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From YouTube: CQC Strategy 2021: Smarter regulation for a safer future – Promoting safe care for people
Description
Hear from Ted Baker our Chief Inspector of Hospitals, as he introduces you to one of our emerging strategy themes ‘Promoting safe care for people’.
Webinar 14 July 2020
B
Okay,
everyone
welcome
this
is
ted
baker,
chief
inspector
of
hospitals
with
the
latest
of
our
strategy,
webinars
we're
looking
at
developing
our
strategy
to
launch
in
the
spring
of
next
year,
and
thank
you
very
much
for
joining
me
today
to
contribute
to
this
webinar
I'll
be
describing
on
on.
I
think
our
thinking
so
far
and
opening
it
up
for
questions,
comments
or
suggestions
from
you
in
due
course
and
we're
very
much
looking
forward
to
hearing
your
views.
B
The
the
overall
working
title
of
our
strategy
at
the
moment
is
smarter
regulation
for
a
safer
future
and
I'll
try
and
explain
what
we're
thinking
about
there.
Looking
at
the
bigger
strategy
picture,
but
focusing
down
on
one
of
our
four
strategic
themes,
which
is
promoting
safe
care
for
people
and
that's
going
to
be
the
focus
of
what
we
discussed
today,
although
I'll
try
and
give
you
the
context
of
the
wider
strategy,
so
you
can
see
the
thinking
about
safety
within
the
wider
context
as
we
go
forward.
Okay,
so
next
slide
please
well!
B
If
there
are
issues
you
want
to
raise
with
us
later
on,
so
thank
you
very
much
for
the
contribution
and
thank
you
to
colleagues
next
slide.
Please
right.
This
is
this.
Is
our
our
structure
for
the
for
the
webinar?
We
will
stick
to
an
hour,
so
we'll
be
finishing
that
three
o'clock
on
the
dot
and
this
webinar
is
being
recorded.
B
Just
for
your
information,
only
the
people
from
the
cqc
will
be
able
to
speak
on
on
the
webinar,
so
you
won't
be
able
to
give
verbal
feedback,
but
there
is
a
chat
session.
So
please
do
use
it
for
feedback
comments
or
questions.
Please
put
your
name
to
the
comments
or
questions
once
so.
We
know
who
we're
talking
to,
but
also
so,
if
necessary,
we
can
follow
it
up
with
you
directly
afterwards,
because
there
may
be
things
we
can't
take
forward
during
this
session,
which
we
want
to
follow
up
with
individuals
on
the
call.
B
So
please
do
give
us
your
name
and
make
sure
that
we
can
contact
you
afterwards.
If
anyone
wants
to
raise
a
question
or
an
issue
that
isn't
directly
relevant
to
the
the
subject
of
the
webinar,
that's
fine,
but
we
won't
deal
with
it
during
the
webinar,
we'll
we'll
come
back
to
you
after
the
event,
because
we
don't
want
to
get
sidetracked
into
other
areas
and
then
we
know
there's
always
so
much
people
want
to
discuss.
B
B
So
you
can
understand
where
we
are
in
the
strata
strategic
process
and
then
I'll
zero
in
on
the
the
theme,
the
strategic
theme
that
we're
focusing
on
today
and
that
is
promoting
safe
care
for
people,
and
that
will
be
the
main
purpose
of
the
webinar.
And
that's
what
I'm
really
interested
in
hearing
your
views
about
once
I've
described
where
we
think
we
are
on
that
our
thinking
on
on
safe
care
it'll
be
great
to
hear
your
comments
or
questions,
and
that
that
will
be
a
break
for
that.
B
An
opportunity
to
ask
ask
questions
at
that
stage.
Then
I'll
just
briefly
describe
how
we,
how
you
can
stay
up
to
date
with
our
strategy
development,
because
we're
very
much
in
the
mid,
mid
range
of
our
strategy.
Development
there'll,
be
lots
more
opportunities
to
to
contribute
on
this
theme
or
on
our
other
themes,
and
I'm
very
keen
that
you
should
stay
up
to
date
with
that
I'll,
explain
that
to
you
and
right
at
the
end,
depending
on
how
much
time
we've
got
we'll
open
it
up
to
more
questions
and
answers.
B
B
We
we
are
here
to
make
sure
health
and
social
care
services
provide
people
with
safe,
effective,
compassionate
high
quality
care,
and
we
encourage
services
to
improve.
Now
that
last
phrase
there
we
encourage
services
to
improve
is
a
very
important
one
for
us,
and
it
is
one
that
we
are
focusing
on
heavily
during
this
strategy.
B
In
fact,
the
rec
the
the
legislation
has
originally
set
up.
The
cqc
very
clearly
said
its
primary
purpose
was
to
encourage
services
to
improve.
So
it
is
very
central
to
our
role
and
we're
not
here
just
to
regulate
for
the
sake
of
telling
people
things
they
can't
do.
We
want
to
be
a
regulator
that
really
helps
people
improve
their
services
and-
and
that
is
a
strong
theme
in
this
strategy
and
we'll
come
back
to
it
as
we
go
through
the
talk
today.
So
so
that's
our
purpose.
It
hasn't
changed.
B
The
vision
for
this
strategy
is,
we
want
to
be
a
world-class
regulator.
Now
we
need
to
define
what
world-class
means,
of
course,
and
that
again
is
a
challenge
for
us.
It's
an
easy
thing
to
say,
but
actually
what
does
being
a
world-class
regulator
mean?
We
want
to
be
able
to
drive
improvements
in
how
people
experience
care
health
and
care
services
working
towards
a
safer
future.
So
the
vision
is
to
be
a
world-class
regulator,
driving
improvements
in
how
people
experience
health
and
care
services
working
towards
a
safer
future.
B
Virtually
every
word
in
that
vision
counts,
because
this
is
about
people's
experience.
