►
Description
We have been running our engagement sessions since June 2021, focussing on different topics to support the delivery of our new strategy.
We’ve held seven events which have brought together providers and professionals who work in health and social care, the organisations who represent them and other strategic stakeholders where their views and feedback have informed the development of our work and in this latest engagement session we:
• Gave an overview of progress to date across the whole new regulatory model
• Showed what we’ve developed following on from previous sessions
• What we’ll be developing next
• Share how we’ll continue to develop and implement
• Tested our current thinking on the above and gathered feedback
The session was led by Dave James, Head of Policy. Watch the presentation and feedback session here.
B
A
A
We're
gonna
do
our
best
to
stick
to
time
today
and
just
to
say
that
our
our
session
in
the
main
room
will
be
recorded,
we're
not
recording
our
breakout
rooms,
but
our
main
room
session
will
be
recorded
and
today's
all
about
working
together.
So
that's
if
we
can
all
be
nonjudgmental
and
respectful
in
how
we
work
and
supportive.
A
Sorry,
I'm
I'm
not
synced
here
to
the
agenda,
so
welcome
introductions
and
then
I'm
going
to
talk
for
around
about
20
to
30
minutes
it
may
or
not.
Take
that
long,
just
to
kind
of
bring
you
up
to
date.
Some
of
that
will
be
a
recap
on
on
the
developing
approach
that
we've
been
working
on.
Some
of
it
will
be
newer
and
that
will
set
us
up
for
our
our
our
sessions
in
the
breakout
rooms.
A
There'll
be
a
chance
after
I've
gone
through
that
presentation,
just
to
kind
of
clear
up
any
any
questions
that
are
arisen
and
then
we'll
have
about
25
minutes
in
our
separate
rooms.
To
have
that
more
focused
discussion
coming
back
at
quarter
past
11,
to
hear
some
of
the
key
points
that
people
have
raised
and
some
of
the
things
that
have
come
out
of
those
conversations
wrapping
up
by
11
30.
A
A
So
in
this
first
slide
we're
just
setting
out
here
how
our
proposed
future
approach
differs
from
what
we
do
now.
So
at
the
moment
we
have
four
assessment
frameworks.
I'm
in
that
top
left
hand
square
there.
We
have
one
for
health,
one
for
social
care
in
terms
of
inspection
and
then
the
same
again
on
our
registration
side.
A
A
I
think
the
other
thing
to
say
about
the
assessment
frameworks,
as
well
as
the
kind
of
the
complexity
the
length
and
and
some
of
the
duplication
that
sits
within
them
is
it's
been
some
time
since
we've
updated
them,
and
health
and
social
care
have
moved
on.
So
we
really
need
to
make
sure
that
our
frameworks
are
are
keeping
pace
with
how
health
and
care
are
delivered
currently
and
and
and
sets
up
for
the
future.
A
In
making
judgments,
we
use
our
key
lines
to
inquiry
and
then
take
away
what
we've
seen
and
found
and
line
that
up
against
our
ratings
characteristics,
of
which
there
are
70
pages.
So
again,
just
to
underline
that
complexity
and
and
the
density
of
our
current
approach,
we
don't
feel-
and
we've
certainly
heard
this
back
from
from
from
our
stakeholders.
A
When
we've,
when
we've
tested
this,
we
don't
feel
that's
as
clear
and
as
accessible
as
it
should
be
for
providers
and
for
people
that
are
working
in
health
and
social
care
to
understand
what
good
looks
like
and
that
whole
process
is
is
very
much
it
kind
of
takes
place
in
in
a
sort
of
offline
space.
So
it's
very
there's
not
a
lot
of
structure
to
that.
A
So
about
what
we're
stepping
into
then
is
a
single
assessment
framework.
And
I'm
just
gonna
break
that
down
in
a
in
a
in
a
moment
which
will
apply
equally
across
all
of
health
and
social
care
and
not
just
to
provide
us
but
to
our
new
duties
in
relation
to
local
authorities
and
integrated
care
system
assessment.
As
well
and
the
process
will
be
much
more
much
more
of
an
ongoing
assessment
of
of
quality
and
risk,
so
really
stepping
away
from
that
distinction
between
monitoring
and
inspection.
A
It's
much
more
about
an
ongoing
program
of
evidence
gathering
and
considering
how
the
evidence
lines
up
against
our
framework
and
and
updating
our
findings,
and
I
think
the
other
key
point
then
to
make
is
that
this
is.
