►
Description
Hear from Dr Rosie Benneyworth, Chief Inspector of Primary Medical Services and Integrated Care at CQC as she discusses our transitional regulatory approach and the latest on our emerging strategy for 2021 and what this means for those working in general practice and other primary care services.
A
A
So
if
we
could
go
on
to
the
next
slide,
please
death.
So,
firstly,
I
just
want
to.
I
want
to
introduce
the
webinar
team
that
we've
got
here
during
the
the
pro
the
course
of
this
webinar.
Please
do
ask
questions
through
the
chat
and
the
webinar
team
will
be
picking
up
some
of
those
questions
as
we
go
through,
but
we
will
also
also
be
having
some
question
breaks
during
during
the
time
as
well.
We
want
this
to
be
a
really
productive
hour.
A
We
know
on
teams,
we
use
teams
a
lot
at
the
cqc,
but
we
know
sometimes
the
technology
doesn't
always
work
so
bear
with
us
if
there's
any
glitches,
but
we
will
do
our
best
to
stick
to
time.
We
know
you're
all
busy
people,
so
we
want
to
be
as
use
this
time
as
wisely
as
possible.
Just
for
your
information.
A
This
is
going
to
be
recorded
and
we
will
be
putting
this
on
our
youtube
page,
and
this
is
very
freely
available
for
you
to
share
with
colleagues
so
that
they
can
have
a
look
and
see
see
what
we've
been
talking
about
today.
So
just
on
to
the
next
slide.
Just
to
give
you
an
idea
of
what
we
will
be
covering
today.
A
If
anything,
during
the
course
of
the
pandemic,
it's
become
apparent
that
our
purpose
is
even
more
important
than
ever
and
during
the
next
few
years,
as
we
go
into
our
new
strategy
and
our
developments
that
are
happening.
This
is
something
we
will
always
come
back
to
as
to
why
we're
here
and
what
we're
doing
and
our
teams
across
the
cqc
are
absolutely
passionate
about
delivering
on
their
purpose.
A
A
We've
seen
huge
acceleration
during
the
pandemic
and
and
in
primary
care,
for
example,
the
use
of
technology,
the
work
that
has
happened
at
primary
care
network
level,
we've
seen
massive
changes,
and
we
know
that
in
order
to
deliver
our
purpose,
we're
going
to
need
to
change
as
well.
We
want
to
really
enable
those
changes.
We
know
that
things
can't
stand
still
for
the
benefit
of
patient
care.
We
need,
we
know
things
have
to
move
forward.
A
A
So
if
we
could
move
to
the
next
slide,
we
started
transforming
the
way
we
worked
back
last
last
year
and
there's
a
timeline.
That's
going
to
be
coming
up
now
and,
as
I
said,
covered
pandemic
has
anything
accelerated
our
work
around
what
we
already
were
planning
we're.
Now,
in
phase
three
of
our
work
and
we're
going
to
be
rolling
out
a
transitional
approach
which
I'll
talk
to
in
a
moment,
our
strategy
is
being
developed.
A
A
We
are
really
really
aware
of
the
huge
challenges
and
pressures
that
all
parts
of
the
health
and
care
system
are
facing.
At
the
moment,
we
work
with
a
large
number
of
gps
and
providers
right
across
the
country
who
tell
us
who
give
us
that
information
as
to
what's
happening
and
we're
monitoring
on
a
on
a
very
regular
basis,
what's
happening
in
all
of
the
different
areas
and
the
impact
that
it's
having
on
the
different
parts
of
the
health
and
care
system.
A
So,
as
you
know,
in
march,
we
stopped
our
routine
inspections,
but
we
didn't
stop
inspecting
during
that
period
of
time.
