►
Description
Hear from Chris Day the Director of Engagement at CQC, as he introduces you to one of our emerging strategy themes ‘Smarter regulation’.
B
Good
afternoon
everybody
and
welcome
to
this
in
the
third
in
a
series
of
webinars
on
our
strategic
themes.
First
of
all,
thank
you
very
much
for
taking
some
time
on
a
friday
afternoon
to
have
a
conversation
with
the
regulator
about
their
strategy.
I
know
that's
not
necessarily
how
you'd
want
to
spend
your
time.
I
hope
it's
useful
for
you
in
the
conversations
that
we're
going
to
have
over
the
next
hour.
So
it's
one
of
the
number
that
we've
done
so
far.
B
We
intend
to
sort
of
continue
these
conversations
on
over
the
next
few
months.
Just
introduce
myself
to
you.
My
name
is
chris
day,
I'm
director
of
engagement
for
cqc
and
I'm
working
with
a
team
of
people
in
secrecy
today
to
give
you
some
opportunity
to
have
a
conversation
about
smarter
regulation,
the
team
are
myself:
natalie
who's,
a
regulatory
policy
manager,
sam
who's,
a
provider,
engagement
manager,
steph
who
stephanie
who's
a
provider,
engagement,
lead
and
and
abigail
who's,
a
senior
provider
engagement
officer.
B
So
as
a
group
of
people
today,
if
you
haven't
been
on
one
of
these
before
there's
just
some
things,
you
probably
need
to
know
on
your
screen.
You
should
have
a
a
a
tool
which
looks
like
a
sort
of
a
question
mark
which
has
a
q
a
in
it,
and
if
you
open
that
you
can
see
the
the
q
a
down
the
side,
please
feel
free
to
type
into
the
chat.
I
know
colleagues
already
have
types
into
the
chat
and
I've
offered
some
questions
and
thoughts
already.
B
Please
use
that
throughout
the
throughout
the
presentation.
There's
about
a
thousand
of
you
on
this.
This
call
today,
so
if
you've
ever
been
on
a
on
a
conference
call
or
a
zoom
meeting
with
lots
of
people
on
we've
deliberately
muted,
every
other
participant,
so
you'll
hear
me,
and
you
have
colleagues
who
help
me
with
the
elements
of
the
q
a
so
if
you've
got
any
questions
or
any
comments,
please
put
them
in
the
chat
and
then
my
colleagues
will
will
make
sure
that
they
are
are
answered.
B
We
we
want
to
make
sure
we
cover
all
the
topics
that
you
raise.
If
we
don't
get
to
a
particular
question
that
you've
asked,
we
will
come
back
to
you
to
give
you
the
an
answer
to
the
question
that
you've
asked.
We'll
also
put
this
as
a
as
a
completed
video
in
in
our
youtube
channel,
so
be
able
to
review
this
again
and
pass
it
around
to
other
colleagues
who
may
want
to
look
at
this
at
a
later
date.
We'll
do
our
best
stick
to
time.
B
I've
only
got
a
relatively
short
amount
of
time
to
cover
quite
a
lot
of
ground
and
I'll
make
sure
that
we,
if
there
are
some
issues
that
are
outstanding,
we'll
try
to
any
big
topics
we'll
try
to
cover
them
in
future.
Conversations
that
we
have
okay,
so
just
to
give
you
a
sense
of
what
we're
going
to
cover
today.
B
Obviously
the
the
the
focus.
This
is
one
of
four,
but
we're
going
to
focus
on
a
conversation
about
how
we
are
changing
our
our
way
of
regulating
over
the
coming
over
the
coming
months.
Today's
focus
is
on
smarter
regulation.
I'll
talk
a
bit
more
about
what
that
is
in
a
moment,
but
these
are
a
number
of
conversations
that
we're
having
in
order
to
prepare
ourselves
to
have
a
more
formal
conversation,
probably
towards
the
autumn
time
about
how
we
think
about
our
strategy
going
forward.
B
Our
current
strategy
ends
on
the
31st
of
march
next
year.
We
want
to
make
sure
we're
in
plenty
of
time
to
think
about
what
how
we'd
want
to
change
the
organization
moving
forward.
I
guess
one
thing:
I've
realized
in
in
the
context
of
trying
to
write
strategies
and
then
implement
them
is
that
five
years
is
an
awful
long
time
to
have
a
strategy.
B
Okay
and
one
thing
that
won't
change
moving
on
to
the
next
slide
is
our
purpose.
So
our
purpose
is
much
much
because
it's
it's
also
in
in
law,
but
for
me,
there's
a
really
important
part
about
not
just
making
sure
that
people
get
safe,
effective,
compassionate,
compassionate
care
that
is
high
quality,
but
also
that
we
encourage
services
to
improve,
and
that
was
a
when
we
wrote
that
purpose
and
some
years
ago
now
that
was
one
of
the
most
important
changes
that
we
wanted
to
make
as
a
regulator.
B
We
don't
want
to
be
a
regulator
that
is
just
counting
how
how
four
things
are
without
any,
without
any
skin
in
the
game,
so
how
things
shouldn't
change
or
improve.
We
want
to
be
an
organization
that
encourages
that
improvement,
but
we
can
only
do
that.
I
think
we
can
do
that
more
effectively
as
if
we
think
about
how,
as
an
organization
what
our
role
is
in
that
how
we
can
develop
our
role
in
that.
B
I
guess
that
the
one
the
other
things
that
have
changed
a
lot
over
the
time
we've
been
regulated
in
the
last
five
years
is
this:
is
the
makeup
and
nature
of
the
sectors
that
we
regulate.