This
is
much
more
about
multiple
points
in
time.
We
want
to
develop
an
approach
that
allows
us
to
to
combine
older
evidence
with
with
newer,
but
within
defined
parameters.
We
need
to
be
sh.
A
We
need
to
be
really
clear
and
that's
partly
what
today
is
about
it's
time
to
explore
this,
how
how
old
can
evidence
get
and
that
will
we
think
that
will
vary
depending
on
the
service
model
and
the
circumstances
and
on
the
particular
evidence
itself.
So
a
strategy
doesn't
need
to
be
looked
at
every
six
months,
but
but
people's
care
plans
and
care
records
would
be
looked
at
more
frequently.
So
it's
trying
to
break
this
down
into
more
sensible
and
manageable
chunks
to
allow
us
to
to
iterate
our
judgments.
A
The
other
change
you'll
have
heard
us
talk
about,
then,
is
using
a
scoring
system.
So,
instead
of
lining
up
against
the
very
narrative
ratings
characteristics,
we
actually
want
to
take
the
principles
that
those
characteristics
are
trying
to
describe
and
put
those
onto
a
four
point
ratings
scale
which
then
aggregates
up
to
give
to
give
ratings,
and
we
want
to
do
a
lot
more
work
to
to
improve
the
how
long
it
takes
us
to
write
up
those
reports
and
and
the
clarity
of
those.
A
So
that's
now
in
the
future.
In
a
nutshell,
if
you
can
move
on
to
the
next
slide,
please
so
I
mentioned
the
assessment
framework,
the
single
assessment
framework
that
we
are
going
to
be
applying
to
essentially
everything
that
we
do
so
that's
providers,
local
authorities
and
integrated
care
systems
we'll
still
be
working
to
the
five
key
questions
of
safe,
effective
caring,
responsive
and
well
led.
A
That's
what
I
expect
and
that's
what
being
treated
as
a
as
a
human
being
and
and
and
as
a
person
really
means
in
in
plain
english
and
we've.
We
think
that's
really
powerful
and
people
have
supported
this
approach.
It's
a
really
powerful
way
of
just
just
kind
of
cutting
through
what
can
easily
turn
into
lots
of
regulatory
noise
and
narrative,
and
actually
just
starting
from
that
simple
place
and
having
that
as
our
north
star
really
is,
what's
gathered.
A
Everything
and
that's
that's
that's
what
we
want
to
be
focused
on
as
we
as
we
step
into
our
future
model
stepping
down
into
the
next
layer,
then
the
quality
statements
we've
borrowed
from
the
style
of
making
it
real
just
think.
Look
at
that
personal
framework,
because,
if
you're
familiar
with
that
you'll
know,
they
also
use
we
statements
and
they
are
essentially
commitments
that
providers
and
commissioners
and
system
leaders
would
make
in
order
to
deliver
on
that
that
level
of
person-centered
care
that
people
have
described.
A
A
We've
had
to
change
those
essentially
because
they
didn't
all
work
for
all
the
different
sectors
that
they
need
to.
They
didn't
work
for
local
authorities
and
integrated
care
systems,
which
a
subset
of
those
statements
would
would
need
to
so.
We've
borrowed
from
the
from
the
really
clear
and
actionable
kind
of
language
of
the
we
statement,
but
yeah
we've
not
actually
used
the
ones
from
the
making
it
real
framework
stepping
down
into
the
evidence.
This
is
essentially
what
the
key
lines
of
inquiry
have
become.
A
So
what
we
found
in
looking
at
those
four
assessment
frameworks
I
mentioned
in
particular
the
inspection
ones
for
our
main
focus
here-
was
that
well,
firstly,
we're
at
we
asked
335
questions
whether
they
were
key
lines
of
inquiry
or
prompts
in
our
documented
methodology,
where
335
separate
questions,
which
is,
is
quite
staggering,
I
think,
and
quite
a
sobering
a
number
to
be
aware
of
what
we
found
is.
Actually.
A
We
are
essentially
asking
six
questions
over
and
over
again,
but
the
reason
that
balloons
so
much
is
because
the
starting
point
in
our
current
framework
are
those
key
lines
of
inquiry.
So
we
we
we
roll
in
the
topic
and
the
source
of
evidence
into
each
of
those
questions
and
very
quickly.