We
continued
to
monitor
providers
and
we
continue
to
regulate,
even
though
we
weren't
doing
our
routine
inspections
and
we
continued
to
respond
to
concerns
raised,
and
we
have
undertaken
some
inspections
over
the
course
of
the
last
few
months
as
a
result
of
that,
where
we've
come
across
concerning
information
or
risks
that
we
feel
we
need
to
go
and
have
a
look
at.
A
We
also
use
that
opportunity
to
help
signpost
people
to
information.
We
raised
risks
both
at
a
regional
and
a
national
level
of
things
that
we
were
hearing
about
and
that
information
we
also
fed
through
to
many
of
our
our
colleagues
in
places
like
the
department
of
health
and
social
care
or
nhs
england.
A
A
A
This
is
a
transitional
approach.
A
number
of
aspects
of
this
approach
will
help
provide
some
learning
into
how
we
regulate
and
how
we
develop
in
the
future
and
we're
also
as
well
as
looking
at
learning
about
this
approach.
This
will
also
help
inform
our
the
direction
of
travel
of
the
organization
and
where
we're
going
from
21
onwards.
A
So
if
we
could
go
into
the
next
slide,
I
just
want
to
spend
some
time
talking
about
how
we're
going
to
regulate
during
the
next
phase
of
the
pandemic.
So
we
will
regulate.
We
started
rolling
out
our
our
transitional
approach.
At
the
beginning
of
october,
we
started
in
adult
social
care
and
also
our
dental
providers.
A
We've
started
rolling
out
all
in
all
hospital
trusts,
from
the
12th
of
october
and
from
the
19th
of
october,
we're
rolling
out
our
new
methodology
in
general
practice:
independent
doctors,
slimming
clinics,
urgent
care
and
out
of
hours.
All
of
the
remaining
said
services
that
we
regulate,
that
I
haven't
covered.
A
We
then
will
continue
to
inspect,
but
this
will
be
on
a
much
more
targeted
and
focused
basis,
and
this
will
be
where
we
have
concerns.
I
just
want-
I
will
say
this
several
times
during
this
presentation,
but
we
will
not
return
to
a
routine
programme
of
inspections
that
are
frequency
based.
I
know
there's
been
a
lot
of
chatter
in
the
media
and
and
various
other
things,
the
the
kind
of
trade
press,
but
I
just
want
to
reiterate
that
we're
not
returning
to
routine
inspections.
A
A
A
So
if
we
could
go
into
the
next
next
slide,
please
death.
I
just
want
to
spend
a
little
bit
of
time
talking
about
monitoring
and
the
way
we
monitor
services
is
being
developed
through
engagement
with
lots
of
stakeholders,
lots
of
people
who
work
in
services,
lots
of
the
public
and,
as
I
said,
this
approach
is
being
developed
for
all
of
the
services
we
regulate
right
across
social
care
and
health,
be
it
nhs
services,
independent
services
of
all
all
shapes
and
sizes.
A
So
our
monitoring
will
have
key
areas
of
focus
based
on
existing
key
lines
of
inquiry,
specifically
targeting
safety,
people's
access
to
services
and
leadership,
but
we
will
continue
to
build
in
other
areas
of
focus
using
our
approach.
Our
inspectors
will
monitor
and
review
information
from
all
available
sources,
collecting
further
information
where
necessary.
A
The
main
way
we'll
gather
information
from
providers
is
through
conversations
we'll
have
with
them.
When
working
through
the
questions
in
the
transitional
methodology,
inspectors
will
not
routinely
ask
for
additional
information
or
evidence
or
request
all
of
the
information
supplied
in
the
examples.
We
want
to
keep
this
as
proportionate
as
possible,
given
the
pressures-
and
we
want
to
make
this
sure
this
is
as
targeted
as
possible.
A
Inspectors
will
apply
professional
judgment
to
identify
the
information
they
need
to
sufficiently
assess
the
risk
level
of
each
key
line
of
inquiry,
and
these
calls,
which
some
providers
will
have,
will
take
about
an
hour,
and
we
don't
anticipate
them
to
be
any
longer
and
they
will
be
done
off-site,
they
will
be.