We
used
to
focus
very
much
on
individual
locations,
individual
organizations,
but
I
guess
what
we've
seen
in
the
last
few
years,
particularly
perhaps
more
brought
to
light
recently
over
the
over
the
response
to
covid,
is
how
much
individual
organizations
are
dependent
on
each
other
for
the
quality
of
care
that
the
local
system,
the
local
area,
produces.
B
So
I'll
touch
a
bit
more
on
that,
as
I
come
in
to
talk
about
how
we
want
to
think
about
our
own,
our
own
response
to
what
we
were
changing
ourselves.
Ultimately,
regulation
has
to
improve
people's
lives.
That's
the
point
of
it.
Isn't
it
isn't
just
here
as
a
as
a
threshold
to
be
crossed
it's
to
design
to
improve
people's
lives?
B
What
I
would
say
is
in
terms
of
trying
to
become
a
better
regulator,
although
that
is
our
purpose.
We
don't
always
get
things
right
as
an
organization,
and
I
think,
there's
a
there's
a
important
bit
steps
off.
The
next
slide
there's
an
important
bit
for
me
about
how
we
respond
to
risks
and
concerns
that
happen
more
in
real
time,
but
crucially,
also
how
we
build
a
better
picture
of
the
health
and
care
across
an
area.
B
So
I
think
recognizing
that
we
we're
not
perfect
ourselves
as
an
organization,
and
just
I've
played
a
conversation.
I've
had
many
times
with
different
providers
and
even
to
be
an
outstanding
provider,
you
don't
have
to
be
perfect.
Nobody
can
be
perfect
all
the
time.
The
key
question
is:
how
do
you
learn
from
from
what
you've
done?
So
I
think
it's
this
important
part
for
us
is.
B
How
do
we
address
those
concerns,
as
well
as
just
the
things
that
an
individual
provider
can
do
and
ultimately,
therefore
having
a
better
picture
of
care
in
a
place
in
an
area
in
a
system
or
in
a
pathway?
Those
are
things
I
think
that
we
have
are
are
becoming
challenges
that
we
must
face.
There
is
a
real
opportunity.
I
think,
around
the
way
that
technology
has
changed
the
way
the
health
and
care
service
is
delivered
to
use
some
of
that
in
the
thinking
about
how
we
respond
better
to
risk.
B
We
recognize
that
the
adjustments
that
we've
been
making
over
the
last
three
to
four
years
have
have
been
guided
a
lot
by
our
across
the
threshold
inspection
activity,
and
that
will
be
an
important
part
of
what
we
do.
But
this
conversation
today
is
more
aimed
at
how
we
build
our
picture
of
understanding
of
how
services
are
performing
between
between
inspections.
B
B
Key
thing
for
me
is:
it
gave
us
the
opportunity
to
have
conversations
with
central
government
that
we
wouldn't
have
been
able
to
have
about
access
to
ppe,
about
training
development
and
about
providers
concerns,
because
we
had
that
real-time
information.
But
how
do
we
how
to
develop
that
further?
How
do
we
think
about
how
that
works?
B
And
I
think
that
the
more
we
can
do
to
to
use
what
we
know
not
just
to
inspect
and
regulate
organizations,
but
to
help
the
the
thinking
and
the
flow
of
information
between
both
national
organizations
and
local
organizations.
The
better
and
acting
on
what
we
know
and
sharing
that
learning
more
broadly,
is
important.
B
Our
aim
is
in
state
of
care,
which
is
towards
october,
is
to
to
publish
those
as
a
as
a
group,
but
we'll
publish
them
in
probably
some
of
those
themes
in
the
meantime,
because
by
describing
what's
working
well
and
understanding,
why
that's
working?
We
hope
that
we
can
prompt
better
conversations
at
a
local
level
and
better
better
conversations
nationally.
B
Let's
move
on
to
the
next
slide.
The
other
thing
to
me
is
about
how
we
share
information
across
organizations
that
we
that
we
regulate
and
how
we
share
information
across
systems,
so
providers
themselves
don't
have
to
complete
information
more
than
once
the
domiciliary
care
tracker,
which
is
the
the
tool
we
I
talked
about
just
before.
B
We
wanted
to
make
sure,
as
we
developed,
that
that
we
weren't
putting
a
further
burden
on
domiciliary
care
providers
of
information
that
they
were
already
providing
to
public
health,
england
or
other
areas.
So
how
we
share
that
information
in
real
time
to
prevent
people
asking
for
the
same
information
is
an
important
point.
One
of
the
most
important
things
to
me
is
the
voice
of
of
people.
B
We've
seen
a
significant
uptick
in
in
people
coming
to
us
with
concerns
actually
not
generally
about
their
care,
but
more
about
the
way
in
which
organizations
operate
between
how
services
operate,
collectively,
to
to
bridge
the
gap
between
health
and
care
or
primary
care
and
adult
social
care.
And
it's
important.
B
So
we
want
to
make
sure
we've
captured
that
and
understand
that
and
and
bring
that
together
with
the
voice
of
care
providers
themselves,
we've
got
obviously
people
in
front
line
carols
and
actually
leaders
in
in
the
care
industry
have
a
will
have
a
strong
sense
of
what's
working.
What's
not
and
what
the
barriers
are.
Many
of
those
good
cases
that
we
talked
about
earlier.
A
lot
of
the
framing
of
those
is
these.
B
We
need
to
deal
with
not
just
individual
organizations,
but
actually
as
a
health
and
care
system
working
with
colleagues
in
public
health
working
potentially
with
with
them
government
departments
in
other
areas
like
housing.
So
how
do
we
work
together
to
have
a
really
a
good
understanding
about
what
a
local
system
response
to
coved,
or
indeed
to
other
health
and
care
issues
should
be?
And
probably
the
last
thing
for
me
is
around
transparency.
