importance
of
the
launch
of
our
data
Insight
unit
with
the
data
and
insight
unit
being
established.
We've
now
got
our
new
Enterprise
data
platform
that
supports
that
as
well,
which
is
really
the
start
of
us
becoming
an
Insight
driven
organization.
The
delivery
of
that
Insight
that
allows
us
to
really
focus
out
regulatory
efforts
really
pleased
with
what
the
team
we've
been
able
to
achieve
there.
A
Sorry,
if
no
one
else
is,
we've
talked
quite
a
bit
about
the
the
technology.
A
I'd
just
be
interested.
If
there
was
any
more
to
say
around
the
the
the
cultural
point
that
was
referred
to
on
page
38
I
mean
you
explain
how
the
cultural
principles
are
working
to
work
in
progress,
but
clearly
this
is
quite
a
major
challenge
for
any
group
of
people
never
mind
during
the
CQC,
but
I
just
wondered
if
you
could
say
a
little
bit
more
on
how
where
we
are
compared
to
the
expectations
we
would
have
had
say
a
year
or
so
ago,
when
the
strategy
was
approved.
D
Yeah
we,
we
are
asking
a
huge
amount
of
our
leaders
in
this
organization
to
drive
our
vision
that
we
we
establish
in
our
in
our
strategy
here,
which
we
launched
last
last
May.
So
so
there's
a
huge
amount
for
our
leaders
to
digest,
but
then
they
are
often
going
through
changes
themselves,
while
supporting
Frontline
colleagues
in
in
the
delivery
of
the
day,
job
and
Tyson's
early
reflection
about
performance
still
being
where
we
would
hope
is
Testament
to
our
inspectors,
as
well
as
our
managers
Etc.
D
So
there
is,
there
is
Big
adjustments
that
we
we
need,
our
colleagues
to
continue
going
to
go
on
the
journey
with
us
on
not
only
in
terms
of
new
ways
of
working
within
the
operations
group,
but
in
how
we
use
data
and
insight
and
how
we
grow
in
confidence
and
how
we
use
that
that
intelligence
to
help
inform
our
our
regulatory
work.
I
think
our
cultural
work
is
is
just
getting
started.
D
I
think
we've
got
more
to
do
and
more
more
to
talk
to
board
about
for
now,
but
I
just
want
to
recognize,
as
we
sit
here
today,
they're
kind
of
huge
efforts
of
our
leaders
in
the
organization
that
are,
you
know,
carrying
on
delivering
business
as
usual,
while
adjusting
to
quite
you
know,
different
ways
of
working
that
we
are
asking
them
in
order
to
ensure
that
we
are
an
effective
regulator
that
we
want
to
be.
A
G
Thank
you
and
I
agree
with
all
that.
Kate
has
said:
I
think
we
will
support
our
managers
and
our
leaders
in
terms
of
training
and
development
needed
to
to
help
them
in
this
space
and
I.
G
Think
when,
when,
when
our
people
come
together
in
their
integrated
teams,
probably
in
the
Autumn
I,
think
that
will
be
quite
a
key
moment
and
I
think
one
of
the
new
ways
of
working
will
be
about
decisions
being
taken
at
the
right
level
and
I
think
that
will
be
when
we
will
start
to
see
some
of
the
some
of
the
cultural
change
that
we're
looking
for
so
I
see.
That
is
quite
quite
an
important
milestone.
A
G
I
I
think
over
the
time
frames
we've
got
planned,
which
is
to
bring
the
teams
together
and
then
to
to
train
them
for
the
rollout
of
the
regulatory
platform
and
the
single
assessment
framework.
Yes,
the
the
conversations
I've
been
having
with
our
academies
and
we've
got
the
resources
in
place
and
clearly
we
will
need
to
give
our
people
the
time
they
need
to
to
do
the
training
properly.
That's
an
area.
We
really
can't
scrimp
and
scrape
on.
C
Of
course,
just
to
run
to
a
point
that
Kate
mentioned
about
about
leaders-
that's
absolutely
right.
There
was
we're
asking
leads
in
the
organizations
to
do
an
awful
lot
in
terms
of
continuing
business
as
usual,
as
we
as
we
think
about
the
future.
Can
I
also
call
out
a
group
of
people
who've
been
acting
as
champions
for
some
of
the
the
changes
that
we
want
to
to
take
forward,
particularly
around
our
use
of
data
and
information
to
guide
our
judgments.
C
Thinking
about
how
that
would
play
out
in
the
multicipate
team
thinking
about
what
the
shape
of
that
would
be
for
how
we
make
decisions
more
collectively.
There's
a
group
of
people
leaders,
but
also
people
from
across
the
organization
who
have
been
engaged
in
that
effort
and
I-
think
there's
a
there's,
a
really
important
story
to
tell
about
people's
desire
to
be
able
to
have
real-time
information,
more
real-time
information,
making,
good
decisions
working
together
and
I.
Think
there's
a
it's
important
to
to
articulate.
C
This
is
not
we're
not
pushing
against
a
sort
of
a
a
culture
that
doesn't
want.
This
I
think
it's
just
making
sure
that
it's
secure
and
I
think
if
we
can
offer
the
security
around
how
we're
going
to
use
the
data
and
information
alongside
our
other
activities.
If
we
can
once
once,
we
can
see
how
people
will
work
together
to
form
a
view
of
an
area,
I
think
there'll
be
strong
support
for
both
the
the
the
technology
and
the
new
ways
of
working,
because
they
people
will
know
it's.
C
What
will
guide
them
to
make
better
views,
not
just
of
providers
but
of
systems
and
services
as
well
in
English
strategy.
One
of
the
biggest
bits
of
feedback
we
had
internally
was
people's
knew
that
we
needed
to
have
a
view
of
both
areas
and
sectors
and
I
think
this.
This
enables
that
and
there's
some
important
challenges
to
go
through
both
in
terms
of
how
we
organize
ourselves
and
how
we
deliver
the
technology
to
support
it.
A
Maybe
going
a
little
bit
beyond
the
scope
of
of
this,
but
we're
talking
about
transformation.
I
mean
you
lead
a
lot
of
the
external
engagement
of
communications
I,
wonder
if
any
feedback
you'd
like
to
give
the
board
on
the
what
the
views
you're
picking
up
in
the
wider
Market,
particularly
those
who
are
going
to
be
subject
to
our
regulation,
so.
C
One
of
the
really
interesting
things
about
this
from
an
external
perspective
is
that
one
of
the
few
things
that
poorly
binds
all
the
people
that
we
regulate
together
is
that
desire
to
move
from
just
the
activity
of
of
inspection.
Being
the
only
thing
that
we
do
to
provide
in
a
service
which
allows
a
provider
to
see
where
they
are
relative
to
other
organizations
that
are
like
them.
C
C
Marx
had
the
I
hope
pleasure
of
talking
to
the
executive
leaders
group
that
we
have
from
across
the
sectors
that
we
regulate
talking
a
bit
about
what
that
might
look
like
in
terms
of
a
new
service
for
all
providers,
and
we've
had
very
strong
support
for
this
idea
of
of
having
a
more
a
greater
understanding
of
how
systems
and
services
are
working
together.