They
will
be
calls
in
the
similar
way
for
those
experienced
an
annual
regulatory
review
type
call.
A
Our
inspection
teams
will
always
have
the
option
to
act
quickly
and
use
their
own
judgment
where
we
get
other
sources
of
information
that
indicate
greater
risk
and
I'm
sure
people
on
this
call
are
aware.
We
get
a
large
number
of
information
from
people
from
whistleblowers
across
the
from
outside
of
the
organization
that
we
act
on
from
any
kind
of
concerns
raised
or
safeguarding
concerns,
and
our
inspectors
absolutely
will
use
their
professional
judgment
if
they
have
concerns
that
they
need
to
act
on
quickly.
A
So
if
we
could
move
to
the
next
area-
and
I
just
want
to
talk
a
little
bit
about
inspection.
So
just
to
reiterate-
and
I
know
I've
said
this
before
we'll
not
be
returning
to
business
as
usual-
we're
not
returning
to
our
fixed
frequency-based
rules
on
inspection.
We
are
very
much
focusing
on
risk
and
we're
clear
that
our
focus
is
absolutely
on
services,
where
we
have
concerns
about
care
and
we
will
take
appropriate
action
to
protect
people
where
necessary.
A
A
So
we
are
piloting
new
ways
of
working
in
general
practice,
and
this
is
also
being
replicated
in
some
other
parts
of
the
organization
like
in
our
adult
social
care
teams
and
we're
looking
at
how
we
can
explore
new
ways
of
gathering
evidence
without
without
actually
having
to
be
on
site,
but
we're
doing
this
with
the
explicit
consent
of
providers.
There's
nothing
happening
behind
the
scenes
that
you
don't
know
about.
A
A
Our
general
practice
focused
inspection
pilot
is
designed
specifically
to
help
us
respond
to
risk
we're
going
to
carry
out
initially
in
about
30
services,
and
this
pilot
is
evaluating
how
developments
in
digital
technologies
and
working
away
from
offices
and
locations
can
be
part
of
the
regulatory
approach
for
the
benefit
of
providers,
the
public
and
the
cqc.
It's
going
to
test
how
we
gather
information,
including
how
we
can
directly
access
evidence,
such
as
clinical
records
and
just
to
reassure
people
on
this
call.
A
A
So,
moving
on
to
the
next
slide,
I
just
wanted
to
touch
on
rating
because
we
know
from
feedback
we've
had
from
the
public
that
our
ratings
and
information
about
our
assessments
are
vital
for
the
public
in
a
way
that
they
can
view
the
quality
of
the
service
that
they're
getting
what's
going
to
happen
with.
The
transitional
monitoring
approach
is
that
after
we've
reviewed
the
monitoring
information
and
the
streamlined
set
of
chloes,
the
key
lines
of
inquiries
will
make
a
judgment.
A
If
we're
confident
at
that
stage
that
our
review
indicates
a
low
level
of
risk
and
there
aren't
any
risks
to
the
people
who
use
services
that
we
can
identify.
Then
we
will
take
no
further
action
and
we
will.
Let
providers
know
the
that
is
the
outcome,
we're
anticipating
that
the
majority
of
people
in
whom
we
have
that
call.
This
will
be
the
outcome,
we're
hoping
that
for
the
majority
of
providers,
we
will
have
a
call.
A
We
will
monitor
the
information
and
the
outcome
will
be
that
no
further
action
is
taken
with
time.
Our
plan
is
to
publish
a
short
sa
statement
on
the
services
page
on
our
website,
so
that
people
who
are
using
the
services
know
what
is
happening.
We
want
to
be
very
transparent
with
the
publicly
used
services
and
and
everyone
who
involved
so
people
know
what
we've
found.
A
We're
also
going
to
share
a
summary
of
that
directly
with
the
provider.