B
B
B
Let's
move
on
to
the
next
slide.
So
this
is
your
you're.
In
a
workshop
there
about
smarter
regulation
have
been
three
other
themes
that
we've
been
looking
at
as
we
go
through
the
the
renew
the
review
of
our
strategy,
the
first
one
being
meeting
people's
needs.
Both
people
use
services
providers
and
others,
and
alongside
smarter
regulation,
we've
got
how
we
provide
safe
care
for
people
and
this
this.
B
This
touches
on
that
idea
of
of
how
we
encourage
openness,
honesty
and
learning,
from
the
way
that
we
we
were
moving
forward
and
the
last
thing
was
around
driving
and
support
and
improvement,
and
that
was
the
focus
of
that
was
very
much
on.
Well,
what's
our
role
in
shaping
and
understanding
improvements,
and
it's
clear
that
in
some
sectors,
there's
a
strong
improvement
offer
from
you
in
the
nhs
you've
got
nhs
improvement,
that's
designed
partly
to
to
support
improvements
in
individual
organizations
if
you're
in
out
of
social
care.
B
It
isn't
that
clear
where
the
improvement
support
comes
from.
So
how
do
we
as
an
organization
support
that?
But
so
today's
is
around
is
around
smarter,
smarter
regulation
and
I,
I
think,
there's
a
there's
a
really
strong.
We
can
strongly
build
on
what
we
have
done
so
far
and
some
of
the
technology
changes
that
we've
made
and
how
we
evolve
and
adapt
that
to
create
a
different,
a
different
offer
for
both
providers
and
for
people
who
use
services.
B
Before
I
get
into
the
conversation
about
some
smarter
regulation,
just
give
you
a
sense
of
where
the
timeline
is
and
where
we
are
now
so
we're.
In
this
period
we've
been
we've
we've
sort
of
thought
a
bit
about
the
areas
that
we
want
to
try
and
cover
in
the
new
strategy,
from
the
conversations
that
we've
had
so
far
and
between
sort
of
now
and
the
autumn.
B
That
is
in
the
in
the
world
that
we
live
in.
That
is
very
much
covert
dependent,
but
that's
the
principle
about
without
how
we'd
like
to
take
for
the
next
period
time.
So
it's
still
very
early
at
the
moment.
We
want
to
have
those
early
conversations
and
then
come
back
once
we've
had
those
initial
conversations
with
with
an
offer
for
a
conversation
in
in
the
next
phase,
so
it
starts
in
october.
B
B
But
if
I
imagine
it
does
not
feel
like
that,
I
imagine
it
feels
that
we
we
would
come
along
every
now
and
again,
we'd
inspect
you
we'd
walk
away,
and
every
now
and
again
we
ask
for
some
information
separately
to
that
one
of
the
one
of
the
things
I
think
we
want
to
try
and
do
with
this
is
to
develop
more
for
providers
to
develop
more
of
a
service
for
them.
So
we
regulate
some
just
short
of
50
000
locations
across
a
range
of
different
different
sectors.
B
We
gather
lots
of
information
as
a
result
of
doing
that,
not
just
from
you
directly
but
actually
from
other
other
partners,
and
that
could
be
an
asset
to
you
and
could
help
you
as
a
provider
from
having
a
good
understanding
about
where
you're
performing
well
relative
to
other
organizations
of
a
similar
type.
But
we
don't
use
it
and
we
don't
use
it
for
that,
for
that
we
use
it
for
the
act
of
inspection.
B
So
one
of
the
conversations
do
we:
do
we
open
up
that
information
and
do
we
have
a
more
real-time
conversation
with
you
about
the
information
which
you
receive
and
the
information
we
receive
so
that
you
have
a
sort
of
an
always-on
view
of
the
quality
of
your
service
connected
to
others?
And
do
we
actually
provide
that
to
you
as
a
service?
If
you
work
in
the
in
the
in
the
nhs,
there
are
organizations
that
provide
this
as
a
service.
B
In
that
way.
It
changes
the
the
conversation
from
being
a
conversation
about
the
act
of
inspection
at
a
particular
time
to
the
act
of
risk
in
a
local
area
which
may
or
may
not
include
your
your
an
individual
provider's
own
performance,
but
I
think,
moving
beyond
the
act
of
inspect
inspection
and
having
other
interventions
that
support
improvement.
B
This
is
not
the
relationship
you've
had
with
a
a
regulator
over
the
course
of
the
years
that
we've
that
we've
operated,
but
if
we
want
to
build
a
better
real-time
picture
of
how
services
are
performing,
I
think
we
need
a
different,
a
different
conversation
about
about
trust
and
how
that
information
is
used.
So
what
information
do
we
share
with
you?
How
do
we
use
some
of
that
to
share
some
information
with
the
public,
and
the
last
question
of
that
is?
B
There
are
at
least
18
organizations
in
health
and
care
that
have
some
view
of
information
collection.
How
do
we
make
better
use
of
that
information
collectively?
So
so
individual
providers
provide
it
once
and
it's
used
many
times
the
conversation
that
we've
we've
talked
about,
probably
for
certain
as
many
years
as
I've
been
involved
in
health
and
care,
but
actually
what
I'm
one
of
the
benefits
of
the
of
the
of
the
issue
around
kovid.
Is
it
forced
a
conversation
in
quick
time
about
how
that
information
was
used
differently?
B
It
is
not
perfect,
it
is
absolutely
not
perfect,
but
how
do
we?
How
do
we
have
a
better
conversation
with
others
that
regulate
so
we
can
share
that
information
in
a
more
real-time
sense.
I
think
the
openness
of
what
we
know
shared
with
with
providers
and
with
others
more
frequently
builds
a
better
picture
of
where
risk
is.