It
is
about
safety,
it
is
about
driving
improvement
and
it
is
about
the
quality
of
us
as
a
regulator
in
using
regulation
effectively,
and
so
that's
that's
really
central
to
our
strategy
going
forward
next
slide,
please.
B
So
the
context
of
this
is
that
is
that
that's
the
the
world
in
which
we
regulate
is
changing,
and
you
know
that
as
well
as
we
do,
and
that
change
appears
to
be
speeding
up
and
to
some
extent
that
change
has
sped
up
even
more
because
of
the
pandemic.
We've
all
been
living
through
over
the
last
few
months.
Things
had
to
change
very
quickly
by
force
of
circumstance,
but
equally,
even
before
that
things
were
changing
quite
significantly
going
forward.
For
instance,
we
know
well,
we
judge
our.
B
We
judge
our
effectiveness
as
a
regulator
by
the
quality
of
the
services
we
regulate,
so
it's
no
good
being
a
brilliant
regulator,
while
the
services
that
we
regulate
are
not
very
good,
we
want
those
services
to
be
as
good
as
they
can
possibly
be.
So
how
do
we
challenge
ourselves
as
a
regulator
to
do
that?
Well,
at
the
moment,
if
with
our
problems
and
services,
then
clearly
those
services
have
a
responsibility
to
sort
them
out,
but
we
as
a
regulator.
B
We
need
to
be
part
of
helping
them
drive
that
improvement,
and
we
know
we
don't
always
get
that
right
at
the
moment.
How
can
we
use
regulation
more
effectively
to
to
drive
improvement
of
services?
We
must
also
be
more
relevant
and
responsive.
We
don't
be
a
regulator
that
gets
in
the
way
of
innovation
and
change.
New
technologies
coming
in
that
technology
needs
to
be
used
effectively
and
safely
to
make
sure
people
get
the
care
care
they
need.
B
B
So
during
the
covid
pandemic,
during
the
the
the
peak
of
the
covid
pandemic,
we
pause
routine
inspections
because
clearly
we
didn't
want
to
add
to
the
burden
and
add
to
the
risk
during
the
the
height
of
the
pandemic.
But
we
didn't
take
our
eye
off
looking
to
care
to
make
sure
it
was
safe
and
that
treatment
was
effective.
B
It
helps
us
understand
the
risk
in
the
system,
but
also
we
help
hope,
help,
support
the
system
and
we've
been
reporting.
What
was
what
we've
been
finding
in
the
emergency
support
framework
in
our
communication
with
providers
in
regular
insight
reports
that
we're
publishing
on
a
monthly
basis,
and
we
can
continue
to
publish
those
over
the
next
few
few
months.
So
we've
changed
very
much
our
approach
to
inspections
and
to
regulation
during
the
covet
19
epidemic,
but
we
do
realize
that
we
need
to
go
back
to
a
planned
program
of
routine
inspections
in
due
course.
B
At
the
moment,
we're
doing
work
on
developing
that,
but
it
will
not
be
going
back
to
what
we're
doing
at
the
start
of
the
pandemic.
We
want
to.
We
want
to
make
sure
that
our
approach
going
forward
is
proportionate
and
responsive
and
wherever
possible,
supportive
of
services
under
pressure
next
slide.
Please
there
are
some
important
things
that
we
think
that
that
important
to
learn
from
the
kovid
crisis,
one
of
the
things
that's
really
come
very
clear
to
us-
is
one.
I've
talked
to
about
how
we've
communicated
and
worked
with
providers.
B
We've
got
a
listen
to
care
providers
and
understand
the
pressures
they
are
under,
but
we've
also
got
to
listen
and
see
care
through
the
eyes
of
people
using
services,
and
that
has
become
very
clear
to
us
and
there's
a
strong
theme
throughout
this
webinar
I'll
come
back
to
it
several
times
again
in
the
future.
So
we've
got
to.
I
think
important.
B
Learning
from
this
is
that
we
need
to
understand
care
from
the
point
of
view
of
providers,
but
also
the
view
of
people
using
services,
but
also
what
is
important
is
about
sharing
information
and
transparency,
and
I
think
one
of
the
things
that's
been
frustrating
at
times
during
the
kv
19
epidemic
is
that
actually
getting
hold
of
the
information
has
been
difficult.
Sometimes
that's
because
the
information
wasn't
available,
but
sometimes
that's
because
the
system
doesn't
naturally
want
to
share
information
and
sharing
information,
making
it
open
and
transparency
about
what
is
going
on.
B
We
think
are
really
very
important
points
that
we've
learned
from
this
this
this
pandemic
and
going
forward.
We
want
to
be
strong
advocates
of
openness,
about
information
and
transparency
about
what
is
going
on
in
the
system.
Transparency.
Sometimes
is
challenging
because
clearly
there
are
problems
there,
but
actually,
if
you
don't
face
up
to
the
problems,
we
will
never
deal
with
them
and
I
think
we,
as
a
regulator,
want
to
be
a
strong
advocate
of
transparency
going
forward.
B
That
happened,
and
because
of
that
we've
launched
a
program
of
what
we
call
provider
collaboration
reviews
which
launched
last
week
and
has
been
continuing
over
the
next
few
weeks,
looking
into
11
11
areas
throughout
england
to
understand
how
providers
have
collaborated
effectively
during
the
covid
epidemic
to
provide
joined
up
care
and
what
we
want
to
extract
from
that
is
some
really
understanding.
What
good
practice
looks
like
and
we'll
be
exploring
with
providers
in
systems
throughout
england
about
what
good
practice
looks
like
in
providing
joined
up
care
across
systems?
B
We'll
be
publishing
a
report
on
that
in
in
our
insight
report
in
september
of
this
year,
and
we
very
much
hope
that
learning
from
that
will
be
used
going
forward,
both
in
terms
of
taking
health
and
care
services,
integration
further
forward
in
the
future,
but
also
in
continuing
the
response
to
the
kerby
pandemic
going
into
the
winter
when
we
may
face
new
challenges.