Before
we
do
this,
we
want
to
work
with
people
who
use
services
and
yourselves
to
make
sure
that
what
we
do
works
for
everyone.
So
that's
that's
an
ongoing
piece
of
work
where
the
outcome
of
our
monitoring
activity
leads
to
us
inspecting
a
service
and,
as
I
said,
we
suspect
this
will
be
the
minority
of
these
assessments.
A
We
will
use
our
existing
inspection
methodologies
and
we'll
adapt
these
to
work
with
the
environment.
We're
in
this
means
that,
across
all
of
the
health
and
care
sectors
we
regulate,
we
can
still
look
at
any
or
all
of
the
key
lines
of
inquiry
and
inspections
to
ensure
people
are
are
receiving
safe,
high
quality
care.
A
Our
ability
to
re-rate
our
services
is
limited
at
the
moment
by
our
published
methodologies,
and
that
is
something
we're
working
on.
As
we
go
forward,
we
may
be
able
to
re-rate
her
services
in
limited
numbers
of
cases,
but
this
will
vary
in
practice
and
it
will
vary
between
the
sectors
that
we
regulate
and
we
will
keep
you
updated
around
this
as
we
work
through
it
through
our
blogs
and
our
regular
bulletins
and
our
updated
guidance.
So
you
know
what
to
expect.
A
B
Thanks
rosie
we've
had
some
some
great
questions
on
the
chat,
thanks
for
everyone
for
submitting
those
and
we'll
we'll
try
to
get
through
as
many
of
them
as
possible
on
this
call.
But
if,
if
we
don't
get
a
chance
to
answer
your
question,
don't
worry
these
will
all
get
fed
into
our
work,
developing
our
transitional
approach
and
strategy
going
forward.
B
One
of
our
most
popular
questions
is
around
the
issue
of
access
in
general
practice
rosie,
and
I
think
we
all
know,
there's
been
a
lot
of
public
conversation
about
access
and
we've
seen
some
great
work
in
the
sector
to
make
sure
people
still
have
access
to
general
practice.
But
I
think
there's
a
question
about.
A
A
Access
is
really
important
for
so
many
reasons.
We
know-
and
I
think
I'm
sure
everyone
shares
my
concerns
on
this-
call
about
the
people
who
who,
for
whatever
reason,
have
chosen
not
to
access
services
or
have
not
been
able
to
access
services
and
they're
two
different
things
for
things
like
cancer
or
other
conditions.
A
That
means
that
their
outcomes
may
not,
as
a
result,
be
as
good,
and
we
know
that
quite
a
lot
of
this
has
been
driven
by
public
behavior
and
by
people
either
being
worried
about
accessing
services
or
choosing
not
to
because
they
haven't
wanted
to
bother
the
nhs
and
and
have
felt
it's
not
appropriate.
So
I
think
the
first
thing
I
would
like
to
say
is
that
we
all
need
to
be
doing
our
part
to
encourage
the
public
to
seek
access
when
they
have
worrying
symptoms
or
worrying
conditions.
A
I
think
the
second
thing
I'd
say
is
that
I
think
that
one
of
the
things
we
are
doing
some
work
around
this,
because
we
do
want
to
understand
what
is
happening
in
access
and
we
do
want
to
pick
up
all
of
the
good
practice
that
people
have
put
in
place.
We
know
that
there
has
been
a
lot
of
changes
and
practices
have
undertaken
a
lot
of
innovation
around
access,
and
we
want
to
pick
that
up
and
we
want
to
share
that
good
practice.
A
Within
those
practices.
We
have
heard
in
a
minority
a
small
number
of
cases
where
the
public
haven't
haven't
been
able
to
access
services.
For
example,
we've
heard
about
practices
that
have
said
if
you're
between
15
and
50
you're
not
allowed
a
face-to-face
appointment
under
any
circumstances
and
clearly
that
is
really
unacceptable
and
we
are
following
up
any
cases
that
we
hear
where
the
public
are
not
getting
appropriate
access,
and
I
think
I
think,
there's
two
aspects.