B
For
me,
there
was
always
the
biggest
risk
in
any
situation
is
the
gap
between
somebody
known
as
a
problem
and
another
group
or
the
same
organization
doing
something
about
it
and
the
more
we
can
share
information
in
real
time.
I
think
the
the
better
we
can
be
at
managing
that
gap
and
managing
that
the
risk
that
we
run
of
not
being
able
to
provide
support,
improvements
and
change
in
services.
So
that's
for
me.
That's.
B
So
we've
talked
about
the
fact
that
we've
relied
upon
the
act
of
inspection
as
the
main
vehicle
for
for
for
our
regular
reaction
doesn't
have
to
be,
and
actually
the
conversations
around
how
we
share
information
more
in
real
time
might
be
other
bits
of
the
regular
toolkit.
Also,
how
we
might
support
better
conversations
between
providers
and
commissioners
might
be
part
of
that
as
well,
how
we
provide
a
bit
more
of
a
tailored
understanding
of
risks
and
and
benefits.
I
think,
particularly
particularly
about
service
reconfiguration-
that's
happening
at
the
moment.
B
How
can
you
feel
confident
about
having
a
conversation
with
us
about
things
that
you
might
want
to
do
because
of
what's
happening
in
a
in
your
local
environment?
And
how
do
you?
How
do
we
help
you
overcome
the
fact
that
you
might
think
I
don't.
I
really
don't
want
to
talk
to
the
regular
about
this
until
I've
got
everything
everything
agreed,
because
actually
we
do
hold
information,
not
just
about
you
as
an
organization
but
about
the
local
health
economy
that
you
that
you're
operating
in
that
might
be
useful
for
you.
B
If
you're
developing
a
different
regulatory
approach,
how
can
we
use
the
eyes
and
ears
of
providers,
provider,
staff,
people
using
services
to
help
us
understand
quality
and
also
help
us
understand
problems
in
quality
and
when
you're,
when
you
go
on
to
inspections,
some
of
the
best
conversations
you
have
about.
What's
not
working,
not
necessarily
in
the
context
of
the
individual
organization,
but
the
local
system
are
the
people
of
frontline
delivering
health
and
care
they.
They
absolutely
understand
the
relationship
between
different
departments
and
also
different
organizations,
and
how
do
we?
B
How
can
we
use
that
to
describe
what
we
want
to
change,
and
why
and
also
are
there
any
aspects
of
our
current
approach
that
you
feel
are
unnecessary
or
unnecessary
burden?
So
those
are
some
of
the
the
issues
I
wouldn't
mind
exploring
from
my
perspective,
the
most
important
part
of
this
just
moving
on
to
my
my
pencil
side
is
about
putting
people
at
the
heart
of
what
we
do
so
everything
we
do
from
the
act
of
inspection
through
to
how
we
write
about
it
and
how
we
regulate.
B
It
is
done
with
that
in
mind,
and
I
think
I
share
common.
We
share
common
purpose
here.
I
think
everybody
that,
on
on
this
call,
the
reason
why
they
do
what
they
do
is
to
provide
a
better
service
for
peop
for
people
that
use
their
services
or
involved
in
their
services.
So
how
do
we
make
sure
we
have
that
at
our
heart,
and
sometimes
we
don't
get
involved
in
a
conversation
about
about
about
bureaucracy?
That's
that's
unnecessary
for
that.
How
do
we
keep
it?
B
How
do
we
keep
it
tight
so
that
we
drive
that
change
your
improvement
and
last
thing
before
I
before
I
shut
up?
There's
thank
you
for
for
coming
to
this
conversation
today.
There
are
other
ways
you
can
get
involved
and
stay
in
touch,
so
there
are
there's
a
digital
platform
which
is
on
this
on
the
screen.
C
Hi
chris,
we
have
had
quite
a
lot
of
questions,
so
thank
you.
Everyone
for
submitting
those
and
we'll
try
to
get
through
as
many
as
we
can
and
we've
had
a
few
questions
about
looking
at
governance
in
organizations
reflecting
on
the
fact
that
we
do
things
like
well-led
assessments
for
nhs
trusts.
Do
we
have
any
plans
to
widen
this
out
to
other
sectors
and
other
types
of
providers.
B
That's
a
really
really
good
question.
One
of
the
things
about
the
provided
collaborative
reviews
is
trying
to
understand
how
individual
organizations
and
collective
conversations
affect
the
health
and
quality
of
care
that
people
receive.
So
at
the
moment
that
they
are,
they
are
designed
as
part
of
the
conversation
apparently
about
some
nhs
organizations.
B
B
A
Yeah
hi
chris,
it's
natalie
here
from
the
policy
team
just
to
build
on
your
point
there
around
we're
really
conscious
that
our
assessment
frameworks
are
large,
complex
documents
and
particularly
the
ways
in
which
we
characterize
ratings
are
increasingly
complex
and
and
what
they
don't
really
clearly
do
is
set
out
how
those
reflect,
how
people
experience
and
receive
care,
and
so
we're
certainly
doing
a
lot
of
work
with
colleagues
at
think
local
act,
personal
as
well
to
explore.
Actually,
could
we
think
about
what
our
statements
might
look
like?
A
C
Great
thanks
both
and
we've
also
had
quite
a
few
questions
about
potential
duplication
in
the
health
and
social
care
system,
both
in
terms
of
monitoring
quality
in
different
parts,
but
also
supporting
providers
to
improve.
Could
we
say
a
bit
more
about
how
we're
going
to
make
sure
that's
not
going
to
become
an
issue
and
how
we
might
work
with
other
agencies.
So.
B
What
I
would
say
is
the
reason
to
talk
about
this
in
the
context
of
new
strategies.
I'm
well
aware.
This
is
not
perfect.