So
we
think
that
learning
about
how
local
systems
work
together
has
proved
very
important,
and
we
are
determined
to
to
learn
from
that.
B
Ourselves
was
also
to
help
help
providers
learn
from
that
as
well.
Next
slide,
please
so
to
get
back
to
the
strategy
itself
and
the
focus
on
the
strategy.
How
are
we
planning
to
change?
Well,
there
are
four
emerging
strategic
themes:
we've
developed
so
far
in
our
consultation
with
stakeholders
with
people
using
services
and
internally
within
the
cqc,
and
these
are
four
themes
as
they
stand
at
the
moment.
First
of
all,
meeting
people's
needs,
and
this
very
much
comes
back
to
our
saying
a
few
minutes
ago.
B
B
B
First
of
all,
it's
the
better
use
of
technology,
and
I
we've
already
started
using
technology
in
a
different
way
in
our
emergency
support
framework
and
what
we've
learned
from
that
we're
going
to
apply
into
our
wider
regulation
going
forward,
but
there's
much
more
to
do
and
in
terms
of
how
we
use
technology
and
move
from
what
has
been
a
very
traditional
paper-based
view
of
regulation
to
a
very
intelligent,
technologically
driven
view
of
regulation.
I
think
it's
going
to
be
very
different.
B
That
will
make
us
very
very
different
in
the
way
we
we
regulate
and
make
us
very
different.
The
way
we
inspect
or
assess
services,
because
we'll
be
doing
it
in
in
a
much
more
fleet
of
foot
way
and
as
the
meeting
only
a
few
minutes
ago,
with
talking
to
colleagues
about
how
can
we
become
a
fleet
of
foot
regulator?
So
that's
part
of
smarter
regulation,
technologically
driven,
but
also
smarter
regulation
is
about
the
relationship.
B
I've
talked
already
about
the
relationship
with
people
using
services
very
important.
We
need
to
listen
to
their
voice,
much
much
more
clearly,
that's
smarter
regulation,
but
we
also
need
to
develop
a
different
relationship
with
people
providing
services,
a
relationship
that
is
more
a
partnership
rather
than
a
kind
of
a
client
relationship
that
we
have
at
the
moment.
So
we
want
to
move
from
what
is
a
very
traditional
view
of
regulation
to
a
very
different
view
of
regulation,
where
regulator
and
provider
are
partners
working
together
to
provide
high
quality
care
for
people
using
services.
B
So
I
won't
talk
about
the
third
theme
there
because
we'll
be
coming
back
to
it
in
detail.
But
the
fourth
theme-
and
I
mentioned
earlier
on
that
one
of
our
key
roles
as
a
as
a
regulator
is
driving
improvement,
and
I
think
one
of
the
things
we've
learned
over
the
last
few
years
is
that
quality
of
care
is
not
static.
B
The
outstanding
hospitals
are
those
who've
got
a
really
really
entrenched,
embedded
quality
improvement
culture
where
every
day
they're
looking
to
improve
their
services.
So
every
day
their
services
are
getting
better
they're
getting
safer
than
they
were
the
day
before
and
building
that
quality
improvement.
View
of
quality
is,
I
think,
really
very
important
in
our
driving
improvement.
B
So
so
we
want
to
understand
how
we,
as
a
regulator,
can
import
can
can
support
all
services
to
to
embed
quality
improvement
as
part
of
their
culture
in
the
way
they
provide
care
so
driving
and
supporting
improvement
again
very
important
to
us
in
our
themes.
But
it's
promoting
safe
care
for
people
that
we'll
be
coming
back
to
in
a
moment
and
just
on
the
right
of
the
slide
there
we
recognize.
This
is
not
just
about
the
providers
changing.
B
It
is
about
us
as
a
regulator
changing,
and
we
do
not
underestimate
how
much
we
as
a
regulator,
need
to
change,
and
I
think
our
our
strategy
as
it
is
today
means
that
in
five
years
time
will
be
a
very
different
organization.
I've
talked
already
about
technology.
I've
talked
already
about
changing
the
way
we
relate
to
providers
and
people
using
services.
B
B
B
What
we
eventually
develop,
as
our
methodology
for
assessing
or
or
or
monitoring
or
inspecting
services,
won't
be
the
emergency
support
framework,
but
the
thinking
that
went
into
it
will
be
helped
drive
what
we
do
and
I
think
that
that
sense
of
a
supportive
regulatory
framework
rather
than
a
compliance
driven
framework,
is
one
we
want
to
develop.
But
equally
it
needs
to
the
rigor
to
make
sure
services
are
safe
and
I
think
getting
that
right
is
what
we
are
learning
to
do
at
the
moment
and
what
I'd
like
your
feedback
on
today.
B
Okay,
so
next
slide,
please
so
promoting
safe
care
for
people
now,
of
course,
safety
has
always
been
part
of
our
regulation.
Up
till
now
so
saying
talking
about
promoting
safety
is
not
new.
I
think
what
we
want
to
emphasize,
though,
is
our
thinking
about
safety
is
changing,
as
I
say,
I
think
we,
as
a
regulator
have
been
seen
to
be
a
compliance
driven,
tick
box,
driven
if
you
like,
and
I'm
sure
some
of
you
can
can
reflect
that
back
and
what
we
want
to
do
is
understand.
B
B
Now
when
we
were
looking
in
hospitals
18
months
ago
into
into
nether
events,
people
challenged
us
on
this
saying,
but
actually
don't
you
realize
shortage
of
resource
the
pressure
of
work
there
are.
It
is
very
difficult
under
those
pressures
to
consistently
always
deliver
care
as
safely
as
we
wanted
to,
and
that
is
a
very
real
concern.