That's
how
you
kind
of
snowball
into
that
huge
amount
of
questions
if
you
flip
that
around
and
if
you
start
with
the
the
expectation
of
quality,
so
the
wii
statement
pitched
at
good,
describes
good,
then
you
can
ask
much
more
simple
questions.
A
A
What
can
we
learn
from
policies,
processes
and
procedures,
and
what
do
what
does?
What
does
the
data,
around
outcomes
and
performance
tell
us,
and
really
that
does
sum
up
all
of
those
335
questions,
so
they
are
part
of
the
engine
room
of
what
we're
looking
to
deliver
here
and
that
might
make
more
sense
as
we
go
through
the
subsequent
slides.
A
Of
course,
at
the
detailed
level,
the
actual
evidence
we
need
to
look
at
would
be
very
different
and
the
actual
best
practice
and
standards
and
guidance
would
be
very
different
across
the
different
models
of
delivery.
So
that
bottom
tier
is
where
we
need
to
be
more
specific
and
and
tailor
the
evidence
requirements
to
the
model
of
delivery
or
to
whether
it's
provider,
integrated
care
system
or
local
authority.
C
A
A
If
we
can
move
on.
Thank
you,
so
the
the
next
few
slides,
then
and
kind
of
building
on
what
we've
talked
about
here
are
trying
to
get
to.
How
does
this
all
add
up
to
a
more
structured
and
consistent
approach,
and
what
will
be
essential
here
is
developing
those
rules
for
the
different
evidence
categories
and
essentially
the
timetables
for
how
frequently
those
evidence
pots
need
to
be
filled
up.
A
Going
back
to
my
point
earlier
that
we're
stepping
away
from
the
big
set-piece
inspections
and
actually
being
more
flexible
in
how
we
gather
evidence
and
tailoring
our
approach
to
to
the
evidence.
So
clearly,
if
we
need
to
observe
care,
we
need
to
be
in
the
setting,
but
we
don't
need
to
be
in
the
setting
to
to
review
documentation
or
to
to
look
at
data.
A
So
it's
really
tailoring
our
approach
and
making
sure
we
make
the
best
use
of
time
on
site
and
that
will
vary
according
to
according
to
the
service
model,
of
course,
so
community-based
community-based
social
care.
There's
not
gonna,
be
really
any
observation,
but
in
in
residential
settings,
for
instance,
or
where
there's
we
might
have
concerns
of
a
close
culture.
Developing
then
would
certainly
be
in
there
much
more
frequently
and
understanding
how
people
are
cared
for,
what
they.
A
Essentially,
I've
talked
about
the
scoring
and
and
that
we
will
be
looking
to
score
those
quality
statements,
those
we
statements
that
would
be
driven
by
scoring
the
the
categories
of
evidence.
So
people's
experience,
we
would
maintain
a
score
on
a
four-point
scale
of
what
we're
hearing
from
people
I
score
for
the
policies,
proceed,
policies,
procedures
and
what
we're
hearing
from
partners
and
that
kind
of
flows
up
to
give
us
a
score
for
the
quality
statement.
Ultimately,
updating
ratings.
A
So
this
is
illustrative
and
great
pains
to
say
that
please
don't
take
a
screenshot
of
this
and
and
think
this
is
how
it
works,
but
this
is
just
trying
to
bring
it
to
life
a
fairly
high
level
in
terms
of
the
categories
of
service
models,
so
we've
got
residential,
inpatient,
community
and
digital
there
and
then
the
six
evidence
categories
along
the
top.
So
just
just
in
case,
because
some
of
this
is,
I
think,
is
quite
difficult
to
visualize.
A
So
this
is
just
one
one
way
of
bringing
it
to
life,
and
this
would
as
I'll
go
into
explain
in
a
moment
this.
This
would
vary
but
broadly,
this
is
essentially
what
a
national
profile
might
look
like
for
each
of
these
service
models,
so
with
observation,
perhaps
happening
once
a
year
in
residential
similarly
was
actively
gathering
people's
experience
once
a
year,
potentially
every
two
years,
speaking
to
staff
and
leaders.
But
please
don't
take
this
as
in
any
way
carving
stone.
A
It
really
isn't
it's
just
to
bring
this
to
life
and
give
us
some
different
numbers,
so
those
first
three
columns
are
very
much
about
what
what
is
it
cqc
initiates?
What
do
we
actively
go
out
and
gather-
and
I
think
these
last
three
a
little
bit
more
about
what
can
we?