I'm
just
looking
at
a
question
there
about
the
the
effect
is
during
kobe
19
and
says
kobe
19
highlighted
to
us
how
just
how
difficult
it
was
to
get
that
sort
of
alignment
of
thinking
around
what
we
were.
B
B
What
coveted
has
brought
about
is
a
sense
that
that
definitely
isn't
working,
and
I
think
it
has.
I
think
we
should
we
should
seize
on
the
opportunity.
In
a
sense,
it's
a
isn't
it
a
shame
that
we
we
we
seize
on
the
opportunity
of
an
obvious
failure
to
do
something
different,
but
I
think
that's
there's
an
inevitability
to
that.
We
are
in
conversation
with
with
groups
like
phe,
with
the
with
adas,
with
the
lga
and
with
nhs
digital
about
how
we
develop
different
tools
that
we
can
more
easily
share
information.
B
Colleagues
will
know
that
part
of
the
issue
is
we
all
have
a
slightly
different
way
of
categorizing
almost
the
same
thing,
so
the
taxonomy
of
what
we
describe
is
is
slightly
different,
but
effectively
means
the
same
thing.
I
think
there's
a
good
conversation
about
just
trying
to
be
clear
about
what
the
outcome
we're
seeking
from
this
is
and
for
us
only
gathering
information
that
we
can't
get
from
another
source.
B
So
we
know
a
good
conversation
the
moment
about
with
nhs
england
about
some
of
the
information
that
they
have
gathered
through
kobe
about
whether
they
maintain
that,
whether
that's
done
differently
when
we
maintain
it,
but
ultimately
it's
done
once
and
then
used
by
others.
So
I
don't
think
it's.
I
don't
think
it's.
I
don't
think
it's
perfect
at
all
at
the
moment
and
it
does
require
some
will.
What
we're
trying
to
do
is
to
leverage
the
problem
that
kobe
has
created
to
try
and
leave
you
a
different
response
and
we're.
B
C
B
One
of
the
things
one
of
the
things
that
we
one
of
the
things
that
we
we
might
try
and
do
for
the
way
we
share
information
with
you
is
make
it
possible
for
you.
So
one
of
the
issues
at
the
moment.
As
you
all
know,
if
you,
if
you
work
with
us,
your
quite
complex,
excel
documents,
flow
into
between
organizations
is
not
necessarily
the
best
way
to
share
information.
B
As
I
say,
some
organizations,
if
you're
an
nhs
trust,
you
might
work
with
allocate
software
who
provide
a
service
similar
to
that
now.
So
we
we.
We
wonder
if
there's
a
vanilla
service
as
sort
of
simple
service,
that
we
should
offer
to
make
it
easier
for
you
to
share
that
information.
But
ultimately,
hopefully
we
want
to
cut
down
a
number
of
requests
that
you're
getting
from
disparate
organizations
so
that
you
only
get
one
request
for
that
information
and
also
to
say
is
we
ne?
We
aren't
necessarily
the
the
we.
B
Don't
necessarily
need
to
be
the
people
that
hold
that
information.
So
if
it's
better
held
in
public
health,
england
or
in
nadas
or
the
lga,
that's
fine,
provided
we
can
access
it
directly
from
there
without
burdening
providers.
I
think
that's
absolutely.
That's
absolutely
fine.
I
think
what
we're
trying
to
do
at
the
moment's
establishment,
who
should
lead
on
understanding
and
collecting
that
information.
One
of
the
really
interesting
ones
at
the
moment
is
the
issues
around
well
interesting,
around
information
around
death.
B
C
B
It's
been
a
question
on
and
off
throughout
the
time
that
we've
rated
organizations
so
just
to
be
just
to
be
clear.
We've
not
had
a
conversation
internally
about
changing
the
four
ratings
parameters
that
we
have
at
the
moment,
but
that's
not
to
say
that
we
we.
This
is
the
early
we're
quite
early
on
in
the
development
of
the
strategy.
B
I
guess
for
me
there's
something
about
inspection
is
one
part
of
how
we
could
assess
how
organizations
are
performing
and-
and
one
of
our
one
of
our
questions
in
this
context
is,
should
we
provide?
Is
it
just
about
the
act
of
inspection?
Is
it
just
about
that
rating?
Is
that
is
that
the
only
thing
that
should
carry
any
weight
or
is
there
other
ways
in
which
we
can
provide
information
alongside
that
rating?
So,
for
example,
an
organization
say
an
organization
is
is
is
requires.
B
Improvement
has
got
a
number
of
things
that
it
needs
to
do
if
it,
if
it.
If
it
goes
through
a
journey
and
some
of
those
things
it
can,
you
can
post
information
or
evidence
about
what
it's
done.
Should
that
form
part
of
what
what
the
public
see
about
that
organization?
So,
alongside
a
rating,
you
always
get
a
sort
of
a
commentary
that
provides
a
sense
of
how
how
where
that
organization
is
traveling,
I'm
not.
B
Just
one
of
the
number
of
ideas
that
come
from
different
conversations,
so
the
short
answer
is:
there's
no
immediate
sense
that
we
were.
We
were
looking
at
changing
our
ratings.
I
think,
if
there
are
any
rating
category
that
you
will
will
always
have
edges
to,
it
will
always
be
a
slight
difference
between
the
bottom
end
of
good
and
the
top
end
of
requires
improvement.
B
I
think
it's
more
for
me
for
both
providers
and
for
the
public
about
what
is
happening
as
a
result
of
that
go
back
to
my
transparency
point.
I
think
it's
more
important
that
organizations
are
able
to
demonstrate
what
they
are
doing
and
that
the
public
understand
what
they
are
doing
and
that's
that's
the
that's
the
crucial
thing.