B
Mean
if
I
could
just
build
on
on
that
point,
any
of
the
conversations
that
that
I've
had
around
around
this
are
are
recognizing
that
about
about
half
of
the
people
that
we
regulate
are
from
the
private
sector,
be
that
Care
Homes,
be
that
private
private
healthcare
and
and
they
they
feel
that
the
ratings
and
demonstrating
improvements
are
are
a
really
vital
part
of
of
their
business
and
the
way
that
the
way
they
operate
as
to
many
NHS
institutions
as
well,
and
so
what
a
lot
of
people
want
is
for
us
to
be
able
to
to
move
ratings
forward
and
be
able
to
come
back
relatively
quickly.
B
Do
a
relatively
modest
amount
of
work
in
order
to
reflect
the
very
latest
position
that
they
feel
their
organization
is
in
and
I
think
what
the
traffic?
What
transformation
does
what
the
work
we're
doing
does
is
it
puts
us
in
a
position
where
we
have
the
the
people,
the
technology
and
the
methodology
in
order
to
move
those
ratings
on
and
reflect
that
that
positive
picture,
because,
although
you
know
there's
a
there's,
often
we
talk
about
things
going
wrong
in
health,
the
social
care.
A
Thanks
yeah
I
think
the
the
point
about
the
fact
that
half
of
the
people
regulate
a
private
sector
is
a
really
important
point,
and
certainly
in
my
engagement
with
stakeholders
as
I've
been
meeting
people,
it's
often
overlooked
right
across
the
piece,
any
other
questions
Amy.
This
is
really
unfair
of
me,
but
I'm
going
to
do
it
anyway.
We
asked
you
to
come
along.
We
haven't
even
asked
you
any
questions,
so
any
final
thoughts
on
the
questions
you
thought
we
were
going
to
ask
you
that
you
would
have
asked.
A
L
Don't
I
don't
have
any
anything
to
add,
really
I've
not
been
to
a
public
board
before
so
I
think
you've
done
a
grand
job
of
interrogating
me
everybody's.
D
Answer
the
questions,
so
thank
you.
Nothing
to
add.
A
Slaves
are
lucky
in
my
victory
here:
I
hadn't
realized
you
walk
in.
Did
it
very
quietly
welcome
right,
we're
here
to
have
an
update
from
you
on
healthwatch
England
I'm
sure
that
Robert
will
chip
in
as
we
get
along
Robert
I,
don't
know
whether
you
want
to
introduce
this
more
seriously.
E
Not
particularly,
it
says,
will
be
the
last
time.
I
do
this
so
I,
just
in
advance
like
to
record
my
thanks
to
Louise
for
the
amazing
ways
he's
taken
over
from
Melton
Northern
filled
the
boots
that
were
there
and
I
think
this
report
will
show
you
how
much
is
being
done
and
the
value
that
healthwatch
England
brings
to
the
public
and
indeed
to
the
CQC,
but
I
don't
want
to
steal
her
glory.
B
M
Thank
you
chair,
and
thank
you
very
much
for
that.
Robert
I
hadn't
prepared
anything
to
start
the
longer
bite
of
which
we're
absolutely
heartbreaking.
At
healthwatch,
England
that
you're
leaving
but
I'm
sure
a
new
chair
will
be
will
be
found.
He'll
do
the
job
he'll
do
the
job
very
well,
so
yeah,
it's
great
to
be
here.
To
present
this
report.
M
Obviously
I'll.
Take
it
as
read.
As
always.
It's
been
a
very
busy
summer,
as
summer
often
is,
even
though
you
hope
it's
going
to
be
a
bit
quieter,
and
this
report
outlines
the
influence
that
that
healthwatch
England
and
the
health
watch
Network
have
brought
to
bear
based
on
what
people
have
told
us
are
on
some
big
issues
that
we've
been
working
on
for
several
years
now:
access
to
NHS,
Dentistry,
elective
weights
and
accessible
information
amongst
other
areas.
M
The
report
also
shows
how
our
profile
has
has
gone
up,
which
we're
very
happy
about
which
in
turn
supports
our
influencing
and
our
brand,
because
we
want
healthwatch
as
a
movement
to
be
exceptionally
well
known.
So
more
and
more
people
come
to
us
with
their
experience
of
Health
and
Care.
M
The
report
also
shows
how
we've
supported
the
local
healthwatch
network,
with
their
capability
and
capacity,
particularly
in
relation
to
working
across
integrated
care
system
footprints
and
something
that
isn't
in
the
report.
But
we're
looking
at
a
couple
of
further
areas
for
Action
this
autumn
and
winter,
and
one
is
looking
at
the
impact
of
cost
of
living
on
health
and
we're
looking
at
a
kind
of
rolling
piece
of
research.
M
So
we
gain
some
input
on
whether
and
how
the
cost
of
living
is
impacting
on
people's
health
and
also
can
healthwatch
England
and
the
healthwatch
network
do
more
given
the
the
likely
unprecedented
winter
pressures,
particularly
in
the
NHS
and
social
care,
including
as
always,
painting
a
very
balanced
picture
and
a
very
solution
focused
picture
in
terms
of
of
the
the
pressures
on
NHS
and
taking
into
account
pressures
on
NHS
staff
as
well,
because
that,
in
turn
again
influences
the
care
that
people
will
receive
and
also
information
and
advice
on
how
to
best
access,
NHS
Services
over
what
will
be
and
exceptionally
busy
period.
A
Sorry,
thank
you.
Louise
questions
for
either
Louise
or
Robert
Melinda.
M
Yes,
thank
you.
We
did
very
much
support
any
new
initiatives
that
that
aim
to
reduce
the
very
long
backlog.
You
know
with
the
record
number
of
people
who
who
are
waiting
for
planned
care,
so
Diagnostic
and
and
surgical
hubs.
We
absolutely
welcome
the
only
caveat
to
that
is
that
if
people
have
to
travel
a
long
way
to
their
nearest
surgical
Hub,
then
we
think
support
should
be
given
to
them,
otherwise
that
risks
creating
inequalities
for
people
who
find
it
difficult
to
travel
for
lots
of
reasons
because
of
pressure,
work
or
cost.
E
F
Thank
you
and
thanks
Louise
I
just
wanted
to
delve
a
little
bit
more
into
mental
health.
I
thought
Belinda
might
ask,
but
I
I'm
going
to
ask
anyway.
So
there's
a
little
paragraph
in
there,
which
is
slightly
buried
but
is
has
a
huge
impact
and
it
says
we've
highlighted
how
the
pandemic
has
exacerbated
issues
in
mental
health,
to
such
an
extent
that
all
the
extra
money
and
services
developed
in
recent
years
is
seemingly
making
little
impact
in
overall
experiences
of
the
care
that
patients
have.
F
M
Yeah
thanks
Holly,
so
I
think
I'm.
Sure
people
around
the
table
will
understand
that
covered
had
a
huge
impact
on
Mental
Health
in
terms
of
diagnosis
across
the
life
course
so
for
young
people.