What
do
we
need
to
make
sure
that
we're
that
that
we're
receiving
in
terms
of
what
can
we
hear
from
our
partners,
and
that
might
be
an
annual
schedule
across
that
top
row?
A
And
okay,
I'm
gonna
move
us
on.
So
really
what
sits
behind
this?
What
kind
of
gets
us
to
to
to
that
table
we've
just
been
looking
at
is
is
a
a
series
of
steps
and-
and
this
slide
is
just
trying
to
describe
how
how
we
overlay
different
layers
of
activity
to
to
to
get
us
to
that
right
hand,
side
of
the
pages,
which
was
where
we
are
going
on
to
make
an
assessment
and
updating
our
scores
for
the
different
evidence
categories.
A
So,
starting
over
on
the
left,
we
will
develop
essentially
a
kind
of
a
starting
position.
I
suppose
the
national
profiles
based
on
service
delivery
model
based
on
what
we
know
about
risks
in
that
in
that
sub
sector,
or
perhaps
also
based
on
national
priorities,
but
that
kind
of
gives
us
kind
of
a
a
version.
One
of
what
a
timetable
for
evidence.
A
So
we
wouldn't
want
to
be
in
a
position
where
we're
essentially
changing,
published
information
and
published
assessments
as
frequently
as
evidence
changes,
because
that
could
be
daily
as,
as
I'm
sure
we
all
know,
we
don't
want
to
be
getting
stepping
into
the
shoes
of
providers
and
actually
doing
their
work
for
them.
There
needs
to
be
an
appropriate
balance,
and
we've
certainly
heard
that
before
and
we've
talked
about
this
idea.
So
what
we're
really
keen
to
hear
about
is
how
would
we?
A
So
the
kind
of
evidence
builds
up
and
provided
there's
nothing
in
there,
which
is
which
is
flagging,
urgent
risk,
which
of
course,
we
would
always
respond
to
immediately.
We
can
allow
that
evidence
to
build
up
and
then
step
into
that
assessment
mode
and
look
at
okay.
What
does
this
tell
us
about
people's
experience?
Are
we
seeing
a
change
here?
Do
we
need
to
update
our
score
of
that
evidence
category
and
what?
What
are
we
hearing
about?
A
But
perhaps
we
would
have
have
a
slower
update
in
terms
of
what
gets
published.
So
we
would
maintain
an
always-on
view
for
providers
of
their
evidence.
Category
scores
what's
published.
Are
the
quality
statement
scores
those
we
statements
that
I
talked
about
and,
of
course,
the
ratings,
and
what
we're
keen
to
understand
is:
can
we
set
some
rules?
A
So
we
don't
update
those
published
judgments
unless
there's
a
change
essentially
or
unless
the
the
time
period
that
we've
set,
and
we
need
to
agree
these,
and
this
is
again
what
today's
about
the
time
period
for
those
being
updated
has
been
reached.
So
we
would
always
confirm
that
judgment
is
up
to
date
against
those
quality
statements
on
our
website.
A
So
it's
it's
breaking
it
down
into
a
different
components
and
different
layers
of
of
detail
and
what's
useful
for
you
to
see
and
to
maintain
an
ongoing
view
of
so
you
can
see
your
direction
of
travel
as
providers
and
what
are
how
our
assessments
are
squaring
up
against
that
and
and
versus
what
what
needs
to
be
in
the
public
domain?
How
do
we
make
sure
that's
always
up
to
date,
but
not,
but
not
too
much,
because
it
could
just
get
very
confusing.
A
Do
the
benefit
that
we
that
we
think
we
would
get
from
exposing
those
scores
on
a
live
and
ongoing
basis
to
providers
is?
Is
it
might
just
reduce
the
need
for
the
levels
of
challenge
that
we
see
in
terms
of
factual
accuracy
and
ratings
reviews?
If
you
can
see
on
a
much
more
up-to-date
basis
how
we
are
considering
the
evidence
that
we
have
that
we've
gathered
or
has
been
sent
to
us,
you
can
offer
other
evidence.
A
You
can
offer,
offer
some
some
of
the
material
that
would
that
would
balance
that
picture
out
essentially
and
so
we're
trying
to
get
into
a
much
more,
I
suppose,
a
much
more
mature
relationship
in
terms
of
how
we
work
with
with
providers
and
just
to
repeat
myself.
That
would
be
the
same
for
local
authorities
and
integrity
care
systems
as
well.