A
A
So
I
think
I
think
it's
something
we.
We
are
doing
some
work
on
to
understand.
We
do
want
to
support
practices
and
we
do
want
to
share
that
best
practice,
but
you
know
for
people
on
the
call.
I
think
it
is
worth
considering.
How
are
you
engaging
with
with
people?
How
are
you
communicating
with
people
around
the
changes
that
you've
made,
and
and
can
you
share
those
great
ideas
with
us?
A
C
No,
I
I
think
rosie
you've
covered
most
things.
I
think
the
point
around
communication
and
and
accessibility
of
information
of
people
using
services
is
really
critical
with
this,
because
what
we
are
finding
is
that
often
two
practices
are
offering
really
good
access
to
patients
are
communicating
this
in
different
ways,
so
people
are
experiencing
that
very
differently
and
could
believe
that
a
practice
has
its
doors
short
when
actually
that
they're
offering
a
perfectly
good
access
to
appointments
once
people
actually
get
through
the
door.
C
C
B
We've
also
had
a
few
questions,
just
wanting
a
bit
more
information
about
what
might
trigger
an
inspection
during
our
transitional
approach
and
vicky
and
manny
have
both
posted
some
answers
in
the
chat.
But
I
wondered
if
we
wanted
to
give
a
bit
more
information
about
the
kind
of
things
that
might
mean
we,
we
end
up
going
into
a
practice
and
inspecting
face-to-face.
A
A
We
hear
about
sexual
assault,
we
hear
about
people
who
are
not
getting
the
care
they
need.
If,
if
there's
serious
concerns
like
that,
then
we
will
follow
them
up
or
if
there's
concerns
about
safeguarding
that
people
are
not
being
safeguarded.
If
there's
concerns
about
human
rights
not
being
considered,
we
will
follow
that
up.
Sometimes
we
get
contacted
by
coroners.
A
We
get
information
about
deaths
that
have
occurred,
serious
things
like
that.
We
will
absolutely
be
following
up,
then
I
think
so
that's
an
absolute
if,
if
there's
kind
of
a
series
of
of
kind
of
lesser
concerns-
but
they
all
add
up
to
something
that
makes
us
think
you
know
this-
this
is
not
not
adding
up
to
a
great
picture
and
we
can't
get
assurance
from
that
provider
from
what
they
tell
us
over
the
phone.
Then
again
we
will
we
will
inspect
and
follow
up
so
vicky.
C
Now
I
think,
you've
covered
it
rosie
we
did
see
during
the
pandemic.
We
did.
We
had
a
slight
decrease
initially
in
the
pandemic
of
people
coming
and
sharing
their
experience
with
us,
which,
which
has
now
started
to
increase
again
and
that's
in
terms
of
people
coming
to
us,
so
people
using
services,
but
also
whistleblowers
coming
to
us-
and
I
just
want
to
emphasize
that
we
we
will
only
inspect
if
we
need
to
inspect
so.
A
B
Thanks
both
we've
also
had
a
few
comments.
Just
sorry,
just
reflecting
on
the
the
pressures
the
system
is
under
at
the
moment
and
the
pressures
providers
are
under,
and
I
wonder
if
we
want
to
reflect
on.
You
know
why
we
think
the
transitional
approach
is
the
right
approach
at
the
moment
and
where,
where
we
are
offering
support
where
it's
needed
and
what
that
might
look
like
for
providers.
A
We're
very
aware
that
demand
on
primary
care
is
going
up
and
we're
very
aware
that
a
lot
of
what's
going
to
happen
in
the
next
few
weeks
and
months
is
an
unknown
and
there's
a
huge
amount
of
uncertainty,
and
we
know
that
that's
compounded,
not
just
with
the
the
the
kind
of
clinical
care
that's
happening
within
providers,
but
it's
compounded
by
the
impact
on
of
testing
and
impact
on
on.