You
know-
and
these
are
these
are.
This-
is
some
of
the
feedback
we
get
from
people.
M
So
if
young
people
in
areas
like
eating
disorders,
for
example,
and
then
all
the
way
through
in
terms
of,
for
example,
dementia
diagnosis-
and
we
know
that
both
covid
seem
to
make
things
very
difficult
for
people,
but
also
then
diagnosis
became
slower
and
then
access
to
treatment
became
slower.
So
despite
mental
health
investment
standard,
obviously,
which
has
been
an
excellent,
you
know
initiative
in
terms
of
parity.
M
We've
seen
demand
go
up
as
with
so
many
other
areas
in
in
Health
and
Care,
and
the
system
really
kind
of
unable
to
cope
with
the
demand,
partly
because
of
other
issues
on
Workforce
and
so
on.
So
we're
starting
to
get
that
not
in
huge
numbers
but
we're
starting
to
get
the
impact
of
that
and
trickle
through
into
our
feedback
and,
unfortunately,
that's
the
case
in
terms
of
a
range
of
areas,
including
cancer.
M
For
example,
where,
where,
before
the
pandemic
people,
you
know,
satisfaction
with
cancer
services
from
diagnosis
through
to
treatment
was,
was
high
and
we've
seen
that
dip
as
well.
So
what
we've
been
doing
is
an
analysis
of
a
range
varies,
including
mental
health,
maternity
and
cancer,
specifically
for
the
long-term
plan
to
show
what's
changed
and
what
we
do
tend
to
find
is
when,
if
people
are
actually
treated
then
their
satisfaction,
you
know
goes
back
up
again
and
they're
they're
being
taken
seriously
and
their
condition
has
been
treated.
M
But
issues
of
access
and
issues
of
diagnosis
has
still
been
reported
to
us
as
being
problematic.
So
so
we
have
fed
that
in
I
know.
Certainly
the
NHS
England
Senior
Team
really
have
listened
to
that
we've
been
in
in
very
constructive
dialogue
about
how
to
support
people
in
that
in
that
pathway.
F
Thank
you
and
I
guess
in
reducing
the
backlog,
which
is
a
priority
for
the
new
secretary
of
state.
It's
easier,
sometimes
to
fix
a
physical
backlog
than
it
is
to
fix
their
mental
health
backlog,
because
mental
health
can
be
so
severe
and
enduring
can't
it.
So
it
makes
planning
for
the
future
that
much
more
difficult,
Mental
Health.
M
M
You
know
it's
about
the
backlog
and
it's
about
dogs
and
dentists.
So
you
know
we
were
happy
to
be
able
to
write
to
the
Secretary
of
State
to
say
that
absolutely
reflects
what
people
are
worried
about
and
that
absolutely
does
include
mental
health
as
well
as
physical
health.
A
J
Louise
great
report,
thanks
very
very
much
I
mean
it's
just
super
the
way
you
as
an
organization
continue
to
focus
on
the
service
user
critical
areas,
so
Dentistry
mental
health
long
covered
winter
planning,
elective
weights,
I
mean
you
know
it's
just
great-
to
see
that
continuous
Focus
reading
the
report,
what
came
through
was
the
the
new
quality
framework
and
some
really
great
digital
and
and
brand
Innovations,
and
your
inclusion
work
and
I
just
wonder
you
know:
I
mean
these
are
really
informative.
J
M
Thank
you
Mark.
Thank
you
for
those
those
words
of
support
as
well
and
I,
know
Health
watch
England.
M
We
really
appreciate
the
support
of
the
whole,
the
whole
board
and
and
executive
colleagues
at
tqc,
so
the
so
the
areas
like
the
quality
framework
and
our
digital
transformation
program
we're
set
in
train
quite
a
long
time
before
I
joined,
which
is
in
February
and
Robert
in
the
committee
and
my
colleagues
and
the
executive,
we're
very
clear
that
one
of
one
of
our
roles
is
to
support
the
152
local
Health
watch
in
their
in
their
capability
and
their
and
their
capacity
to
do
their
job,
because,
because
we're
we're
on
the
shoulders,
you
know
all
of
750
000
pieces
of
feedback
a
year
that
we
get
vast
majority
of
that
comes
in
through
local
healthwatch,
so
from
a
digital
transformation.
M
Point
absolutely
crucial
that
we're
able
to
collect
that
data
in
a
in
a
safe
and
anonymized
way,
and
and
use
it
properly
to
to
to
influence
policy
areas
and
the
quality
framework
as
well,
which
also
includes
supporting
local
healthwatch,
to
improve
their
quality
diversity
and
inclusion.
Practice
again.
M
Very
delighted
to
have
inherited
that
as
a
quality
assurance
piece
of
work
and
there
are
a
range
of
domains
in
the
quality
framework
which
include
leadership,
collaboration,
best
engagement
methods,
sustainability
and
influence
impact
EDI,
as
as
we've
spoken
about,
so
we
are
on
a
journey
to
try
and
ensure
that
all
local
Health
watch
undergo
the
quality
framework.
M
So
these
are
the
kinds
of
measures
that
make
the
network
stronger.
They,
you
know
more
are
more
capable
are
they
do
an
absolutely
excellent
job
in
their
local
areas
and
most
of
them,
of
course,
also
collaborate
with
the
regional
CQC
teams
and
some
have
a
really
close
working
relationship
with
them.
But
it
is
a
question
that
I'll
take
back
to
the
team,
because
I
certainly
think
more
can
be
done
on
a
local
and
Regional
level.
We
have
very
good
relations
nationally
here
with
the
with
the
CQC
team,
but
on
a
local
level.
M
J
E
We'll
get
up,
I
was
just
out
of
the
quality
framework
pointed
one
of
the
areas
in
which
it
assists
is
actually
in
the
relationship
between
local
Health
Works
and
their
commissioning
local
Authority,
because
it
produces
a
much
better
understanding
of
what
the
Commissioners
should
be.
Looking
for
and
and
may
I
say
paying
for
in
relation
to
their
local
network.
A
The
other
questions
Louise
aren't
a
couple
I
think
not
for
the
first
time
in
my
time,
at
the
board,
Sally
got
there.
First
I
would
I
think
you've
answered
the
demand
on
Mental
Health,
not
at
all.
It
saves
me
asking
so
I'm
not
going
to
repeat
the
question.
I'll
say
it
again:
I've
built
an
observation,
perhaps
I
mean
clearly
it's
disappointing
from
everyone's
point
of
view,
not
least
the
government
or
the
fundingness
that
the
additional
mental
health
funding
isn't
been
producing.
A
The
results
would
have
liked,
but
I
think
anything
that
we
can
do
to
help
inform
I
mean
you've,
said
we're
informing
the
long-term
plan,
but
any
further
insights
we
can
give
as
to
why
that
is
the
case.
I
mean
I
I
by
from
talking
to
some
of
the
the
non-profit
providers
or
charities
in
the
sectors.
I
have
done
recently
of
the
way
they
present.