Quite
a
lot
on
that
slide,
but
the
next
slide
just
brings
to
life
a
little
bit.
A
A
A
Sorry,
my
notes
aren't
making
sense
here
so
essentially
yeah
a
timetable
for
for
evidence,
collection
as
as
set
out
in
that
example
table,
and
then
how
that
would
play
out.
There's
an
annual
gp
patient
experience
survey.
We
get
those
results
annually,
we
receive
annual
vaccination
rates
and
we
receive
annual
cancer
detection
rates.
A
So
that
starts
to
to
build
up
those
pots
of
evidence.
We
we
would
be
seeing
on
a
quarterly
basis,
prescribing
indicators
such
such
as
antibiotic
synthetics
control,
drugs
and
so
on.
Quarterly
updates
on
cervical
cancer
screening
monthly
updates
on
analysis
of
feedback
from
people
using
services
such
as
through
our
own,
give
feedback
on
care
service
or
through
the
nhs
choices
and
weighing
that
up
against
what
we
know
about
quality
in
that
area
or
in
that
service.
So
in
this
example,
the
service
is
good.
A
There
is
no
flagging
risk
in
terms
of
this
service.
There
are
some
concerns
in
this
geographical
patch
around
access
to
services.
So
what
that
would
do
is
that
might
just
nudge
the
timetable
and
and
kind
of
ramp
up
how
frequently
we've
been
looking
to
gather
evidence
that
lines
up
against
that
quality
statement
and
in
line
with
that
timetable,
we're
updating
our
our
evidence,
category
scores
that
hits
a
few
of
the
quality
statements.
A
So
the
evidence
will
relate
to
different
quality
statements
and
in
this
example,
for
instance,
six
quarter
statements
are
updated.
Some
scores
have
improved.
Some
scores
have
declined,
but
none
of
that
has
been
sufficiently
significant
to
change
the
overarching
rating
which
which
is
good
and
so
just
to
bring
it
to
life
a
little
bit
in
terms
of
the
different
levels
of
interaction
with
evidence
and
how
that
how
that
plays
through
so
we're
kind
of
at
the
start
of
the
next
phase
of
of
activity
here.
D
A
My
colleague
who's
leading
that
work
isn't
isn't
with
us
today,
but
I
I
I
think
what
I
would
say
is
we
need
to
make
sure
we
don't
create
another
layer
of
reporting
unnecessarily.
We
we
need
to
make
sure
that
we
that
we
link
in
with
how
nhs
england
already
fulfill
their
duties
and
how
we
complement
that
and
add
value,
and
it's
a
similar,
similar
issue
on
the
local
authority
side.
A
There's
already
lots
going
on
there
and
how
improvement
is
supported
and
driven,
and
what
we
don't
want
to
do
is
just
kind
of
step
in
the
way
of
all
that
we
need
to
work
out.
Where
do
we
add
value,
and
but
I
would
expect
that
some
information
would
be
would
be
needed
to
be
sent
to
us
if
it
doesn't
already
exist
somewhere
else
that
that's
our
watch
word
same
for
the
provider
approach.
If
it
already
exist
somewhere,
we
don't
need
to
come
and
ask
providers
for
it.
We
can.
We
can
use
what
already
exists.
A
D
E
A
We
we
would,
we
would
have
that
on
our
well
I'll
give
feedback
on
care
service.
We
already
have
that
option.
You
know
people
can
can
raise
with
concerns.
We
wouldn't
expect
providers
to
give
us
a
day
by
day
up
to
date,
submission
of
what
they're
hearing
in
terms
of
complaints,
but
we
would.
There
is
a
quality
statement
in
there
in
there.
That's
about
how
people
are
encouraged
to
share
feedback
and
and
people
that
want
to
complain,
are
supported.
A
E
E
A
Don't
do
that?
No!
No!
We
don't
have
the
the
resources
for
that,
but
we
will
consider
what
kind
of
the
insight
that
we
can
draw
from
those
complaints
and
whether
they
point
to
specific
concerns,
and
we
would
look
to
follow
that
up.
We
we
do
want
to
get
better
at
kind
of
closing
the
feedback
loop
for
people
in
terms
of
when
they've
shared
information
with
us,
and
we
and
we've
gone
on
to
do
whatever
it
might
be
at
the
moment.
E
A
E
E
Yeah,
do
you
think
the
only
question
I
actually
have
as
well?
It's
like
you
know.
Currently
we
actually
meet
in
limbo
because
we
really
cobain
so
and
so
forth.