You
know:
people
being
off
sick
in
practices.
A
We're
aware
that
actually,
this
is
having
a
massive
impact
on
people's
personal
lives
and
mental
health
and
everything
else.
So
we
we
are
completely
aware
of
that.
I
think
it's
fair
to
say
the
the.
However,
the
the
areas
we've
been
following
up
during
the
pandemic
are
areas
that
actually
have
not
often
the
risk
has
not
been
related
to
the
covert
pandemic.
A
I
mean
we're
seeing
some
very
shocking
kind
of
clinical
care
we've
seen
areas
where
the
the
you
know,
there's
we've
we've
seen
areas
of
sexual
abuse,
we've
seen
area
of
patients,
we've
seen
areas
of
deaths
of
patients
as
a
result
of
poor
care.
So
we
are
not
talking
about
things
that
are.
You
know,
mop
heads
and
buckets
here,
we're
talking
about
really
serious
aspects
of
clinical
care
that
have
a
direct
impact
on
on
patients
and
they
have
been
present
despite
kovid.
A
Not
you
know,
because
of
covid,
actually
in
the
experience
that
we've
had
over
the
last
few
months-
and
I
think
I
think
that
is
why
we
feel
we
need
an
approach
that
actually
is
proportionate.
But
we
can't
take
our
eye
off
the
ball,
because
patients
do
deserve
good
quality
care,
and
we
know
that
the
vast
majority
of
practices
are
offering
really
good
quality
care.
A
But
we
need
to
continue
to
monitor
the
situation.
We
also
know
that
actually
things
can
change
very
rapidly
and
it
can
be
due
to
a
whole
variety
factors
that
can
impact
on
the
quality
of
care
of
providers.
So
we
can't
just
assume
that
all
all
providers
that
were
good
will
stay
good,
because
we
know,
for
example,
in
our
evidence
from
last
year,
that
17
of
good
and
outstanding
practices
their
their
quality
of
care
deteriorated.
So
we
do
have
to
have
a
mechanism
of
monitoring.
A
We
want
to
make
that
as
proportionate
as
possible.
We
want
to
have
as
minimal
impact
as
we
can
on
practices
that
you
know
going
ahead
and
doing
well
and
doing
the
right
things,
but
we
do
need
to
have
a
mechanism
of
picking
up,
poor
practice
and
and
actually
for
the
benefit
of
you
know
general
practice
as
a
whole.
The
the
reputation
that
some
of
these
very
poor
providers
can
can
lead
to
and
the
damage
that
can
cause
more
broadly,
is
is
huge
and,
I
think
we'd
all
agree.
B
A
Yes,
certainly
sam,
so
just
to
whiz
through
a
final
few
slides
and
if
we
could
go
to
the
next
slide.
I
just
wanted
to
talk
about
the
the
new
strategy
that
we're
going
to
be
implementing
from
may
of
next
year.
It's
going
to
be
out
to
consultation
in
january.
We
do
want
to
hear
your
thoughts
about
it,
but
there
are
four
key
themes
of
this.
A
A
So
if
we
could
go
on
to
the
next
next
slide
if
possible-
and
I
just
wanted
to
briefly
talk
about
the
people
aspect,
and
so
we
want
to
regulate
through
the
ideas
of
people
using
services,
and
we
also
want
to
know
that
we
want
people
to
know
that
if
they've
taken
the
time
to
feedback
on
services,
that
we've
listened,
that
we've
acted
on,
what
they've
told
us.
Sorry,
the
bin
man's
just
turned
up
outside
my
door
and
is
making
lots
of
noise.
So
apologies.
A
A
We
want
to
do
everything
we
can
as
a
regulator
to
address
those
inequalities,
particularly
about
warranted
variation
and
inequalities
in
health
and
care,
and,
finally,
just
to
mention
on
the
slide.
