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Description
In this episode of CQC Connect, the podcast from the Care Quality Commission, CQC's Annabelle Stigwood and Dr Devina Maru are joined by special guest Dr Farzana Hussain to discuss the CQC's Regulators' Pioneer Fund Project, which is looking at reducing health inequalities in areas of deprivation through better regulatory recognition and the sharing of best practice.
More information on the project can be found on CQC's Citizen Lab page: https://cqc.citizenlab.co/en-GB/projects/tackling-health-inequalities/9
The full project report can be read on CQC's website: https://www.cqc.org.uk/publications/evaluation/regulators-pioneer-fund-project-regulatory-recognition-sharing-innovative
Listen to more podcasts from the CQC: https://soundcloud.com/carequalitycommission
Find out more information about the CQC and how it regulates health and social care in England: https://www.cqc.org.uk/
A
B
A
The
cqc
today
we
are
going
to
be
looking
at
the
cqc's
regulator's
pioneer
fund
project,
which
is
looking
at
reducing
health
inequalities
in
areas
of
deprivation
through
better
regulatory
recognition
and
the
sharing
of
best
practice.
With
funding
from
the
department
for
business,
energy
and
industrial
strategy.
C
Thanks
david,
so
we
know
this
covered.
19
pandemic
has
had
a
huge
impact
on
health
and
social
care,
and
it's
really
exposed
a
lot
of
health
inequalities
faced
both
by
people
who
use
the
services
and
also
people
who
provide
the
care,
and
we
felt
that
the
cqc
as
the
regulator
of
health
services
should
encourage
improvement
and
innovation
in
this
area
and
is
also
one
of
cqc's
new
core
ambitions
as
part
of
their
strategy,
which
has
an
emphasis
on
reducing
inequalities
and
promoting
innovation.
A
D
You
know
david,
that's
such
an
interesting
question
because
I
think
sometimes
there's
a
bit
of
confusion
about
what
innovation
actually
is
and
what
this
means
in
a
gp
practice
and
sometimes
there's
a
misconception
that
an
intervention
or
approach
is
only
innovative
if
something
new
is
invented
or
implemented,
and
whilst
that
might
be
the
case,
it
doesn't
have
to
be.
The
innovation
can
be
improving
an
existing
system
or
practice
and
refining
it
to
better
respond
to
the
health
inequalities
and
and
meet
the
needs
of
the
patients.
D
We
know
that
their
causes
of
health
inequalities
are
vast
and
complex,
and
these
can
include
factors
such
as
poverty
discrimination
and
they
can
be.
They
can
be
motivated
by
economic
or
educational
reasons.
For
example,
the
effects
can
be
seen
they're
massively
concerning
they
can
be
seen
on
people's
well-being,
their
their
healthy
life
expectancy,
their
morbidity
and
mortality.
D
D
But
similarly
we
understand
that
practice.
Populations
are
unique
and
not
all
innovations
can
be
rolled
out
to
other
practices
that
that
just
simply
doesn't
doesn't
work.
We
don't
underestimate
the
importance
of
adapting
innovation
to
the
local
context
and
getting
that
implementation
right.
That
way,
innovation
can
make
a
real
difference
in
tackling
health
inequalities.
A
B
So
I
think
it's
following
on
from
annabelle's
point:
isn't
it
about
what
is
innovation,
and
does
innovation
always
have
to
be
something
new?
The
reason
that
it's
important
david-
and
you
know
if
I
give
you
a
personal
example-
I
I
work
in
an
area
in
east
london
that
it
is
highly
deprived
and
sadly,
we
had
the
highest
kobe
death
rate
in
the
country
in
the
first
wave
and
covid
has
just
really
uncovered
health
inequalities.
It's
shown
a
light
on
them.
B
It's
not
the
health
inequalities
weren't
there
before,
but
it's
great
to
see
that
it's
really
on
everybody's
mind
now,
so
we
can
change
it
because,
as
annabelle
says,
this
is
avoidable.
So
if
we
think
about
general
practice
so
we're
all
trying
to
achieve
similar
things
but
we're
all
starting
from
different
baselines.