For
me,
that
is
probably
slightly
missing
from
the
way
in
which
we
use
the
ratings
currently,
which
are
the
only
vehicle
for
describing
quality
of
care
in
a
particular
location.
C
Thanks
chris
we've
also
had
quite
a
few
questions
asking
about
whether
we're
thinking
about
taking
more
of
you
about
of
the
performance
of
commissioners
and
in
and
linked
to.
That
is
also
a
question
about
how
much
of
the
kind
of
ambitions
in
this
strategy
could
we
realize
with
current
legislation,
or
would
we
need
to
think
about
new
legislation
to
do
some
of
this
work?.
B
So
I
think
I
could
do
the
yes,
no
and
maybe
parts
of
this.
Let
me
try
and
do
so.
We
are
doing
work
on
providing
collaborative
reviews.
At
the
moment.
We
are
clear
that
provided
classroom
reviews
which
are
focused
on
providers
but
give
the
provider
the
opportunity
to
talk
about
commissioning.
Behavior
are
something
that
we
can
absolutely
do
without
any
change
to
our
legal
powers,
but
colleagues
are
right
in
in
order
to
we.
B
B
Well,
why
it's
working
and
what
some
of
the
barriers
to
that
working
will
be,
and
in
some
contexts
and
not
all
contexts
that
was
about
commissioning
relationships,
not
just
not
just
health,
but
also
care,
so
that
there
was
a
a
mixture
of
of
relationships
in
play.
I
think
you
can
describe
some
of
that
without
the
without
needing
to
formally
regulate
commissioning
behavior.
B
The
hsga
may
not
be
able
to
enact
in
the
either
the
autumn
or
in
the
or
in
the
the
early
part
of
next
year,
and
I
think
what
our
our
decision
has
been
is
that
we
let
us
use
the
full
extent
of
the
powers
that
we
have
with
provided
club
to
reviews
to
showcase,
what's
working
to
showcase,
where
the
barriers
might
be
and
then
to
try
to
enact
that
change
nationally.
I
think
there
is
still
there's
still
much
more
we
can
do.
B
We
think
I
think
that
will
be
helpful
to
commissioners
and
to
providers
in
in
setting
their
agenda
and
going
back
to
the
point
I
made
earlier
nobody's
trying
to
do
a
bad
job
here.
I
think
it's
about
how
we
use
the
convening
power
of
our
information
to
help
and
support
conversations
that
happen
between
providers
and
commissioners.
Certainly
when
we
did
the
lsr's
recently,
we've
done
the
provided
country
reviews
some
of
the
the
early
conversations
have
been.
B
This
is
really
useful
information
that
helps
us
understand
our
area
collectively,
rather
than
just
our
individual
organization,
and
I
think,
there's
something
powerful
about
giving
information
to
organizations
that
allows
them
to
have
a
conversation
rather
than
just
talking
about
their
individual
performance.
So
I
think
we
will
be
able
to
do
this
from
within
our
existing
powers.
There
is
certainly
more
we
could
do
around
the
formal
rating
of
commissioning,
but
I
don't
think
we
have
to
do
that
to
be
able
to
get
some
of
the
benefit
from
those
those
joint
conversations.
C
Thanks
chris
we've
also
had
quite
a
few
questions
about
data
collection,
in
particular
around
provider,
information
returns
and
provider,
information
collection
tools.
Could
we
say
a
bit
more
about
our
ambition
to
improve
this
area
of
our
work,
and
I
think
both
in
what
would
be
useful
to
hear
both
in
the
short
term
and
the
longer
term.
B
I
think
the
key
thing
for
me
about
information
collection
is
is
sort
of
threefold,
is
let's
only
collect
information
that
we're
going
to
do
something
with?
Let's
not
collect
information
for
the
sake
of
that
information.
So
I
think
that
you
know
being
really
frank.
I
think
there
are
probably
times
in
the
past
and
we've
collected
everything
that
we
think
we
could
possibly
need
to
know
about
an
organization
rather
than
the
things
that
really
matter.
So
what
are
the
what's
the
information
that
we
collect?
B
B
And
then
you
only
see
it
at
the
points
before
an
inspection,
but
it's
there
more
in
real
time.
So,
if
you're,
not
if
you're,
not
a
domiciliary
care
provider,
you
won't.
You
won't
necessarily
believe
any
of
that,
but
but
we
have
made
some
significant
progress
and
changes
to
the
way
the
information
is
collected
in
in
the
development
of
the
domiciliary
care.
Tracker,
it
isn't
perfect
and
there's
certainly
some
work
to
do
to
develop
it,
but
it
does
provide
a
more
and
easier
to
fill
in
approach.
B
The
other
thing
for
me
is
the
except
one
of
the
interesting
things
about
the
esf
is
well,
it's
a
question.
It's
a
question.
It's
a
series
of
questions
that
you
will
actually
form
something
that
we
complete,
but
you
don't
need
to,
and
I
think
I
would.
I
would
like
to
see
more
more
people
crossing
the
threshold
into
provider
organizations,
but
without
the
act
of
the
inspection
they
might
just
come
in
to
help
understand
and
share
and
share
information.
C
B
B
What
would
it
take
to
to
to
come
back
and
and
change
your
rating
on
the
basis
of
the
information
that's
been,
provided,
it
might
be
it.
It
might
be
possible
to
do
that
in
some
sectors
in
some
areas,
not
not
necessarily
in
all
areas,
and
I
think
we
want
to
consider
that
and
the
great
thing
about
being
so
early
in
the
process
is
we
can
take
your
views
on
that,
whether
you
think
that's
a
terrible
idea
or
a
good
idea
and
respond
to
those.