I
think
of
providers.
But
equally,
I
think
we
as
a
regulator
want
to
challenge
that
we
want
to
say
actually,
you
know
whatever
the
circumstances.
B
Safety
should
always
be
top
of
the
list
and
he's
been
very
interesting
during
the
covid19
epidemic,
the
the
the
sense
that
safety
actually
should
be
coming
to
the
fore
during
the
kermit
19
epidemic
and
I've
seen
some
really
good
work
around
that
going
on
in
some
of
the
services
I
visited
during
the
epidemic.
So
there's
there's
a
real
sense
that
even
under
intense
pressure,
you
can
put
safety
first,
and
that
is
part
of
what
we're
talking
about
here.
B
The
expectation
that
that
safety
will
always
be
the
top
priority,
and
people
really
mean
that
and
deliver
that,
but
that
has
to
be
part
of
the
culture
we've
talked
here
in
some
of
the
other
aspects
of
safety
that
are
really
important.
Speaking
up
again
is
really
very
important
and
I
suppose
one
of
the
concerns
we
have
about
health
and
social
care
is
that
speaking
up,
cultures
are
very
variable
and
we
still
hear
far
too
often
the
fact
that
the
staff
feel
reluctant
to
speak
up
because
they
feel
they'll
be
blamed
or
or
there'll
be
some.
B
Detriment
to
them
about
speaking
up,
but
equally,
I
think
the
culture
in
which
they
work
doesn't
encourage.
Speaking
up
often,
the
culture
is
very
hierarchical
and
for
junior
people
to
speak
up,
it's
very
difficult.
It
is
very
difficult
because
it
is
seen
to
be
disruptive
and
not
playing
the
game.
Well,
in
actual
fact,
it's
speaking
out
should
be
seen
as
everyone's
responsibility.
B
How
can
we
get
to
a
culture
where
people
are
speaking
up
is
welcomed
because
speaking
up
about
safety
concerns
is
what
drives
safety
and
consistent
safety.
So
how
can
we
get
to
that
culture
and
how
can
we,
as
a
regulator,
get
to
encouraging
that
culture?
So
this
is
not
just
about
how
services
develop
it,
but
how
we,
as
a
regulator,
can
develop
a
culture
now
the
the
sense
about
when
something
goes
wrong,
not
blaming
the
people
involved,
but
actually
helping
them.
B
Learn
from
that
and
promote
that
learning
again
is
very
important
and
I
suppose
sometimes
we
as
a
regulator,
are
perceived
to
be
part
of
the
blame
culture.
I
think
that
is
a
concern
to
me.
How
can
we,
as
a
regulator,
still
be
an
effective
regulator
but
not
be
part
of
driving
the
blame
culture,
and
I
think
that
is
one
of
the
one
of
the
big
challenges
for
us
as
an
organization.
B
There
may
be
areas
where
we
want
to
prioritize
and
we
haven't
decided
on
any
priorities
yet,
but,
for
instance,
within
the
nhs
there
are
national
patient
safety
alerts
and
we've
been
working
with
nhs
improvement
to
make
sure
those
national
patient
safety
alerts
are
seen
as
a
priority
by
providers
and
and
that
priority
is
reflected
in
our
regulation.
What
about
other
parts
of
healthcare?
What
about
social
care?
How
do
we
set
priorities
in
those
areas?
How
do
we
make
sure
that
people
understand
the
priorities
in
those
areas?
B
For
instance,
we
know
that
there
are
enormous
numbers
of
safety
of
medicine
safety
errors
across
the
nhs.
We
have
no
idea
how
many
there
are
in
social
care,
but
there's
no
reason
to
think
that
the
safety
risks
are
any
different.
How
do
we
work
across
the
whole
health
and
social
care
system
to
make
sure
there's
a
common
understanding
of
safety?
I
think
is
one
of
the
things
we
need
to
understand.
B
We
want
to
work
with
providers
to
identify
safety
issues
and
particularly
where
those
safety
issues
fall
as
the
boundary
between
different
providers,
and
this
comes
back
to
the
system
integration
we're
talking
about,
and
this
is
interesting
one.
If
you
looked
at
our
local
system
reviews
from
about
two
years
ago,
there
was
a
report
on
that
called
beyond
barriers
which,
which
was
very
influential
in
our
internal
thinking
in
the
cqc,
and
very
much-
is
a
driver
behind
this.
This
strategy,
but
also,
I
think,
influential
beyond
that.
B
One
of
the
one
of
the
things
we
launched
about
two
years
ago
now
was
a
policy
for
healthcare,
called
learning
from
deaths
and
one
of
the
one
of
the
items
that
we
we
found
was
really
significant.
There
was
that,
if
patients
didn't
die
within
a
provider,
their
death
was
often
not
investigated
because
they
died
somewhere
else.
So
if
someone
died
after
being
discharged
home
often
the
pride
didn't
look
into
why
they
died
and
what
we
said
was
it's
important
people
understand
that
even
people
who've
left
your
service.
B
It
may
be
important
to
understand
what
has
happened
to
them
in
their
care
so
that
we
can
learn
the
lessons
and
improve,
and
so
this
moving
safety,
so
isn't
provider
specific
but
built
across
systems.
I
think
is
increasingly
important
and
I
think
the
penultimate
bullet
point
there
is,
I
think,
potentially
transformational.
B
That's
focused
around
our
understanding
of
the
services
we
provide,
while
the
people
using
services
may
think
about
safety
in
a
very
different
way,
and
some
of
that
may
be
about
their
or
autonomy
as
individuals
and
about
you
know
the
respect
for
that,
but
some
of
it
may
just
be.
They
see
things
in
a
different
way
and
they
can
see
safety
risks
that
we
can't
see
because
they
are
seeing
it
through
the
eyes
of
people
using
services
and
so
what
we
want
to
as
part
of
the
safety
culture
we
want
to
encourage.