So
if
I
take
an
example
of
cancer,
so,
for
example,
general
practice
is
very
involved
with
screening
for
cervical
cancer-
it's
the
sixth
most
common
cancer
around,
but
sadly
it
doesn't
have
any
symptoms
with
it.
B
So
the
screening
is
very,
very
important
to
save
the
lives
of
some
very
young
women.
We
know
that
under
35s
tend
not
to
comfort
their
screening.
That
much
so
I
have
a
friend
who
works
in
laoton,
which
is
only
five
miles
down
the
road
from
me,
and
his
only
difficulty
in
achieving
99
is
that
some
of
his
lady
patients
go
and
have
it
done
privately,
and
they
don't
give
him
the
the
results.
B
I,
on
the
other
hand,
to
reach
76
and
when
the
target
is
80
percent,
really
had
to
think
differently.
We
were
stuck
at
about
50
for
a
number
of
years,
so,
with
the
innovation
wasn't
anything
dramatic,
it
was
really
thinking
about.
Why
is
it
our
patients
are
not
coming?
How
do
we
tackle
that?
Do
we
have
the
workforce
then
to
actually
encourage
these
people
to
come
more
because
we
know
they're
not
going
to
come
with
one
text
message:
they're
not
going
to
come
with
one
invitation,
so
something
that
we
did
at
our
practice.
B
B
In
order
for
that
to
happen,
we
needed
to
ensure
that
everybody
in
the
practice,
every
single
member
of
my
team
of
10
from
receptionist
to
healthcare
assistant,
knew
that
if
somebody
was
coming
in,
they
would
look
to
see
if
they
needed
a
smear
and
then
they
would
be
able
to
have
that
sensitive
conversation
to
encourage
them
to
have
it
there
and
then
so.
These
things,
each
part
of
that
is
not
particularly
innovative.
B
You
would
think
of
that
as
good
clinical
care,
but
piecing
it
all
together
and
actually
achieving
those
thoughts
is
very
innovative
and
it's
something
that
I'm
really
pleased
to
say.
Our
practice
was
commended
for
by
cqc,
because
you
know
in
an
area
where
we
have
very
low
uptake
rates
for
cervical
cytology,
never
more
important.
Now,
because
in
the
first
wave
of
covid,
london
had
a
pause
for
six
months
on
cytology.
So
we
have
a
lot
of
people
who
need
those
tests.
B
So
that's
a
small
example
of
things
that
may
sound
obvious,
but
actually
doing
them
doing
them
together.
As
a
team,
so
we're
all
working
together
to
achieve
a
shared
aim
and
keeping
at
it
as
well
and
ensuring
that
we
do
it
with
the
sensitivity
for
our
patients,
it's
quite
frightening
for
a
woman
to
come
in
for
a,
for
example,
a
chest
examination,
someone
to
say:
do
you
smear
for
you
now
when
she's
actually
quite
scared
about
it,
and
there
may
be
lots
of
reasons
she
may
feel
embarrassed
about
it
so
put
together.
B
C
Thank
you
fazana
for
saying
that,
because,
as
a
regulator,
cqc
is
really
committed
to
ensuring
that
people
receive
safe,
effective.
This
compassionate
high
quality
care
and,
like
you
said
it's
putting
all
these
pieces
together.
That
makes
it
innovative
and
ensuring
it's
safe,
and
we
do
acknowledge
that
there
are
still
inequalities
in
health
care
across
different
areas
of
the
country
and
amongst
different
populations.
C
B
So
helpful
to
hear
you
say
that
davina,
because
one
of
I
think
the
frustrations
has
been
for
many
providers
and
myself
is
that
we
do
often
look
at
the
end
picture
target.
So
if
we
take
the
cervical
cytology,
for
example,
is
80
percent.
But
as
you
say,
it's
how
you
got
there.
So
my
friend
in
lauten
is
getting
there
in
a
very
different
way
to
how
how
we
are
getting
there
and
yeah
for
us
to
to
increase
our
smear
targets
from
50
to
74
took
two
years.
B
It
took
two
years
and
now,
though,
that
that
behavior
has
embedded
both
within
the
practice
and
also
our
patients.