B
The
key
thing
for
me
is
how
do
you,
if
the
at
the
moment,
we're
based
on
the
act
of
inspection
and
an
inspection,
might
be
18
months
out
of
date?
Is
it
better
to
have
a
more
real-time
view
of
the
quality
of
care,
and
should
that
change
the
rating
I.e
is?
Is
it
more
than
just
the
act
of
in
of
the
formal
inspection
that
changes
the
rating?
A
good
example
of
it
is
a
responsive
review.
B
So,
at
the
moment,
majority
responsive
reviews
do
not
change
the
the
nature
of
a
rating,
but
actually
could
they
and
should
they?
If
you,
if
you
go
in
to
respond
to
a
concern,
and
actually
you
find
that
not
only
is
it
not
a
problem
but
there's
actually
some
really
good
stuff
going
in.
Should
it
change
the
way
you
see
well-led
or
safe
in
a
in
a
setting?
B
And
for
me
this
is
about
trust.
So
if
what
is
the
basis
of
which
we
would
change
a
rating,
what
information
would
lead
to
it
and
and
how
would
we
make
sure
that
was
fair
and
gave
providers
and
the
public
a
fair
view
of
what
that
organization
was
was
was
was
how
it
was
performing
at
any
given
time.
So
I
don't
think
it's
it's
not
a
decision
we're
going
to
enter
into
lightly.
Again,
I
don't
if
colleagues
from
the
politician,
what,
if
you
not
if
you
want
to
offer
any
comments
on
that.
A
Yeah,
no,
I
completely
agree
chris
there's
something
for
me
about
coming
back
to
the
purpose
of
all
this,
so
I
think
under
smarter
regulation.
What
we
really
you
know
our
really
big
aim
on
this
is:
how
do
we
make
sure
that
we're
sharing
high
quality,
up-to-date
information
with
the
public,
with
providers
with
all
our
stakeholders-
and
we
know
that
ratings
are
a
fundamental
part
of
that?
A
So
how
could
you
know
what
different
ways
can
we
work
that
will
allow
us
to
keep
our
ratings
much
more
up
to
date
and
we're
really
interested
in
a
conversation
and
views
on
how
we
can
do
that?
We
know
that
inspection
is
integral
to
how
we
do
that
work
at
the
moment.
But
how
can
we
work
differently?
How
you
know,
how
could
we
use
more
targeted,
more
focused
inspections
in
in
the
future?
A
Could
we
actually
be
more
effective
coming
in,
for
short,
bursts
of
inspections
much
more
frequently
and
then
supplementing
that
with
with
other
ways
of
working-
and
I
think
chris
mentioned
that
idea
of
the
regulatory
toolkit-
you
know
we're
really
interested
in
what
are
all
these
alternative
approaches
we
could
take
to
to
view
inequality?
How
could
we
feed
in
things
like
accreditation,
like
your
self-assessments,
like
what
information
from
commissioners
survey
results?
B
So
I
hope
you're
taking
from
that.
There's
no
decision
about
that,
but
I'll
be
really
really
useful
to
have
a
good
conversation
about
it
and,
as
you
might
imagine,
we're
talking
to
public
groups
about
this
as
well,
I
think
there's
a
there's
a
really
there's
an
important
trust
element
for
both
for
both
providers
and
the
public.
In
this
it's
got
to
work
for
both
groups.
So
after
this
event
today,
if
you've
got
really
strong
feelings
on
this
or
any
views,
please
do
share
them
with
us
because
they,
this
is
generally.
B
We
are
at
a
point
where
these
these
are
really
helpful
in
framing
some
of
our
thinking
over
the
coming
months.
I
don't
think
it's
there's
a
there's,
a
neat
answer
to
it,
but
I
think
there
is
some
opportunity
perhaps
to
see
how
change
happens.
One
of
the
conversations
I
have
with
often
with
them
with
their
sector
leads.
B
Is
you
can't
see
the
change
that
I've
enacted
since
you
last
inspected
me
and
actually
the
ability
to
sort
of
share
and
understand
how
that's
how
that's
happening
in
real
time
and
perhaps
test
that
against
public
perception
of
organizations
might
be
something
that
that
would
that
would
be
really
helpful.
But
I
think
there's
a
there's
a
fair
way
to
go
so
it'd
be
good
good
to
get
colleagues
views
on
that.
B
B
I
think
I
think
organizationally
we've
we've
sometimes
taken
a
view
that
the
more
you
write
down
the
more
consistent
you
are
so
going
back
to
the
bit
about
guidance.
I
think,
having
thousands
of
pages
of
guidance
doesn't
actually
help
anybody
be
more
consistent.
What
it
does
is
it
does
it.
It
frames
a
number
of
things
that
everybody
has
to
consider.
B
What
we
would
like
to
do.
I
think
what
lies
behind
consistency
is
a
feeling
of
unfairness
and
a
feeling
of
people,
not
understanding
individual
organizations,
and
I
think
part
of
what
the
solution
to
this
is
is
only
part
of
it.
It's
been
really
really
clear
and
focused
on
what
outcomes
are
we
when
we,
when
we
use
our
regulations?
B
Inspectors
are
to
each
other,
the
the
more
they
understand,
the
organization,
the
better
judged.
They
are
of
an
organization's,
an
organization's
position
and
I
think
the
more
we
can
focus
on
outcome
measures
of
what
we're
looking
for
and
better
conversations
between
the
act
of
individual
inspections
to
give
people
a
sense
of
why
an
organization
is
performing
as
it
is
that
that
is,
I
think,
a
better
place
to
be.