So
our
actual
assessment
inspection
was
based
on
the
previous
process
and
framework.
Now
what
happened
to
people?
I
could
look
like
ourselves
do
we
are
we
actually
reassessed
in
the
previous
framework
or
the
new
framework.
A
A
What
I
think
what
that
will
probably
look
like
is:
we
need
to
transition,
so
we
need
to
convert
what
your
current
findings
are.
What
your
current
kind
of
ratings
are,
if
you
like,
and
the
judgments
were
published
into
the
new
framework,
so
kind
of
drop
that
into
the
the
categories
that
we
have
our
clear,
a
framework
in
the
single
assessment
framework
and
and
convert
that
into
into
the
scores
and
that's
kind
of
the
baseline,
so
we're
able
to
start
from
that.
So
that's
that's!
Our
preferred
approach
is
to
actually
transition.
A
We
don't
in
fact
I
can
rule
it
out,
we're
not.
We
don't
need
to
go
out
and
do
a
comprehensive
program
using
the
the
new
approach.
It's
it's
more
about.
How
does
our
current
set
of
judgments
line
up
with
our
the
future
way
that
we
want
to
structure
our
assessments
and
report
on
what
we
find
and,
and
so
the
baseline's
already
there
yeah.
E
So,
for
example,
in
our
case
we
were
our
previous
inspection.
We
we
required
improvement
on
our
long-term
conditions.
Okay,
so
what
we've
actually
done?
We've
done
a
lot
of
work
in
long-term
condition,
with
the
rcgp
as
well
and
with
the
support
of
our
ccg
as
well,
and
we're
using
arden's
long-term
conditions
template
now
going
forward,
and
then
we
can
see
compared
to
previous
years
figures
great
there's,
a
massive
improvement,
the
right
trajectory
so
and
so
forth.
A
E
E
A
F
That's
fine,
my
name
is
so,
I
suppose,
just
to
say.
Thank
you
very
much,
for
this
is
the
first
time
I've
attended
the
the
session
that
you've
kind
of
presented.
I
think
my
question
is
around
the
the
new
ics
and
I
absolutely
understand
that
there
isn't
another
layer
of
regulation
that
you
want
to
create.
However,
things
are
really
going
to
be
changing,
so
you've
got
you
know,
providers
are
going
to
be
working
together.
A
So
it's
it's
going
to
be
about
what
aspects
of
of
that
framework
make
most
sense
to
look
at
through
the
local
authority
lens
and
what
makes
most
sense
to
look
at
through
the
integrated
care
systems
lens
and
so
perhaps
an
example
of
that
is.
There
is
a
commitment
in
there
we
statement
about
insuring
as
enough
simply
skilled
work,
staff
and
workforce.
A
Clearly,
that's
a
provider
issue
that
we
need
to
stay
on
top
of
and
make
an
assessment
of,
and
potentially
we
could
look
at
the
local
authority
level,
but
actually
what
we're
most
interested
in
is:
what's
the
integrated
workforce
strategy
at
system
level,
so
it's
it's
about
pitching
it
at
the
right
level
and
sometimes
we'll
need
to
look
at
the
same.
The
same
quality
statements,
but
the
evidence
and
the
way
that
we
gather
that
in
the
way
and
become
the
lens
that
we
apply
to
it
would
be
very
different.
F
Okay,
that's
really
helpful.
Just
one
final
point
then,
based
on
that,
I
think
it
would
be
really
helpful
for
some
clarity,
particularly
for
patients
and
the
public,
in
the
way
that
morals
going
to
work,
because
I
you
will
you'll
see
very
soon
that
complaints
are
going
to
be
more
about.
People
are
not
going
to
know.
You
know
who
to
come,
who
to
complain
about
in
terms
of
their
provider
context
or
that
kind
of
integrated
working
system
and
the
cqc,
together
with
other
regulators,
really
need
to
look
at
this
very
clearly.
A
G
Hi
yeah,
it's
wendy
winterbottom
from
edinburgh,
just
thinking
about
the
data
collection,
you're
doing
and
becoming
smarter
with
that,
if
you
like
collecting
it
more
often
will
that
feed
through
into
the
insight
tools
so
that
data
that's
within
there
is
more
up
to
date.
We'll
trust
that,
seeing
that
coming
through
in
the
inside
too.