So
they
know
that.
Actually
you
know
what
they'll
get
a
call
that
they'll
get
another
call
then
they'll
get
another
call.
So
they
know
that
and-
and
it
does
change
behavior,
so
it
does
make
it
easier
then,
to
tackle
that
health,
inequality,
and-
and
absolutely
I
mean
this-
is
so
important.
B
We
know
don't
we
that
the
marmot
20
report
came
out
and
that
if
you
are
a
woman
living
in
an
area
of
high
deprivation,
you
are
actually
living
10
years
less
than
you
were
before.
If
we
just
think
about
that,
obviously
being
a
woman
living
in
a
deprived
area,
it's
shocking
to
think
that
you
know
I
live
in
one
of
the
most
iconic
cities
in
the
world.
I
live
in
newham
and
actually
people
are
dying.
Women
are
dying,
10
years
younger.
So
it's
something
that
I
think
we
all
have
a
responsibility
to
tackle.
A
D
One
of
the
practices
that
I'm
thinking
of
worked
with
patients
who'd
been
relocated
from
their
homes
to
live
in
in
houses
of
multiple
occupation
on
a
large
scale,
and
they
were
away
from
their
their
support
networks.
Their
children
were
walking
miles
to
school
every
day
with
only
a
disused
car
park
to
to
play
in.
D
D
But
the
issue
that
I
had
as
an
inspector-
and
we
have
as
a
regulator,
is
how
do
you
measure
that?
How
do
you
measure
that
innovation,
because
that's
having
an
impact
on
on
people's
lives?
But
it's
not
as
as
fazana
fazana
discussed
before
that's
not
going
to
show
up
tomorrow.
That's
not
that's
not
going
to
show
up
in
tomorrow's
quaff
figures
or
public
health
data,
but
it's
making
a
real
difference.
D
So
as
we
as
we
move
forward
with
this
project,
what
we're
looking
at
is
how
to
capture
that
innovation
and
how
to
and
how
to
not
necessarily
measure
the
innovation
but
capture
it.
We
need
to
be
looking
at
people's
experiences
rather
than
just
sticking
to
to
traditional
data
sources
and,
as
vasana
said,
it
takes
time
for
those
kinds
of
innovations
to
be
to
be
measurable
at
all.
D
It
might
never
translate
into
into
a
traditional
data
source.
So,
although
this
project's
in
its
in
its
early
stages,
the
vision
is,
is
that
we
could
capture
to
capture
that
innovation
when
it
starts,
we
want
to
be
able
to
say
to
practices.
This
is
an
innovative
approach
to
tackle
health
inequalities
and
celebrate
it
celebrate
it
at
the
at
the
inception
and
as
the
innovation
becomes
embedded
into
routine
practice,
we
need
to
be
looking
beyond
those
numbers.
We
need
to
listen
to
what
people
telling
us
and
we
as
an
organization,
need
to
be
dynamic
understanding.
B
I'm
really
interested
to
hear
you
say
that
annabelle
and
it
really
pleased
actually
because
it
it's
difficult,
isn't
it
because,
obviously,
as
regulators,
of
course
you
need
to
give
the
public
and
yourselves
assurance
that
practices
are
safe.
As
davina
said,
you
know,
that's
one
of
the
the
key
one
of
the
clothes.
Isn't
it
one
of
the
indicators
but
as
we
move
and
covid
and
the
pandemic
has
shown
us,
the
vaccine
rollout
has
shown
us
that
actually,
general
practice
doesn't
work
in
isolation,
we're
part
of
a
system.
B
I
probably
at
the
time,
wouldn't
have
thought
of
that
as
an
innovation,
but
thinking
about
it
it
is
a
different
project
that
we're
doing
now
that's
a
more
system
based
is
we
found,
sadly,
that
many
of
our
young
children
in
newark
get
stabbed
to
death?
It's
a
problem
across
the
country
very
much
a
problem
in
london,
but
I
have
had
three
teenagers,
which
is
quite
a
lot
for
a
list
of
only
5
000
patients
stabbed
to
death.