A
This
is
not
just
mental
health
but
including
mental
health
that
you
get
into
a
sort
of
spiral
and
if
things
aren't
quite
right
in
one
area,
it
then
creates
a
problem
in
another
area
and
sometimes
there's
quite
a
fine
line
between
it.
Just
getting
worse
or
getting
better,
you
know
ones
on
the
cusp
of
something
and
unfortunately
these
with
a
lot
of
extra
money
and
thinking
you
get
over
the
line
and
then
it
it
doesn't
quite
happen.
A
But
at
the
margin
some
small
changes
can
make
quite
a
difference
as
to
whether
you
get
on
top
of
it
or
whether
it
just
you
know
or
whatever,
but
you
you
do
it
that
continual
spiral.
So
that's
a
message:
I've
been
picking
up
elsewhere.
If
you
have
any
observations,
fine,
but
otherwise,
I
would
just
note
that
I've
had
nothing
any
further
insights
being
give
a
degree
while
I'm
on
the
phone
completely
different
point.
A
You
did
mention
in
here
talk
about
the
new
website
and
the
volumes
coming
in,
and
you
made
the
point
I
believe
if
I
can
find
it
that
obviously
things
were
affected
by
covid
and
and
you
had
requests
there,
but
you
did
say
that
traffic
is
145
higher
than
before
the
pandemic,
and
I
just
wondered.
If
there
was
anything
about
what
people
are
asking
about
or
inquiring
about.
It
would
be
helpful
to
know
so.
Two
very
unrelated
points.
M
Thanks
so
really
important
points
on
mental
health,
and
actually
you
know
in
some
areas.
Obviously,
the
the
mental
health
investment
standard
and
the
amount
of
funds
are
going
into.
Mental
health
have
made
a
difference,
but
the
the
rise
in
demand,
because
mainly
because
and
including
people,
for
example,
who
are
on
waiting
lists
for
a
very
long
time
or
whose
long-term
conditions
have
deteriorated.
M
Who
may
also
need
mental
health
support
have
increased
that
demand,
so
certainly
one
of
our
asks
is
of
of
local
systems
is
when
people
are
waiting
for
up
to
two
years
or
long
periods
of
time
that
their
mental
health
is
supported
in
someone
they're
they're
referred
onto
that
so
yeah
I.
Take
the
take
your
own
sellers
point
that
it's
something
we
should
really
keep
an
eye
on
and
on
the
on
the
website.
M
Yes,
it's
it's
great
that,
even
though
there's
been
a
dip
that
that
we
still
have
a
large
number
of
website
visitors
and
that's
one
of
the
one
of
the
good
things
about
our
being
a
provider
of
information
and
advice-
is
that
you
know
people
didn't
stop.
Looking
at
our
website
for
information
and
advice.
Just
you
know,
even
though
they
came
because
okay,
because
in
lots
of
them
are
stayed
so
that's
great,
and
you
know
we
are
a
significant
multiplier
of
NHS
advice.
M
You
know
we
just
put
something
out
on
monkey
pox,
for
example,
so
we
you
know
we're
trying
to
make
sure
that
if
people
come
to
us
for
to
give
feedback
that
it's
also
a
place
where
they
can
find
advice
about
about
Health
and
Care,
so
we
do
a
significant
amount
of
digital
marketing
as
well.
You
know
all
the
social
media
that
kind
of
stuff
which
which
the
team
are
really
experts
at
and
that
keeps
the
numbers
up.
M
I
would
say
that
I've
personally
had
more
of
a
personal
focus
on
getting
into
the
media
in
order
to
to
make
the
kind
of
kind
of
bigger
changes
that
we
want
to
see.
But
yeah,
that's
our
that's
how
that's
our
front
door,
so
that's
the
website's
our
front
door.
So
it's
incredibly
important.
A
I'm
sorry,
but
I
should
probably
have
said
since
it's
been
raised
just
a
word
on
the
chair
arrangements.
So
everyone's
aware,
the
Department
of
Health
and
Social
care
has
been
running
up
a
recruitment
campaign
for
a
replacement
for
Robert,
who
would
also
then,
as
Robert,
has
become
a
an
only
D
on
this
board
and
indeed
also
looking
for
a
couple
of
other
LEDs
to
to
take
account
of
rotation.
That's
going
on
the
that
closed
about
a
couple
of
weeks
ago.
A
Obviously
it's
still
30
days
in
the
process,
but
I
think
the
Vindication
is
we
have
a
good
interest
in
the
role
So.
The
plan
is
that
there
will
be
the
I
want
to
go
to
Google
steps
of
the
process,
but
the
plan
is
that
there
would
be
interviews
in
November
and
from
that,
if
there's
a
good
short
list
that
will
then
go
to
ministers
now,
after
that
it
depends
on
Minister
availability,
so
I
think
would
be
pretty
clear:
we're
not
going
to
have
a
success
of
a
Robert
in
place.
A
A
I
think
it
brings
us
on
to
a
couple
of
items
for
formal
approval
and
then
the
complaints
report
at
the
end,
the
we
circulated
and
you
have
the
minutes
of
the
previous
public
board
meeting
any
comments
or
those
or
can
I
take
them
as
agreed
agreed.
Okay,
thank
you
very
much.
A
There
were
sorry,
no
I
think
significant
matters
or
Rising
approval
can't
actually
find
the
page
of
my
papers
here,
but
I
don't
believe
there
were.
So
unless
there's
any
questions,
I'll
move
on
to
the
approval
amount
was
rising
from
the
board
effect
of
this
review.
I'll.
Take
this
the
to
remind
you
and
I'm,
also
partly
for
reference
for
people
listening
in
the
audience
was
aboard
effect
on
this
review
carried
out
probably
about
10
months
ago.
A
Now
we
considered
that
internally
shortly
after
I
my
arrival
and
we've
made
some
changes
internally,
most
of
which
I
don't
think,
are
of
relevance
to
people
listening
in
or
to
The
Wider
board
here.
But
there
are
one
or
two
things
that
do
require
board
approval
and
change.
So
the
three
of
them
which
are
here
so
I'll,
introduce
them
all
very
briefly
and
then
take
them.
One
by
one.
People
have
any
questions
and
for
approval.
A
One
of
them
was
that
we
had
a
desire
to
have
a
a
greater
focus
on
the
actually.
Let
me
started
daughter
the
regular
governance
committee,
I
I,
it
hadn't
met
for
a
little
while
and
obviously
a
huge
amount
of
change
going
on
inside
the
organization
anyway
about
our
regulatory
model.
So
we
decided
to
spend
quite
a
bit
of
time
looking
at
what
would
be
impropriate
terms
of
reference.
A
But
it's
a
combination
of
continual
Assurance,
of
what
we're
doing,
but
also
I,
think
looking
externally
at
evidence
or
looking
at
evidence
that
may
be
available
into
any
externally
about
the
model
and
also
looking
to
the
Future
so
that
we
can
anticipate
regulatory
changes.
So
there's
three
main
items
in
the
rgc
in
terms
of
reference
there
we
came
and
to
you
the
we
have
recruited
the
new
board
secretary,
who
will
join
us
at
the
beginning
of
November.