B
We
want
to
make
sure
that
people
who
use
services
are
influential
in
that
safety
culture
not
seen
as
recipients
of
the
safety
culture
but
equal
partners
so
setting
safety
priorities.
How
do
you
involve
service
users,
understanding
safety
risks?
How
do
you
involve
service
users
investigating
and
learning
from
from
safety
issues?
How
do
you
involve
service
users
they're
going
to
ask
the
questions
that
perhaps
the
professionals
won't
ask?
B
That
is
something
we're
constantly
challenging
ourselves
to
do
and
we
believe,
as
a
smarter
regulator,
we
should
be
able
to
do
that
better
and
that's
going
to
be
a
challenge
for
us
in
terms
of
regulation
going
forward.
So
those
are
lots
of
comments.
I've
made
about
safety
for
you
and
I
hope
they
they've
stimulated
some
thinking
for
you.
Can
we
go
on
the
next
slide,
please
so
safety?
These
are
some
of
the
questions
that
perhaps
we
can.
I
can
challenge
to
you.
B
Do
you
do
you
agree
with
some
of
the
things
I've
said:
what
are
the
barriers
to
a
safe
culture?
Do
you
see
other
barriers
that
perhaps
I
haven't
touched
on
and
that
you
think
we
need
to
focus
on
this
point
about
people
being
partners
in
their
own
safety?
How
can
we
make
it
real
last
we
want
to
do
is
to
create
a
kind
of
tokenistic
culture
where
people
are
are
invited
to
to
get
involved
in
safety.
B
Want
this
to
be
real,
we
want
people
who
are
using
services
to
fill
real
partners
in
safety
where
they
want
to
where
they
want
to.
How
can
we
develop
our
role
as
a
leader
in
this
area?
Now
safety
clearly
means
we
have
to
work
with
other
parts
of
the
system,
because
safety
is
not
purely
our
we're,
not
the
only
leaders
in
this
area,
and
so
I've
talked
about
working
with
other
regulators
very
important.
But
how
can
the
cqc
develop
its
role
in
this
area
and
what
are
the
drivers?
B
The
cpc
can
use
to
improve
safety
and
produce
promote
safe
care
for
people?
Are
there
any
crew
drivers
that
I
haven't
mentioned
that
you
think
are
important,
or
is
there
any
way
we
can
use
the
drivers?
I
have
mentioned
it
in
different
ways
to
drive
safety
over
to
you
now
send
your
questions.
Now
I
haven't,
got
the
chat
screen
up,
so
I
can't
see
what
there
is
on
it.
So
can
I
hand
over
to
one
of
my
colleagues
just
to
highlight
any
questions
or
comments
or
feedback
that
there
is.
A
That's
that's
great
thanks
ted,
just
to
say
to
everybody
on
the
call
today
that
everybody
will
receive
this
slide
pack
after
after
the
webinar
today
and
we'll
also,
the
recording
of
this
webinar
will
go
on
to
our
website
as
well.
So
you
don't
have
to
worry
about
that,
and
we've
had
a
lot
of
queries
through
around
testing
and
also
the
esf,
and
we
will
get
back
to
those
individuals
outside
of
this
webinar,
but
we'll
stick
to
the
strategy
questions
today.
A
B
Okay,
well,
the
the
the
chair
there
was
that
one
is
the
conversations
are
going
on
at
the
moment.
So
your
feedback
today
is
important
and
towards
the
end
of
this
webinar
I'll,
give
you
some
more
details
about
how
you
can
stay
abreast
of
what
we're
doing
and
how
you
can
feed
back
into
that,
and
there
are,
of
course,
more
webinars
being
organized
so
very
much.
B
We
want
your
involvement
in
that
there
will
be
a
formal
consultation
that
comes
out
in
it
over
the
winter
months
which
which
I
mentioned
earlier
on,
and
we
want
as
many
people
to
contribute
to
that
as
possible.
So
so
please
do
get
involved
in
the
consultations
going
on
at
the
moment.
It's
very
dynamic
we're
very
interested
in
your
views,
but
please
do
respond
to
the
formal
consultation
as
well.
A
B
Well,
we
want
to
look
at
systems
and
how
systems
work
together,
and
it's
so
it's
very
important
that
that
that
we
we
understand
the
system
dynamics
and
how
they
work
together.
We
don't
regulate
commissioners,
and
so
so
you
know
we
don't
regulate.
Commissioners
and
and
for
us
to
regulate
commissions,
would
mean
a
change
in
legislation,
but
what
we
want
to
do
is
work
with
commissioning
bodies
as
partners
in
this.
Interestingly,
the
with
the
development
of
integrated
care
systems
in
in
health
and
social
care.
B
There
will
be
a
blurring
of
lines
between
commissioning
and
providers.
Integrated
care
systems
are
present,
not
legal
entities
so
that
we
will
not
register
them
as
such
and
we'll
need
to
find
a
way
of
relating
to
them.
If
they
become
legal
entities,
then
they'll
become
registerable
providers
and
there'll
be
an
opportunity
for
us
to
have
a
more
direct,
regulated
relationship
with
them.
So
I
think,
in
answer
to
your
question,
we
don't
have
the
power
to
regulate
commissions.
At
the
moment
we
have.
B
Without
those
powers,
we
can't
do
do
another
report
quite
like
that,
although
we
are
looking
at
how
providers
work
together
but
going
forward,
I
think
there's
a
real
need
for
regulation
and
commissioners
to
work
in
partnership
and
we're
very
keen
to
do
that.
Developing
our
strategy.
I
think
they're
important
partners
for
us,
as
are
the
providers
themselves.
B
I
think
there
is
a
there's,
a
real
sense
that
if
we're
gonna
provide
health
and
care
well
in
these
challenging
times,
we
all
need
to
work
together.