B
I
I
would
far
rather
have
a
real-time
update
for
of
information
about
an
organization
that
is
five
or
six
pages
long,
but
gives
a
real
sense
of
this
is
how
the
organization
is
performing
today,
that
the
organization
would
recognize
and
a
service
user
would
recognize,
because
that's
that's
that's
the
challenge
is:
how
do
you
create
that
real-time
view
of
an
organization
that
everybody
recognizes
and
how
do
you
update
it
regularly
to
so
it
continues
to
be
fair
to
both
service
user
and
provider.
It
is
a
challenge.
C
Thanks
chris
we've
maybe
got
time
for
a
couple
more
questions,
but
if
we
don't
don't
get
through
all
the
questions
today,
we
will
look
to
reply
after
this
webinar
to
as
many
as
possible.
We've
also
had
a
few
questions
talking
about
the
kind
of
speed
of
change
we
might
be
taking
to
implement
this
strategy,
and
I
think
a
few
people
have
commented
that
kovid19
has
really
highlighted
the
need
for
urgent
change
in
health
and
social
care
and
whether
we'll
have
the
same
urgency
for
this
strategy.
B
Absolutely
I
mean,
I
think,
one
of
the
things
that
we
as
a
so
we've
influenced
a
new
approach
in
esf
and
if
you're
working
in
domicile
recap
implemented
a
new
change
in
how
we
collect
information
domiciliary
care.
In
a
matter
of
weeks,
we
even
slightly
went
into
into
testing
of
adult
social
care
staff
for
a
few
weeks
as
well.
I
think
I
think
there
is
definitely
some
changes
that
we
as
a
group
need
to
make
quickly.
B
B
What
we
want
to
do
with
this
is
to
have
a
conversation
now,
so
we
can
introduce
develop
some
of
the
change
that
we
want
to
make
to
our
work.
The
reason
why
we're
starting
providing
clarity
reviews
now
is
because
we
think
that
might
be
part
of
how
we
want
to
do
the
future,
so
we
want
to
test
and
trial
how
that
works.
B
Now
that
does
rely
upon
a
different
relationship
with
you,
so
we
know
that
we
want
to
think
about
how
we
might
change
the
way
we
we
we
approach
our
understanding
of
individual
services
and
how
we,
how
we
ask
them
to
work
together
to
form
a
view
of
a
local
area
that
requires
good
conversations
with
with
providers
collectively,
so
that
we
can
do
that,
and
it
means
that
you
are
part
of
the
testing
of
this
with
us,
as
you
yourselves,
transition
in
real
time
to
to
different
service
models.
So
we're
absolutely
aware
of
that.
B
We've
been
been
doing
some
work
with
them:
digital
providers,
in
particular
around
the
the
additional
types
of
service
that
might
be
offered
during
covered
and
post
copied,
and
we
are
well
aware
that
we
need
to
be
supportive
of
that
change
and
not
a
barrier
to
it.
I
would
one
of
the
two
things
I'd
say
just
to
finish
on.
That
is,
if
you
perceive
that
we
are,
we
are
a
barrier
to
a
change
that
you
or
organizations
that
you
work
with
want
to
make.
Tell
us,
because
we
don't
want
to
be
that
barrier.
B
We
don't
think
we
are
that
barrier,
but
you
will
see
a
number
of
times
where
we
might
talk
to
you
in
the
coming
months
to
say:
would
you
help
us
trial
this?
We
are
doing
that,
particularly
so
we're
going
to
fail
fast
if
something
doesn't
work
or
we
can
develop
our
thinking
as
we
move
towards
the
end
of
the
year,
so
that
by
the
time
we
go
out
to
a
formal
consultation,
we
absolutely
know
the
things
that
we
want
to
do
will
work
in
the
context
of
where
we
go
with
the
next
strategy.
C
B
C
B
I
think,
undoubtedly
having
a
having
a
a
large
scale,
inspection
large-scale
inspection
activity
was
right
for
its
time,
but
I
think
now
we
need
to
be
more
agile
in
our
approach.
So
absolutely
we
will
be
looking
at
a
more
real-time,
real-time
sharing
of
information
between
organizations
and
a
more
real-time
understanding
about
how
providers
are
performing
unless
large-scale
inspections,
with
lots
and
lots
of
people
coming
into
an
organization
it
was.
B
It
was
useful
to
get
sort
of
when
we
were
doing
that
work
around
trying
to
establish
a
baseline
for
all
sets
that
we
regulate
it.
It
was
useful
and
did
provide
that
that
baseline,
but
what
you
realize
from
that
is
that
there
is
so
much
that
is
still
missing
from
once
every
year
or
twice
twice
once
every
two
years:
inspection
that
you
need
to
gain
from
real-time
conversations.
B
The
other
thing
about
people
physically
being
there
is
that
we
are
piloting
with
domiciliary
care
providers,
as
it
happens,
the
ability
to
access
information
remotely
and
talk
to
service
users
remotely.
So
do
you
even
have
to
physically
cross
the
threshold
every
time
and
domicile
account
obviously
you're
in
people's
homes.
B
We're
part
of
an
approach
where
we
don't
even
have
to
be
in
people's
homes.
We
can
talk
to
people
over
the
phone
and
talk
to
them
about
the
care
they're
receiving.
These
are
trials
of
different
ways
of
working,
but
each
of
them
is
designed
to
reduce
the
burden
on
providers,
but
still
make
sure
we
have
a
good
real-time
understanding
about
how
services
are
performing.
B
Well,
I
just
thank
you
if
you've
stuck
with
the
flower.
Thank
you
very
much
for
your
for
your
time
and
please
do
take
me
up
on
the
offer
of
providing
some
further
thoughts
on
what
you've
heard
today.
It
is
important
that
we
get
your
views
on
this.
It
will
guide
our
thinking
as
we
develop
our
our
strategy
over
the
coming
months
and
look
out
for
further
opportunities
to
to
engage
with
us
feel
free
to
drop.