A
There
are
a
number
of
tasks
we
would
like
her
to
do
in
order
to
tidy
some
things
up,
and
one
of
them
is
to
review
the
terms
of
reference
of
all
of
the
committers,
how
to
make
sure
that
they're
conformed
there
are
one
or
two
differences
between
them.
A
So
we
will
come
back
to
you
later
on
with
anything
arising
out
of
those
that
process.
So
it's
possible
that
these
won't
be
the
very
final
version,
but
we
believe
that
these
substantively
will
be
what
the
final
things
look
like.
So
what
we're
asking
for
is
approval
for
these.
On
our
substantive
interim
basis
on
the
understanding,
there
may
be
some
minor
consequential
conforming
changes
later.
A
The
second
is
who
we
have
at
the
moment
when
audit
and
corporate
governance
committee
for
a
number
of
reasons,
probably
two
key
ones-
are
discussions
coming
out
of
the
effect
on
this
review,
but
also
the
oil
committee's
own
considerations
of
its
role,
including
from
the
findings
of
an
internal
audit
review.
We
are
making
some
looking
at
the
way
we
handle
risk
and
some
changes
proposed
to
the
the
risk
framework
within
the
organization.
A
Some
of
that
may
come
back
to
the
board
in
due
course,
but
just
as
a
matter
of
principle,
we
felt
that
it
would
be
useful
to
recognize
that
now,
in
the
change
of
name
of
this
committee,
The
Proposal
in
front
of
you
is
this
should
be
an
audit
and
risk
committee.
I
have
a
minor
change
on
that
reflecting
further
on
some
other
guidance,
including
as
it
happens,
the
cabinet
office
proposals.
A
We
thought
that
to
call
it
the
ordered
and
risk
Assurance
committee,
because
it
is
there
to
provide
Assurance
on
risk,
rather
manage
risk,
which
is
an
executive
role.
So
the
recommendation
in
front
of
you
is
to
create
to
rename
the
audit
and
corporate
governance
committee
as
the
audit
and
risk
assurance
committee
and
the
same
point
on
on
terms
of
reference.
There's
no
terms
of
reference
point
of
view
today,
but
if
we
have
changes
so
we'll
come
back
to
you
and
then
last,
but
by
no
means
least
is
we.
A
We
suggest
it
would
be
useful
to
reaffirm
committee
membership
and
reflection
to
audit
and
risk
assurance,
and
also
we
felt
that
we
needed
to
bolster
the
regulatory
governments
committee,
which
are
a
whole
bunch
of
reasons
only
held
a
couple
of
members,
so
we
are
proposing
that
Belinda
and
Stephen
Marston
should
join
that
Committee
in
both
of
accepted
their
willingness
to
do
so.
So
that
was
my
introduction
to
the
topics.
Perhaps,
if
I
just
tape
them
in
order
the
regulatory
governance
committee
any
comments
on
those
terms
of
reference,
or
can
we
approve
them
fruit?
A
Okay,
thank
you
very
much,
probably
the
least
controversial,
less
controversial,
the
change
of
name
to
the
audit
and
risk
Assurance
committee.
Everybody
comfortable
with
that
and
I'll
say
it's
only
a
change
of
name,
but
it
does
reflect
I
think
a
shift,
an
emphasis
of
the
what
the
committee
will
be
doing
going
forward
and
then
last,
but
no
means
least
approval
for
the
members
of
those
two
important
committees
working
on
behalf
of
the
wider
board.
Everybody
counseling
up:
okay!
Well,
thank
you
very
much.
Everybody!
A
No
Rebecca
I
think
the
the
last
item
on
the
agendas
is
you
and
Peter
welcome
to
talk
about
the
annual
complaints
report.
L
L
So
this
isn't
our
first
complaints
report,
but
it's
the
first
one
we've
done
in
public.
So
previously,
we've
we've
done
an
internal
report,
but
it
seems
important
to
put
into
public
as
much
as
we
can
so
I
hope.
This
is
a
welcome
initiative.
L
The
report
pulls
out
both
the
facts
and
figures
about
our
individual
complaint
resolution
and
also
I
hope.
It
gives
the
board
a
flavor
of
the
broader
work
that
the
team
does
with
the
organization
in
terms
of
learning
and
Improvement
and
highlights
the
kind
of
quite
extensive
project
in
collaboration.
Work
that's
gone
on
over
the
year,
so
I'm
not
going
to
repeat.
L
What's
in
the
report,
say
perhaps
just
to
say,
if
it's
helpful,
you
can
see
that
the
numbers
dropped
during
the
pandemic
so
kind
of
similar
to
last
year
and
that
the
majority
of
complaints
continue
to
be
about
the
conduct
of
inspections
and
complaints
about
our
administrative
processes.
So
probably
this
this
year
isn't
radically
different
from
last
year.
In
terms
of
Trends,
but
you've
got
a
hopefully
welcome
detail
there
about
in
your
improvement,
work
and
and
a
little
bit
of
the
thematics
that
meet
has
drawn
out
for
you.
A
Thank
you.
Thank
you.
Rebecca
Rebecca,
just
for
good
questions
meet
or
is
anything
you
want
to
do
after
that
or.
N
Thank
you
very
much
good
afternoon,
everyone
just
in
terms
of
the
themes
as
Rebecca
highlighted
and
the
main
theme
of
in
terms
of
our
performance
and
inspection,
related
activity
or
cqc's
handling
of
concerns
about
a
service.
These
main
themes
have
not
changed
over
the
last
few
years
and
is
a
consistent
type
of
complaint
which
we
handle.
Often
our
complaints
processes
are
also
seen
as
an
alternative
procedure
by
which
to
remedy
matters
pertaining
to
inspections,
reports
or
judgments,
but
we
encourage
providers
to
use
the
processes
that
are
in
place
to
handle
such
issues.
N
Similarly,
so
we
also
advise
the
public
that
complaints
about
services
are
not
managed
or
overseen
by
us
in
the
National
complaints
team,
and
we
also
refer
these
on
in
all
instances
where
a
complainter
is
made
to
us.
We
offer
our
customers
an
explanation
and
signpost
them
to
our
the
processes
or
organizations
who
are
and
so
who
who
can
who
they
can
take
their
complaints
up
with
I.
Think
it's
also
important
to
stress
that
we
have
built
into
our
processes.
Ways
in
which
colleagues
who
may
be
the
subject
of
the
complaint
can
be
supported.
N
This
is
to
ensure
their
well-being
and
to
provide
some
Assurance
of
being
valued
and
being
looked
after
through
the
process
in
terms
of
transformation.
We
report
on
any
themes
and
Trends
which
we
identify
in
future
reports.
Turning
just
to
improvements
with
each
complaint,
we
seek
to
address
the
issue
for
the
customer
and
we
do
this
bar
for
an
explanation
and
apology.
N
If
we
make
a
mistake,
what
the
report
has
intended
to
highlight
is
how
we
also
stay
connected
with
other
improvements
and
changes
which
are
taking
place
across
the
organization,
so
we
may
share
this
with
the
customer
to
provide
them
with
some
additional
Assurance.