There
needs
to
be
collaboration,
so
we
need
to
respect
each
other's
roles
but
be
willing
to
collaborate,
and
that
applies
to
us
as
the
regulator
as
much
as
the
commissioners
and
the
providers,
and
I
think
you
know
that
is
a
real
challenge
for
us
all,
because
the
system
can
sometimes
feel
very
fragmented.
A
B
We
well
the
the
emergency
support
framework,
is
an
opportunity
for
us
to
talk
to
providers
and
explore
how
they
perceive
their
risk.
As
I
say,
we
want
to
do
that
in
a
supportive
way
and
we
are
very
much
listening
to
what
they
tell
us
about
the
challenges
for
them,
but
that
doesn't
mean
we're
not
listening
to
service
users
who
are
raising
concerns
with
us.
B
That
doesn't
mean
we're
not
listening
to
members
of
staff
who
are
raising
concerns
with
us,
and
that
does
not
mean
we're
monitoring
outcomes
where
we
have
access
to
data
on
that.
So
so
we
are
looking
at
re
at
at
safety
in
the
round.
We
want
to
support
us.
We
want
to
take
a
supportive
view
to
reflect
what
I'm
saying,
but
equally,
if
we
identify
safety
risks
in
care
homes
or
any
other
providers.
I
should
say
this
is
not
unique
to
care
homes.
Then
we
will
take.
B
We
will,
if
necessary,
undertake
inspections,
and
at
the
moment
we
are
undertaking
responsive
inspections,
because
risk
has
been
identified
in
all
health
and
social
care
sectors.
So
so
those
inspections
are
going
on
at
the
moment,
regardless
of
the
of
the
pandemic
and
where
necessary,
we
are
taking
enforcement
action
to
protect
people.
B
So
our
basic
role
as
a
regulator
that
can
take
enforcement
action
to
protect
people
has
not
gone
away,
but
I
think
our
strategy
is
very
much
about
going
beyond
that
and
it's
about
smarter
regulation
to
come
back
to
what
I
said
purely
driving.
Safety
by
enforcement
has
limit
is
limited
and
how
it
can
drive
safety.
B
But
having
said
that,
if
we
really
want
safe
care
to
be
delivered
consistently,
we
have
to
work
in
collaboration
with
providers
and
with
people
using
services
to
build
a
really
strong
safety
culture
across
all
health
and
social
care.
And
that
is
our
ambition.
It
may
sound
very
ambitious
to
you,
but
what's
the
point
in
doing
this,
we're
really
ambitious
about
safety.
That's
really
what
I'm
challenging
myself
about.
A
B
But
smarter
regulation
has
to
be
about
understanding
having
a
a
real-time
viewer
of
quality
and
safety,
rather
than
the
episodic
view
of
quality
and
safety
that
comes
from
just
doing
inspections
according
to
a
timetable,
which
is
what
we,
which
is
what
we've
traditionally
done,
and
we
have
very
much
have
this
ambition
to
have
a
real-time
view
of
quality
and
safety
driven
by
a
technological
platform.
That
can
mean
that
when
we
do
intervene,
we're
intervening
in
the
right
places
at
the
right
time.
A
B
Yes,
but
this
interesting
interesting
question
chris,
there
is
a
lot
of
nice
guidance
and
what
we
can't
do
is
go
and
inspect
each
service
against
each
piece
of
nice
guidance
that
would
be
enormously
resource,
intensive
and
disruptive
to
the
service.
What
we
need
to
do
is
to
make
sure
the
services
are
led
in
a
way
that
puts
the
evidence-based
guidance
absolutely
at
the
core
of
delivering
safe
care.
So
this
comes
back
to
the
culture
question
I
I
talked
about
now.
B
That
doesn't
mean
we
won't
specifically
go
in
and
look
at
specific
bits
of
nice
guidance
occasionally,
but
what
we
can't
do
is
go
and
look
at
all
the
nice
guidance
all
the
time,
and
this
this
also
reflects
the
national
patient
safety
alerts
that
I
was
talking
about.
When
I
was
speaking,
we
are
now
working
with
nhs
improvement
to
make
sure
national
patient
safety
alerts
are
being
issued
on
a
consistent
way
and
we
will
be
going
and
inspecting
some
providers
about
around
specific
national
patient
safety
alerts.
B
But
fundamentally,
we
want
to
make
sure
the
providers
have
the
right
culture,
the
right
governance,
the
right
values
to
make
sure
that
safety
alerts
are
always
implemented,
not
to
wait
for
the
cqc
to
come
around
and
find
out
they're
not
and
then
do
something
about
it.
We
want
to
move
away
from
the
sense
of
people
are
waiting
for
the
cqc
to
tell
them
to
do
something
to
a
sense
where
the
system
it
delivers
consistently
on
safety
and
evidence-based
care
all
the
time,
and
that
is
very
much
about
leadership
and
culture.
B
A
That's
great
thanks,
ted
this
one's
anonymous,
but
social
care
often
have
a
blame
culture
within
safeguardings,
which
is
not
helpful
or
supportive.
Neither
does
it
help
with
the
lessons
learnt
principle.
How
do
you
plan
to
change
this
culture
from
social
services?
As
for
providers?
This
can
impact
what
impact
their
transparency
and
openness.
B
Absolutely
and
well
I
I
I
I'm
from
medical
background.
I
work
in
hospitals,
so
I
don't
comment
too
much
about
social
care,
but
having
said
that,
what
you
say
sounds
very
typical
of
what
I
see
in
lots
of
health
services
as
well,
and
I
think
this
blame
culture
is
very
difficult
because
it
is
part
of
the
system,
culture
and,
as
I
said
as
I
was
talking,
one
of
my
concerns
is:
how
do
we
stop
the
cqc
being
part
of
the
a
driver
of
the
system
culture
around
blame?