H
D
H
So
we
couldn't
see
that
example,
it
would
have
been
helpful
and
I'm
really
concerned
that
this
is
actually
going
to
add
work
to
gp
practices
rather
than
reduce
it,
which
I
thought
was
the
intention,
because
gp
practices
are
now
individual
businesses
they're
part
of
the
ics
they've
got
they're
part
of
primary
care
networks.
What
I
can
see
happen
is
everything
you
ask
the
ics,
for
they
will
go
out
to
the
individual
practices.
H
H
A
So,
even
though
there
are
six
evidence
categories,
it's
not
the
case
that
we
need
to
have
the
evidence
under
all
of
those
in
order
to
make
an
assessment.
At
the
moment
we're
not.
We
are
not
consistent
in
terms
of
different
inspectors.
Some
of
them
will
go
out
and
want
to
look
at
spend
the
whole
day
in
the
office.
I
Oh
yes,
I
just
wanted
to
pick
up
on
a
question
actually
that
my
colleague
asked
in
the
chat
which
is
around
how
this
model
actually
works
with
the
relationship
owner
that
we
have
as
a
trust
from
cqc
like
will
that
continue?
Will
it
be
expanded,
because
a
lot
of
what
you're
talking
about
in
terms
of
real-time
assurance
does
come
through
that
route?
So
I
just
kind
of
wanted
to
understand
that
a
little
bit
more.
A
Yeah
and
it'd
be
great
to
to
hear
reflections
as
we
go
into
the
rooms
on
this
yeah.
Our
assumption
is:
is
that
that
that
would
continue.
It
does
work.
We
know
it
works,
it's
it
can
be
variable,
so
there's
something
there
about.
How
do
we
make
that
a
more
consistent
offer,
but
we're
really
keen
to
to
kind
of
extract
as
much
as
we
can
from
that?
I
suppose
so.
A
Relationship
management
at
the
moment
would
fit
into
the
monitoring
aspect
but,
as
you
rightly
say,
there's
actually
lots
of
valuable
insight
and
information
from
that
and,
let's
not,
let's
not
feel
we
have
to
park
that
and
then
move
it
into
an
inspection
process
actually
well.
How?
How
do
we
play
in
what
we're
getting
from
relationship
management
and
and
play
that
into
our
our
understanding
of
quality
and
risk,
and
actually
that's
a
valid
source
of
evidence?
I
I
suppose
what
I'm
trying
to
avoid
is
the
duplication
aspect.
So,
if
we're
doing,
if
we're
managing
something
through
relationship
management
and
there's
queries
through
that
route,
I
wouldn't
expect
then
to
have
to
provide
it
in
a
different
way,
because
very
often
that
does
happen.
So
I
think
it's
just
making
sure
that.
J
A
Absolutely
and
again
that
will
go
back
to
as
being
really
clear
on
what
the
required
evidence
is
and
building
the
rules
around
that
and
and
essentially
preventing
that
from
from
happening
by
by
building
walls
around
that
evidence.
But
that's
very
much
where
we're
at
the
moment
is:
how
do
we
do
this?
How
does
it,
how
does
it
vary
for
different
types
of
a
provider
and
what
are
the
actual
rules
that
we
need
to
design.
A
B
I
will
I
will,
I
think
the
breakup
room
questions
are
just
on
the
next
slide
and
if
everybody
just
wanted
to
have
a
quick
peek
before
I
release
everyone
into
the
rooms,
just
a
quick
note
to
say
that
I'll
be
hanging
back
in
the
main
room.
So
if
there
are
any
sort
of
like
technical
issues
and
such
and
you
kind
of
don't
make
it
into
a
breakout
room,
I'll,
be
kind
of
on
hand
to
to
work
all
of
that
out
and
but
I'll
I'll
send
everyone
off
now.
J
So
I
think,
there's
there's
just
a
bit
of
anxiety
around
that
that
we
might
want
to
say
a
bit
more
about
in
the
future,
so
kind
of
be
a
bit
clearer
about
how
we're
not
going
to
be
duplicating
and
how
we'll
work
together
to
avoid
that
some
from
room
two.
We
talked
about
the
importance
of
corroboration
around
evidence,
so
I
know
there
was.
There
were
some
concerns
around
people's
experiences
of
care,
and
you
know
how
would
we
check
that
those
are
actually
valid
concerns
about
a
service?
J
How
would
we
put
evidence,
alongside
other
evidence
to
make
sure
it
told
the
same
story
etc,
and
we
talked
about
the
importance
of
making
sure
the
new
model
addresses
consistency
or
current
inconsistency
to
me
more
more
accurate.