We
do
this
in
several
ways
by
reviewing
internet
updates
bulletins,
seeking
information
from
policy
or
business
leads
and
other
ways
which
we
stay
connected
is
through
Improvement,
through
direct
collaboration
or
working
groups
or
quality
projects,
and
by
exchanging
information
and
data.
N
Just
over
the
last
year,
we
received
no
adverse
findings
from
the
Parliamentary
and
Health
Service
ombudsman's
office.
However,
they
do
have
a
number
of
cases
open
at
this
time
and
which
have
not
been
concluded.
Reporting
on
those
will
be
included
in
future
reports
separately.
I'm,
a
member
of
the
Parliamentary
Health
Service
ombudsman's
working
group
looking
at
and
devising
a
new
NHS
complaint
standards
framework.
Essentially,
a
gold
standard
of
good
complaints,
handling,
one
of
the
Ambitions
of
the
framework
is
to
ensure
greater
consistency
and
complaints
handling
by
organizations
in
their
remit.
N
They
are
also
in
discussion
with
our
policy,
leads
for
assessing
provider
level,
complaints
handling,
but
also
they're,
looking
to
extend
this
framework
to
government
departments
and
armless
organizations
like
us
in
future.
This
is
really
helpful
insights
for
us
as
an
organization,
and
we
can
use
the
framework
to
further
align
our
processes
to
their
guiding
principles
and,
finally,
We
Gather
and
record
all
complement.
Compliments
about
CQC
and
share
this
with
Senior
Management
to
recognize
our
good
practice
and
interactions
with
providers
for
the
public.
Thank
you
very
much.
A
Okay,
thanks
very
much
indeed,
questions
for
Rebecca
or
Mita.
E
Robert,
thank
you
for
this
report
and
I
welcome
this
being
in
the
public
board
meeting
and
some
transparency,
which
is
something
that
all
organizations
should
follow
in
the
public
sector
at
least.
So
you
two
improvements
which
seem
to
be
Allied
here,
which
you
mentioned.
One
is
about
the
Buddy
scheme
and
the
other
is
we
call
liaison
with
trade.
You
is
about
support
for
colleagues
and
I.
Just
wonder
if
you
might
say
a
word
or
two
about
what
effect
and
impact
the
sort
of
complaints
we
get
can
have
on.
Colleagues.
N
Very
good
question
I
think
some
most
people
feel
that
they're
adequately
supported
through
their
line
management
structure,
because
we
have
Independence
in
the
process.
So
managers
are
there
to
support
individuals
who
are
the
subject
of
a
complaint.
Frequently
people
do
use
these
other
schemes.
N
I
think
that
a
lot
of
people
do
find
it
quite
upsetting
I
think
to
be
at
the
center
of
a
complaint,
and
they
worry
about
it.
I
think
what
we
try
to
do
is
to
give
them
assurance
and
we're
also
available
within
the
team,
to
provide
that
level
of
assurance
to
people
as
well.
I
think
sometimes
timeliness
of
an
investigation,
so
if
it
takes
longer
than
what
we
anticipate
can
prolong
some
of
that
that
worry
and
anxiety
for
individuals.
E
Implore,
the
patients
with
colleagues
one
one
of
the
issues,
I
always
think
about
complaints
procedures,
whether
they
be
ours
or
anyone
else
is
they
are
inherently
adversarial.
N
Absolutely
I
think
that's
one
of
the
things
that
we
do
actually
try
to
encourage.
We
try
to
encourage
those
local
discussions
between
inspection
managers
and
Senior
Management
locally
with
the
particular
providers
as
well
to
iron
out
some
of
those
issues
and
to
probably
also
understand
how
how
well
and
what
we
do
during
an
inspection.
So
that's
widely
understood,
I
think
perhaps
there's
some
misconceptions
around.
N
That
I
think
there
was
a
particular
leaflet
flyer
that
what
to
expect
out
of
an
inspection
and
I
think
that's
something
that
we're
looking
to
promote
quite
widely
as
well,
so
that
it
kind
of
addresses
some
of
those
new
points
about
how
people
feel
when
they
go
out
and
inspect,
and
what
providers
can
expect
from
us
as
well.
H
Related
to
follow
at
the
same
point,
because
I'm
interested
in
whether
there's
a
different
type
of
sort
of
feedback
loop
that
tries
to
look
at
the
sort
of
the
common
patterns
and
themes
in
this,
so
as
well
as
supporting
the
individual
in
the
individual
investigation
and
we're
sort
of
drawing
this
together,
so
that
inspectors
and
assessors
are
sort
of
aware
these
are
common
trigger
points.
This
is
what
sometimes
happens,
just
sort
of
be
aware
that
these
are
these
are
common
trigger
points,
particularly
perhaps,
if
there's
a
pattern
in
in
the
ones
that
you
uphold.
H
N
Absolutely
yes,
so
this
is
a
difficult
question.
Actually,
so
one
of
the
things
that
we're
looking
to
do-
and
we
have
done
this
in
the
past-
is
if
we
picked
up,
we
have
dare
I,
say
a
spreadsheet
that
records
also
the
names
of
individuals.
Who've
been
complained
about,
so
if
we
get
that
kind
of
repeat
pattern
pertaining
to
particular
individuals
or
colleagues,
that's
something
that
we
will
highlight
to
the
Senior
Management
and
the
team.
N
N
So
this
this
forms
part
of
our
arms,
do
a
lot
of
presentations
across
the
organization,
particularly
so
in
adult
social
care,
for
example,
which
is
the
area
that
generates
sort
of
like
the
most
level
of
complaints
that
we
receive
and
we
try
to
engage
with
the
teams
to
make
them
aware
of
these
kind
of
thematic
things
as
well.
We
also
present
reports
on
a
monthly
basis
to
all
relevant
directors
across
the
organization
where
we
have
complaints
made
in
their
particular
areas.
A
K
I
I
would
Echo
Robert's
Point
in
that
complaints
of
you
know
a
fantastic
lens
on
how
you're
really
doing
this.
Whether
Robert
hits
the
road
when
when
people
are
not
happy
with
with
their
experience
of
dealing
with
the
organization
and
it's
a
tremendous
learning
experience
and
the
more
open
and
transparent
we
can
be
about
the
learnings
and
the
insights
that
we
get
from
this,
the
better
we
will.
K
K
You
know
as
this
moves
forward,
that
I
would
probably
like
to
have
seen
that
you
know
it's
helpful
to
see
the
the
the
themes
and
Improvement
highlights
and
that
sort
of
General
description
of
how
we
respond
to
this.
But
you
know
for
for
the
for
the
57
that
were
upheld
or
partially
upheld,
I
think
I'd
I'd
want
some
sort
of
assurance
that
the
the
recommended
actions
in
each
case
were
delivered
and
carried
through.
K
That's
obviously,
you
know
you
describe
how
it
happens,
but
that
sort
of
assurance
that
they
they'd
all
been
closed
out
would
be
would
be
helpful.