B
Just
in
the
past
few
years
and
my
my
last
patient
it's
in
public
domain,
it
was
on
the
bbc
just
two
octobers
ago,
baptista
was
stabbed
to
death
at
half
past
three
in
the
afternoon
on
his
way
home
from
school.
Two
minutes
from
where
I
live,
and
I
just
thought
to
myself:
what
are
we
doing
for
these
people
because
they're
not
on
a
cough
register?
We
wouldn't
know
about
them,
but
actually
kids
are
dying.
B
These
are
people
who
have
not
lived
a
life
yet
so
I'm
fortunate
to
be
part
of
a
national
health
inequalities
project
called
the
complete
care
communities.
London
has
three
sites,
there's
20
or
20
something
sites
over
the
country.
That's
expanding
and
we
have
chosen
as
a
primary
care
network,
not
a
practice
as
a
primary
care
network
of
seven
practices.
I'm
the
clinical
director
for
one
of
our
primary
care
networks
to
look
at
this
group
of
young
people
11
to
16
year
olds
to
identify
them
and
think:
can
we
identify
any
risk
factors?
B
Is
there
anything
we
can
think
of
and
we've
just
come
up
together
as
a
group
of
practices
to
think
about,
perhaps
you
know,
are
they
going
to
school?
Home
is
just
a
couple
of
risk
factors,
but
the
great
thing
about
that-
and
I
was
interested
listening
to
annabelle-
is
that
we've
been
working
with
schools.
We've
been
working
with
public
health,
we've
been
working
with
some
young
people
and
I've
never
done
that
before
20
years
as
a
gp,
and
not
only
is
it
really
exciting.
B
I
think
that
it's
definitely
going
to
improve
population
health,
I'm
not
sure
how
you
regulate
something
like
that,
but
but
but
I'm
sure
there's
a
way,
and
these
are
the
things
that
are.
I
think
you
know
what
I'll
call
like
big
big
scale-
innovation,
but
not
doing
it
on
our
own,
and
I
think
our
general
practices
are
great,
we're
small,
agile
organizations
in
that
sense,
we're
very
different
to
hospitals
and
community
trust.
B
We
can
implement
change
very
quickly,
but
there's
a
lot
that
we
can't
do
on
our
own
and
working
collaboratively,
and
you
know
when
we
saw
the
nhs
long-term
plan
come
out
in
2019
and
even
today's
integrated
care
systems
coming
in.
It
is
about
collaboration,
because
we
know
that
our
patients
are
the
people.
We
serve
need
more
than
just
one
service
and
they
don't
mind
what
services
it
is.
B
We
need
a
joined
up
service,
so
it's
great
to
hear
your
example
and
I
think
I'd
love
to
see
and
be
part
of
that
sort
of
innovation
more
where
we've
got
our
schools,
our
public
health,
our
voluntary
sectors,
so
we're
more
than
halfway
through
our
project
pilot.
We'll
keep
you
posted
on
how
that's
going
with
without
trying
to
reduce
knife
crime.
C
So
we've
definitely
we've
collected
over
80
case
studies,
actually
revealing
this
innovative
practice,
so
we're
working
with
yorkshire
and
humber
academic
health
science
network.
So
they
are
collaborating
partners
for
this
project
and
we've
been
liaising
with
the
external
stakeholders
such
as
nhs
england
and
improvement
health
inequalities
team
and
we're
going
to
use
all
of
this
learning.
From
these
case
studies.
C
D
And
I
think
that
in
our
field
work,
what
what
came
out
was
that
practices
don't
always
know
if
what
they're
doing
is
innovative.
So
we
need
to
find
a
way
of
of
capturing
that
innovation
and
as
a
regulator
we
need
to.
We
need
to
review
how
you
know
going
back
to
the
point
about
about
measuring
impact.
We
need
to
go.
We
need
to
find
out.
B
That's
such
an
important
point:
isn't
it
animal
where
practices
don't
always
know
if
they're
doing
something
innovative?
So
you,
if
you
had
asked
me
five
six
years
ago
with
the
cytology,
is
that
innovative?
I
would
say?