B
Let's
be
clear
about
this:
blame
does
not
drive
safety.
Blame
drives
defensive
behavior.
That
makes
things
less
safe.
That's
absolutely
clear
to
me
and
it's
abundantly
clear
for
any
any
examination
of
safety
cultures.
Blame
is
really
destructive
of
safety.
It
stops
people
being
open
about
things.
They're
worried
about-
and
the
last
thing
you
want-
is
people
not
to
be
open
about
things
they
worry
about,
because
actually,
that
is
the
most
important
opportunity
to
learn.
B
You
know
a
regulator
that
many
people
will
portray
as
a
regulator
that
blames
people
when
things
go
wrong,
become
a
regulator
that
drives
a
no
blame,
a
just
culture,
a
culture
where
people
feel
free
to
speak
up
and
people
you
know
are
not
worried
about
talking
about
safety
concerns
because
they
understand
generally
about
talking
about
them
and
being
open
about
them.
Will
they
ever
be
a
properly
addressed?
A
B
And
I
totally
agree
with
you:
I
totally
agree
with
you,
and
that
doesn't
mean
we
don't
have
a
role,
and
you
know-
and
this
is
one
of
the
problems
that
that
we
sometimes
have
is
we-
we
have
a
regulatory
role,
we
have
to
take
enforcement
action
where
we
see
problems
that
that
need
to
be
addressed.
That
doesn't
mean
we're
blaming
people.
We
are
just
doing
what
our
role
is
and
people
need
to
understand
and
respect
our
role,
but
also
need
to
work
with
us
to
make
that
role.
If
you
like
unnecessary.
A
Yes,
one
more
so
this
one
comes
from
lola
and
will
cqc
be
looking
at
developing
black
asian
minority
and
ethnicity
regulations
and
ensure
this
is
embedded
in
the
inspection
framework
to
promote
equality
of
opportunity,
diversity
and
inclusion
and
eradicate
race
inequality
and
help
drive
continuous
improvement
and
safe
care
within
the
health
and
social
care
sector
and
that's
from
lola.
Thank
you.
Lola.
B
And
the
answer
to
that
is
yes,
I
I
mean
I
talked
about
health
inequalities
and,
of
course,
one
of
the
things
that
has
come
really
clear
out
of
the
code.
19
epidemic
is
inequalities
around
race
in
terms
of
outcomes
from
the
kermit
19
and
understanding.
Why
that's
happening
and
what
services
are
doing
to
protect
people
against
the
effect
of
it?
Absolutely
because
it
goes
much
wider
than
that,
and
I
have
to
say,
I
think
one
of
the
frustrations
is
there's
a
lot
of
talk
about
health
inequalities
in
lots
of
parts
of
the
system.
B
But
actually
we
are
not
seeing
much
change
in
that
and
I
think
it's
absolutely
fundamental.
We
as
a
regulator
need
to
focus
on
that
area
and
we
will
build
building
all
aspects
of
health
inequalities,
including
race
equality,
into
our
inspection
process
going
forward.
We
already
take
very,
very
strong
note
of
workforce
rate
equality
in
the
nhs
as
part
of
our
well-led
inspections
and
we'll
continue
to
do
so.
So
we
very
much
want
to
be
a
real
major
driver
of
equality
across
the
health
and
social
care
service
system.
B
B
Okay,
fine,
so
let
me
this
slide
is
about,
and
it
comes
back
to
a
theme
that
I've
touched
on
several
times
during
this
this
webinar,
and
that
is
about
people
using
services
and
and
in
terms
of
safety.
I
think,
as
I
said,
I
think
if
we
can
involve
people
really
really
involve
people
as
equal
partners
in
using
services.
Then
I
think
that
could
be
transformational
and
safety,
and
I
strongly
think
that
that
is
the
way
forward.
B
It's
not
going
to
be
easy
because
it's
not
the
expectation
of
the
system,
it's
not
necessarily
expectation
of
service
users,
but
actually
there's
a
lot
of
wisdom
out
there
amongst
the
people
using
services.
They
can
challenge
our
thinking.
They
can
challenge.
Our
group
think
can
make
us
think
differently,
but
equally,
we
need
to
understand
from
people
from
people's
perspective,
about
how
the
services
work
for
them,
and
it's
really
central
to
our
thinking
going
forward
is
how
do
we
build
a
regulation
through
the
eyes
of
people
using
services?
B
So
this
comes
back
to
safety,
as
I
just
mentioned,
but
equally
comes
back
to
the
issues
about
systems
and
how
the
systems
create
care
around
people
using
services.
It
comes
back
to
what
I
should
talk
about
with
lola
about
how
people
get
consistent
care,
regardless
of
you
know
their
backgrounds,
whatever
they
may
be,
and
making
sure
that
people
are
health.
Inequalities
are
being
addressed
effectively,
and
I
think
you
know
this.
This
is
this
is
a
real
opportunity,
and
so
so
I
think
putting
people
at
heart.
B
Probably
the
easiest
way
to
get
involved
is
our
digital
platform,
and
you
can
see
the
the
web
address
there
in
terms
of
this,
and
this
is
an
opportunity
to
to
comment
on
a
much
more
frequent
basis
on
our
developing
strategy,
and
it
is
important
to
us.
So
please,
if
you
haven't
log
into
a
a
citizen,
lab
platform
and
get
involved
in
our
developing
strategy
development,
as
I
hope
I've
suggested
to
you
today.
There
is
a
lot
to
discuss
and
we
are
very
keen
on
hearing
your
views.
B
There
will
also
be
opportunities
in
the
regular
provider
bulletins
that
come
out
on
a
regular
basis
twice
a
month,
they've
had
a
strong
covit
19
focus
inevitably
over
the
last
few
months,
but
equally
there'll
be
opportunities
to
understand
further
chances
to
to
to
get
involved
in
our
in
our
strategic
development.