Secondly,
I
see
that
a
a
small,
very
small
number
of
the
complaints
received
related
to
whistleblowing
situations.
K
You
know
those
are
obviously
ones
that
we
should
really
later
in
on
I,
don't
know
whether
those
were
ones
that
which
were
upheld
or
partially
upheld
in
any
way,
but
but
almost
regardless,
whether
they
were
or
weren't,
they
will
be
learning
experiences
and
if
there's
any
aspect
of
that,
where
there
was
some
substance
to
the
to
to
the
complaint,
we
should.
We
should
I
think
hear
about
that
in
some
detail
and
make
sure
that
we
are
doing
all
that
we
can
to
be
a
listening
and
responding
organization.
N
Thank
you.
That's
really
helpful,
so,
just
in
terms
of
addressing
the
point
about
Assurance
one
of
the
things
that
we
tend
to
do
and
I'm
sorry,
it's
not
obviously
included
in
the
report,
but
we
will
not
close
a
complaint
until
we've
implemented
any
recommendations,
so
that
complaint
will
stay
open
on
our
systems
until
such
time
that
we've
implemented
the
respective
action
pertaining
to
that
particular
complaint.
N
And
if
we're
not
able
to
do
it
at
the
time
when
we've
concluded
that
particular
investigation,
we
will
always
go
back
to
the
customer
to
let
them
know.
We
have
now
implemented
this
particular
action.
So
there's
that
whole
feedback
loop
of
making
sure
that
we
say
what
we
say
we
were
going
to
do
as
part
of
the
investigation
in
terms
of
the
whistleblown
complaints.
A
Okay,
thanks
for
the
comment
Mark
of
the
response
meter,
any
other
questions
or
comments.
These
are
just
a
couple
for
me.
As
usual,
the
first
ones
have
been
dealt
with
already,
but
I
was
pleased
to
see
that
you
did
pick
up
in
your
remarks
and
the
comment
about
support
for
for
people
I
mean,
as
you
say,
it
can
be
a
distressing
experience
with
whatever
the
role
of
the
individual.
A
Just
to
follow
on
what
you
already
said,
though,
if
somebody
has
been
through
that
process,
I
mean
clearly.
If,
if
the
things
upheld,
there
may
be
some
action
with
the
individual,
that's
that
that's
one
thing,
but
if
the
complaint
is
not
upheld
at
one
level
it's
dealt
with
and
that
your
system
closed
it
down,
but
that
doesn't
mean
to
say
that
the
individual
is
entirely
happy
about
it.
A
So
I
just
wondered
if,
if
you
could
say
a
little
bit
more
about
what
happens
when
it's
closed,
if
we've
determined
that
the
complaint
wasn't
valid
in
the
first
place,
particularly
because
some
of
these
things
can
get
quite
unpleasant
and
personal,
the
way
that
they're
praised.
So
that
was
one
thing
and
the
other
I'm
just
a
bit
of
confirmation
that
you
did
talk
about
the
phso
guidance
which
I'm
very
familiar
with
from
a
previous
role,
and
you
talked
about
sitting
on
the
working
group,
which
is
great,
you
said
I
mean
the
clearly.
A
This
is
designed
primarily
for
the
NHS,
but
you
said
it
would
ultimately
apply
to
ALB.
Can
I
take
it
from
what
you're
saying
that
you
would
next
well,
can
you
would
there
be
any
changes
to
what
we're
doing
if
the
current
ways
of
thinking
for
trust
were
to
be
implemented
here
or
I?
Think
I
was
implying
for
what
you
said
or
thought
you
implied
that
wouldn't
be
changed,
but
if
there
isn't
any,
perhaps
you'd
confirm
that
thanks.
N
So,
yes,
that
the
answer
is
yes
to
the
latter
question
in
terms
of
the
coming
under
the
jurisdiction,
we
will
be
working
on
the
framework
just
to
align
it
even
further.
I
think
I
think
we
operate
a
fairly
consistent
and
aligned
complaints
process
to
to
the
current
complaints,
handling
principles
that
the
pope
phso
have,
but
it
there's
no
harm
in
revisiting
that
so
just
to
make
sure.
So,
yes,
we
will
come
under
that
agreement
as
well
in
future.
N
Oh
sorry
and
the
other
point
about
complaints
where
they're
sort
of
not
valid,
it's
a
tricky
one.
If
I'm,
because
once
the
complaint's
done,
we
generally
don't
tend
to
get
a
lot
of
feedback.
I
think
some
of
the
issues
arise
where
there
might
be
challenging
situations
or
individuals
whose
behaviors
are
particularly
unreasonable,
perhaps
in
terms
of
how
they've
engaged
so
that
sort
of
that
work
takes
outside
of
complaints
process
and
generally.
N
I
think
there's
other
mechanisms
as
well,
that
we
do
use
across
CQC
there's
the
personal
safety
register
as
well,
which
reports,
perhaps
particular
individuals
who
might
be
displaying
behaviors,
which
are
really
quite
unreasonable
to
us
as
an
organization.
So
we
have
that.
We
also
have
our
frequent
contact
and
unreasonable
customer
policy
as
well,
which
we
can
also
use
to
again
to
perhaps
signal
to
individuals
that
there
are
certain
behaviors
Etc
that
we
won't
accept,
which
aligns
to
our
Zero
Tolerance
policy
or
that
we
have
as
an
organization.
A
Thank
you
very
much
if
I
look
around
again
any
last
questions:
okay,
well,
Mita.
Thank
you
very
much
indeed,
for
joining
us
very
helpful
to
see
out
and
just
echoing
comments
of
other
colleagues
thank
the
executive
for
when
you
listen
to
the
public
domain.
I
think
that's
entirely
appropriate,
so
I'm
glad
to
have
to.
A
You
I
think
that
ends
the
the
formal
business
of
the
meeting.
A
But,
as
you
know,
we
do
give
members
of
the
public
an
opportunity
to
ask
questions,
and
we
have
several
so
I
know
just
read
the
questions
out
and
then
we've
identified
a
member
of
the
executive
team
who
might
be
best
pleased
to
answer
it
because
it's
three
from
Robin
Pike
and
one
from
Jade
Taylor
I'll,
take
them
one
by
one,
because
different
people
are
answering
so
the
first
one
Robin
Pike
asks
what
steps
CQC
can
take
to
enhance
its
reputation
with
the
public
Chris.
C
So
I'm
sure
just
give
you
some
some
some
background
information
first.
So
a
lot
of
our
reputation
is
built
around
trust
and
we
take
Parts
in
a
an
annual
survey.
Work
with
other
organizations
across
Health
and
Care,
and
indeed
other
organizations
in
government
and
our
our
trust
school
I'm,
happy
to
say,
has
continue
to
remain
strong,
despite
changes
to
other
parts
of
wider
government.
So
our
trust
score
about
this.
Do
people
feel
that
cc
is
on
the
side
of
people.
C
Use
Services
is
at
78,
while
78
is
100,
it's
significantly
greater
than
other
organizations
of
a
of
a
comparable
size,
but
there
is
an
issue
about
how
we
and
I
think
that's
partly
led
to
the
rise
that
we've
seen
in
give
feedback
on
care
over
the
last
couple
of
years.