Well,
no,
I
don't
think
so.
You
know
this
is
what
we're
supposed
to
be
doing
we're
supposed
to
be
increasing
our
tomatoes.
Certainly
when
we
put
it
all
together,
we
thought
actually
we're
doing
something
a
bit
different
to
others,
but
others
could
also
do
that.
It's
not
it
once
you've
kind
of
got
your
recipe.
D
D
Is
we
want
to
be
able
to
not
just
capture
but
support
practices
to
evidence
their
innovation,
because
if,
if
they,
if
practices,
don't
aren't
aware
that
they're,
what
they're
doing
is
innovative,
then
chances
are
that
they're
going
to
struggle
or
they
could
do
with
some
support
or
help
to
show
the
regulators
what
they're
doing,
because
quite
often
practices
are
doing
really
innovative
things,
but
they
struggle
to
evidence
it
through
our
current
regulatory
systems.
There
are
ways
currently
where
we
can
capture
innovation,
but
I
think
that
it
definitely
needs
definitely
needs
some
further
improvement.
D
A
C
Thanks
david,
so
as
anabar
and
fazana
alluded
to
these
innovative
approaches
can
have
significant
benefits
for
populations
that
may
be
going
unrecognized
with
sometimes
potentially
a
negative
impact
on
ratings,
and-
and
we
don't
want
gps
having
this
perception-
that
innovative
solutions
are
not
valued.
So
we
really
want
to
change
this,
and
this
project
is
in
line
with
the
government's
priorities
as
well
in
relation
to
encouraging
innovation
in
primary
care,
and
we
also
want
to
try
and
improve
gp
practices,
experience
of
and
confidence
in
regulation.
C
So
we've
already
seen
remarkable
examples
in
the
case
studies
we've
collected
to
date
and
really
what
we
aim
to
achieve
in
this
project
is
helping
these
practices
evidence
that
innovation.
So
it's
recognized
within
the
regulatory
process
and
therefore
will
foster
this
supportive
regulatory
environment
for
services
where
they
feel
able
to
try
these
new
approaches
to
care
to
reduce
health
inequalities.
So
that's
our
main
overall.
A
B
B
We,
we
can't
think
of
more
innovative
ways
or
smarter
ways
to
work
that
would
actually
help
the
workforce
as
well,
because
we're
just
so
busy.
So
I
I
think
some
intentional
time
and
headspace,
which
sadly
is
not
given
to
general
practice
and
wasn't
given
before
the
pandemic,
and
I
think
until
that
time
for
innovation
is
valued.
B
B
I
think
there
is
something
that,
if
I
may
be
so
bold
as
well,
that
the
the
gp
provider
relationship
with
the
regulator
at
the
moment
is
still
they're
coming
to
mark
my
homework,
which
you
know
how
we
change
their
issue,
because
it's
clear
that
that's
not
what
it's
about
and
I
have
had
a
cqc
visit
myself
as
a
you
know,
as
a
registered
provider.
It
certainly
wasn't.
B
It
didn't
feel
like
there
was
just
homework
being
marked,
but
I
think
that
that
is
something
that
then
puts
gp
providers,
maybe
puts
them
on
the
defensive
a
little
bit.
So
it's
harder
to
share
if
you
don't
know
that
you're
doing
something
innovative.
So
I
think
those
two
are
probably
the
biggest
things
that
need
to
be
addressed:
giving
gps
and
their
teams
headspace
to
actually
think
about
doing
something
differently,
and
also
thinking
about
how
we
view
our
regulators
differently.
B
C
Thanks
david
and
our
next
steps
is
basically
learning
from
all
these
case
studies.
Learning
from
the
interviews
we've
undertaken,
the
roundtable
events,
the
focus
groups
and
applying
this
to
create
something
where
we
can
help
the
providers
evidence
their
innovation,
because,
at
the
end
of
the
day,
we
feel
better
regulatory
recognition
and
the
sharing
of
this
best
practice
could
really
pave
the
way
for
exciting
developments
in
our
primary
care
sector,
bringing
benefits
to
both
practice
teams
and
people
using
the
services.