So
that
is
important
and
then,
of
course,
you
can
follow
us
on
cqc
twitter
account
and
that
will
have
latest
information
about
our
plans
and
developments
and
opportunities
to
get
involved.
So
please
do
get
involved
in
all
those.
B
Please
stay
with
us
and
contribute
it.
Our
strategy
will
only
be
better
with
your
comments
and
feedback,
so
it
is
important
for
us
that
we
hear
all
views
on
this
and
make
sure
that
we
take
into
account
everyone's
perspective
on
the
way
forward.
So
thank
you
for
that.
Next
slide,
please,
okay,
so
we
have,
I
think,
seven
or
eight
minutes
to
go.
So
there
are
opportunities
for
a
few
final
questions
on
the
strategy
or
anything
else
you
want
to
develop
so
over
to
you
again.
A
So,
there's
a
there's,
a
few
that
have
come
through
it.
I
just
want
to
we'll
take
three
because
they've
got
the
most
the
most
likes.
This
is
more
of
a
discussion
point,
but
this
is
rachel
frost
from
b's
care
agency
in
medway,
so
she's
put
a
post
about
barriers
to
safe
culture
she's,
but
there
are
so
many
times
that
nhs
social
services
do
not
provide
enough
information
or
the
correct
information
to
provide
us
when
handling
the
individual
into
their
care.
A
B
Well,
rachel
is
a
good
point
and
I
think
I
I
I
would
support
that.
It
is
often
people
being
transferred
for
different
parts
of
the
system
where
risks
really
occur,
and
one
of
the
key
elements
of
that
is
the
handover
of
information,
and
it
is
strange,
isn't
it
that
that
so
many
systems
have
multiple
different
information
systems
that
don't
talk
to
one
another
and
as
integrated
systems
develop
one
of
the
key
elements
that
is
going
to
drive.
B
That
is
an
integrated
information
system
so
that
you
know,
there's
no
area
where
people
information
about
individual
patients,
their
care,
their
care
plan
or
all
their
needs
are
lost
between
different
providers.
So
I
think
that's
a
real
challenge.
It
has
a
safety
risk,
but
it
also
has
a
risk
about
the
quality
of
care
overall,
and
I
think
I
I
think
that
is
a
real
challenge.
So,
yes,
safety,
isn't
just
about
safety
needs
visual
providers.
A
B
So
we
do
need
to
go
out
to
conversation
about
that
in
the
new
year
that
will
take
into
account
our
strategic
direction
in
terms
of
will
the
chloe's
change.
Well,
I
can't
preempt
that
at
the
moment,
because
we
haven't
made
that
decision,
we
are
working
on
it
and
we
want
to
consult
on
it.
I
think,
broadly,
the
clothes
won't
change
radically.
We
may
want
to
streamline
them
a
bit
in
order
in
order
to
make
sure
that
our
inspection
methodology
and
our
assessment
framework
is
as
efficient
as
effective
and
focused
as
possible.
A
B
Good
good
challenge-
and
I
think
it's
important-
I
mean
clearly
a
lot
of
this-
is
about
our
inspectors.
I
mean
we
want
our
inspectors
not
to
be
tick
box
inspectors.
We
want
them
to
use
their
own
professional
judgment.
A
lot
of
them
are
very,
very
experienced
and
skilled
in
what
they
do.
But
equally
consistency
is
a
constant
challenge
and
technology,
I
think,
will
help
us
help
us
improve
that
consistency
to
a
great
extent
by
creating
technological
platforms
to
drive
assessments
and
inspections.
But
this
is
never
going
to
be
just
a
tick
box
exercise.
B
We
will
inspec,
expect
our
inspectors
to
use
professional
judgement
and
to
focus
where
they
feel
focus
is
necessary
in
individual
providers,
but
let
just
to
come
back
to
what
are
saying
about
smarter
regulation
in
the
at
the
end.
If
inspection
drives
everything
could
we
do
in
regulation,
then
we're
not
in
smarter
regulation
territory,
and
I
think
we
would
like
to
build
up
our
understanding
of
the
quality
of
care
in
in
in
providers
with
by
that
relationship
with
providers
and
use
inspection
purely
as
a
backup
to
that,
rather
than
a
central
driver.
B
A
That's
great
I'll,
just
read
out
one
more
and
then
I
think
we'll
have
to
close
for
today,
but
just
to
say
to
everybody
that
we
have
captured
all
of
this
information
and
it
is
all
going
to
help
to
feed
and
shape
our
strategy
as
we
develop
it.
And
so
this
is
from
marie
patterson.
Will
you
be
sharing
best
practice
in
regard
to
supporting
service
users
to
have
a
voice
or
how
we
can
capture
the
views
of
service
users?
Experiences
of
services.
B
Well,
I
I
I
think
we
should,
because
we
want
to
promote
that
and
clearly
we
need
to
learn
what
best
practice
is
and
promote
that.
But
I
think
one
of
our
jobs
and
driving
improvement
is
to
identify
and
celebrate
services
that
are
doing
aspects
of
care
really
well,
and
you
know
if
we
really
believe
that
that's
this
involvement
of
service
users
is
really
transformational,
then
we
want
to
see
it
done
really.
B
Okay,
well,
in
which
case,
thank
you
thank
you
for
my
colleagues
at
cqc
for
their
support
and
thank
you.
Everyone,
who's
joined
the
webinar.
I
hope
it's
been
interesting
to
you.
I
hope
it's
been
stimulating
and
I
hope
you've
got
some
sense
about
where
we're
going,
but
also
some
sense
about
how
you
can
influence
where
we're
going,
because,
as
I
say,
nothing
is
set
in
stone,
yet
we'll
be
going
out
for
a
formal
consultation
later
and
we're
very
much
interested
in
your
continuing
review.