There
is
a
challenge
to
how
do
we
sustain
that,
so
just
to
talk
through
some
of
the
things
that
we
are
doing?
Specifically,
we've
mentioned
a
couple
of
times
in
this
conversation
and
elsewhere.
C
Listening
and
acting
on
the
feedback
we
receive
about
care,
so
I
think
I
said
earlier
that
almost
half
of
our
responsive
inspections
are
related
to
feedback
that
we
receive
for
people
who
services
or
from
whistleblowers
and
I
think
demonstrating
that
we
are
using
and
acting
on.
The
information
from
the
from
the
public
is
critical.
I
think
the
other
thing
that
that's
that's
important
is
ensuring
that
we
focus
on
what
is
important
to
public.
So
at
the
moment,
we're
particularly
focused
on
arguments
care,
maternity
and
services
for
people
with
mental
health,
learn
disabilities
on
autism.
C
All
of
those
areas
are
things
that
we've
had
strong
feedback
from
the
public
and
they
recognize
that
we
are
both
seeking
to
protect
people
from
poor
care
and
also
seeking
to
take
Swift
action.
So
an
important
message
in
terms
of
the
work
that
we
undertake
the
third
area
is
reporting
the
outputs
in
a
clear
and
simple
way,
and
my
team
are
currently
looking
at
how
we
improve
the
outcome
of
reports.
So
it's
a
clear
and
simple
focus
on
what
people
who
use
Services
want
and
inspect,
there's
more
work.
C
We
need
to
do
on
on
raising
the
awareness
of
CC's
role
and
purpose.
We
we
talked
in
the
earlier
part
of
this
discussion
to
colleagues
from
healthwatch
and
in
partnership
with
them
and
a
number
of
other
organizations.
We
we've
launched
tell
us
about
your
care
campaign
this
year,
which
seeks
to
go
where
people
are
so
rather
than
waiting
for
people
to
to
to
use
our
services
as
a
regulator
trying
to
be
where
people
are
at.
C
The
point
where
they
need
support
from
us
I
think
is
critical,
so
encouraging
people,
because
your
partner
organizations
to
to
share
our
information
so
that
we
can
collectively
gain
a
better
understanding
of
how
services
are
are
working
and
that
also
culminating
the
4
000
voices
work
that
I
mentioned
earlier.
All
of
that
I
think
being
where
people
are
making
sure
that
we've
we've
acted
on
people's
feedback
and
providing
better
information
to
the
public
will
enhance
not
so
much
our
reputation.
It's
actually.
Our
action.
C
A
A
The
second
question
from
Mr
Pike
is
how
is
CQC
currently
regulating
ambulance
trusts.
I
would
only
talk
turn
to
Sean
for
that,
but,
as
I
mentioned
at
the
beginning,
he's
on
vacation,
so
Tyson
can
ask
you
to
respond.
Please
of.
G
Course,
thank
you
Ian
and
thank
you.
Thank
you
for
the
question.
I
mean
it's
clear.
There
have
been
unprecedented
pressures
on
the
ambulance
system
over
over
recent
months
and
we
remain
Vigilant
to
that.
We
are
monitoring
risk
very
closely,
and
that
includes
response
times
and
Handover
delays.
Looking
for
short
assurances
that
services
are
doing
all
they
can
to
be
responsive,
And
Timely,
given
the
pressures
I,
think
it's
fair
to
say.
We
have
adopted
a
twin
track
approach
to
this.
G
We've
also
included
ambulance
services
in
our
inspections
of
recent
inspections
of
10,
urgent
and
Emergency
Care
pathways,
and
secondly,
the
second
part
of
our
approach
is
to
support
the
work
that
others
are
doing
in
this
space,
in
particular
nhf
England,
who
clearly
have
Ambi
the
ambulance
sector
on
their
Improvement
radar,
and
we
work
closely
with
them
and
their
National
Guardians
office,
who
are
undertaking
a
speak-up
review
of
the
culture
within
ambulance,
trust.
So
in
the
round
that
that's
our
approach
to
regulation
of
ambulances
at
the
moment.
A
G
Thank
you.
Thank
you
again
for
the
question
I'm
very
happy
to
to
pick
up
on
that
I
think
it's
fair
to
say
that
colleagues
in
the
National
customer
service
center
continue
to
perform
well
in
terms
of
responding
to
telephone
calls
depending
upon
the
type
of
inquiry
between
87
and
92
percent,
of
calls
are
answered
and
I
think
the
most
important
metric
is
the
average
average
waiting
time
for
the
calls
to
be
answered,
and
there
are
four
different
types
of
calls
that
the
teams
and
process.
G
Firstly,
the
waiting
time
is
under
two
minutes
for
mental
health
act.
Calls
it's
just
over
two
minutes
for
safeguarding
calls.
It's
six
minutes
for
registration,
calls
and
four
minutes
for
more
General
inquiries.
A
Okay,
thank
you
very
much.
So
those
are
Mr.
Pike's
questions,
one
last
question:
this
one's
from
Jay
Taylor:
it's
quite
a
long
question
I'm
going
to
ask
Ian
tratham
to
respond
to
it,
but
the
question
was
as
an
employer
in
cases
where
the
CQC
has
lost
an
employment
tribunal
with
regards
to
whistleblowing
will
CQC
act
as
a
role
model
for
the
system,
accept
the
judgment
and
decline
to
then
take
employment
tribunal
cases
to
a
pale
appeal
out
of
the
rider.
This
would
protect
patients,
save
the
public
purse
and
developing
a
learning
culture.
B
Thanks
thanks
very
much
Ian,
this
I
think
Jays
is
referring
to
the
recent
case
involving
Mr
Kumar.
Just
for
for
clarity,
we're
not
appealing
that
that
judgment
and
I
have
no
intention
of
doing
that.
I
think
it
is
worth
saying
we
have
very
few
employment
tribunal
cases
in
the
round.
We
have
a
handful
at
any
one
time
and
very
few
of
them
actually
proceed
to
a
tribunal.
B
I
think
it
would
be
difficult
for
us
to
to
make
a
blanket
statement
that
we
were
never
going
to
appeal
an
employment
tribunal,
but
but
but
I
think
it
would
be
something
that
would
be
really
very
much
by
exception.
So
I
I
think
it
is
something
we
take.
We
take
very
seriously,
but
thank
you
for
the
question
Jake.
Thank
you.
Yes,.
A
I'm
just
right,
it
did
link
it
to
the
public
post.
That
is
something
we
have
to
take
account
of
what
I
think
that
doesn't
mean.
We
have
to
look
at
each
case
on
its
merits,
rather
than
making
a
blanket
statements
about
what
we
would
or
wouldn't
do.
So.
Thank
you,
Ed
that
can
having
concluded
the
questions.
I
hope
those
answers
were
helpful.
That
concludes
this
meeting,
so
details
of
our
next
meeting,
which
will
be
in
December,
will
be
posted
in
due
course,
including
the
papers.