So
that's
both
about
consistency
of
assessments,
but
also
the
consistency
when
we
report
following
an
assessment
as
well.
J
J
If
we're
talking
about
kind
of
ongoing
collection
and
assessment,
etc.
I
think
I
think
there
was
definitely
a
call
for
us
to
share
more
information
about
how
we
do
things
like
identify
risk
and
re-rate
without
an
inspection
in
the
future.
What
might
that
actually
look
like
in
practice
and
again
on
the
duplication,
question,
and
I
think
there
was
there-
was
something
about
looking
at
the
outcomes,
evidence
category
and
really
thinking
about.
J
What's
what's
realistic
to
expect
from
specific
provider
types
in
terms
of
outcomes
that
could
be
measured
there,
so
guess
kind
of
you
know
yeah.
Taking
that
realistic
view
of
what's
possible
there,
then
for
room
for
definitely
a
big
positive
about
it.
Being
you
know,
more,
more
timely,
up-to-date
ratings,
etc.
J
Definitely,
a
big
improvement
in
some
of
the
long
frequencies
between
inspection
and
rating
that
we
had
in
the
past.
So
that's
definitely
a
big
positive
and
we
also
had
some
some
feedback
from
room
five
around
again:
the
kind
of
duplication
between
system
level
and
provider
level
assessments
and
making
sure
we
avoid
that.
J
Definitely
an
appetite
to
get
into
more
detail
on
the
kind
of
on
our
scoring
approach
so
running
through
what
that
might
look
like.
There
was
a
specific
question
about
how
this
might
be
applied
to
the
dental
sector,
where
we've
obviously
got
quite
a
different
model
at
the
moment
and
a
bit
of
interest
in
how
what
that's
going
to
look
like
going
forward.
How
that
model
will
change,
etc,
and
I
think
I've
run
through
most
of
the
main
points
there,
but
others
from
the
rooms
might
want
to
jump
in
with
comments.
C
A
C
A
A
A
E
A
I
think
there's
a
the
we
we
continue
to
develop.
This
is
very
much
developing
the
approach
through
these
engagement
sessions
towards
the
end
of
the
sort
of
middle
to
end
of
the
summer,
we'll
be
starting
to
test
this
out
with
small
groups
of
providers
just
to
really
start
to
put
some
flesh
on
the
bones,
and
it's
gradually
building
up
from
there
through
to
kind
of
spring
of
next
year
that,
where
we'll
be
starting
to
really
start
to
implement
more
so
it's
there's
plenty
of
time.
E
A
C
A
You
can
do
that,
of
course,
as
well
as
these
sessions
and
there's
our
digital
platform,
signing
up
to
our
bulletin
and
blogs,
via
twitter
and
and
and
linking
into
our
cqc
connect
where
we
are
putting
podcasts
out
there
as
well.
But
that's
all
to
supplement
these,
these
more
targeted
engagement
sessions
carol
did
you
want
to
come
in
there.
H
Sorry
yeah,
it
was
just
just
a
quick
one
on
that
last
comment
about.
You
know
the
gp
practice
that
wants
to
throw
his
hat
into
the
ring.
Frankly,
you,
if
you're,
going
to
do
this
in
the
way
that
you're
talking
about
you,
can't
just
have
individual
practices,
throwing
the
hat
into
the
ring.
You
can
talk
to
the
pcns
and
the
ics's
to
make
sure
that
somebody
is
prepared
to
test
across
the
whole
range
of
of
providers,
not
not
just
individuals
just
to
comment.
A
Yeah,
no
thanks,
thanks
carol,
I
didn't
I
didn't
mean
to
give
the
impression
that
we
were
yeah
taking
that
approach.
We
we
have
an
implementation
plan
which
is
which
is
in
development,
so
we
we
would
absolutely
need
to
have
those
those
proper
approaches
and
checks
and
balances
in
place.
Absolutely
okay.
A
Thank
you.
Well
thanks.
Everyone
thanks
for
coming
this
morning
and
and
for
sharing
your
thoughts,
it's
all
been
incredibly
useful
and
we
can
feed
it
into
our
ongoing
work
and
look
forward
to
speaking
with
you
again
as
we
get
into
that
next
level
of
detail
in
our
in
our
next
session.
So
I
hope
you
have
a
good
day
and
thanks
very
much.