We
know
that
the
quality
of
care,
someone
experiences
is
partly
between
about
what
they
experience
in
one
provider,
so
you
know
what
they
experience
in
a
general
practice,
but
actually
a
lot
of
the
quality
of
what
someone
experiences
relates
to
how
they
move
through
between
lots
of
different
parts
of
the
health
and
care
system.
A
We
know
people
particularly
long-term
conditions,
multiple
long-term
conditions,
complex
needs.
They
often
are
involved
in
lots
of
different
services
and
actually
the
quality
of
the
care
that
they
receive
very
much
depends
on
how
those
providers
work
together,
and
I
think
for
us,
it's
absolutely
imperative
that
the
people
in
local
communities
providers
in
local
communities
right
across
the
health
and
care
system
work
together
to
really
meet
the
needs
of
their
local
populations,
and
we
think
that
that
will
also
help
look
at
inequalities
as
well.
A
A
We
heard
that
sometimes
ratings
of
a
service
can
mask
concerns
in
other
areas.
In
in
smaller
areas,
we
did
get
strong
support
for
the
use
of
inspection
in
our
regulatory
work,
but
we've
had
a
clear
message
that
this
should
be
more
targeted.
So
we're
really
developing
proposals
about
how
we
plan
to
evolve
our
ratings
program
to
make
sure
they're
up
to
date
meaningful
and
they
focus
on
what
matters
to
people
most.
A
A
A
Sorry,
avoidable
harm
is
still
one
of
the
top
10
killers
in
the
world.
There's
there's
been
a
lot
of
discussion
about
this
over
the
last
few
years,
but
we
still
have
a
significant
amount
of
avoidable
harm
across
all
of
the
services,
and
we
need
to
really
promote
that
culture
where
people
can
talk
about
things
that
go
wrong.
People
can
speak
up
about
concerns.
A
A
Finally,
the
final
area
is
around
improvement
and
we
need
to
know
we
need
to
make
sure
that
people
have
a
consistent
offer
to
help
them
improve.
So
we
want
the
whole
system
to
be
continually
improving
both
within
providers,
but
also
right
across
those
providers,
and
we
want
to
make
sure
that
that
the
quality
of
care
that
people
get
continues
to
develop.
A
We
also
know
there
isn't
a
consistent
offer
at
the
moment
for
practices
that
are
struggling,
we're
trying
to
address
that
with
our
partners,
we're
working
closely
with
partners
across
the
nhs
england
and
nhs
improvement
and
the
royal
college,
because
I'm
keen
that
we
we
actually
when
practices
are
struggling
or
even,
if
they're,
starting
to
wobble
and
deteriorate
that
actually
they
get
help
and
support
so
that
they
can
get
some
early
help
to
really
improve
what
they're
doing
so.
Patient
care
gets
better.
A
Please
do
get
involved
and
we'll
put
up
a
link
at
the
end,
with
ways
to
get
involved
and
give
your
feedback
as
well
as
through
this,
through
this
discussion
and
in
the
future.
As
going
on
to
the
next
slide.
Please
just
to
let
you
know
we,
we
are
planning
to
publish
the
strategy
in
may
and
we
want
to
be
in
a
place
where
we
start
straight
away.
This
isn't
going
to
be
a
document
that
sits
on
a
shelf.
A
A
Yes,
really
good
question
and
it's
something
we
are
looking
at
the
moment
in
how
we
do
this
in
our
ideal
world
we'd
be
able
to
have
the
information
without
having
any
impact
on
providers
and
we'd,
be
able
to
to
gather
information
and
and
work
with
other
regulators
as
well,
so
that
information
we
can
get
from
various
sources.
So
we
can
continue
that
monitoring
in
the
background,
without
having
any
impact
we
are.
We
are
working
on
that.
It
is
something
that
is
high
on
our
priority
as
part
of
our
developments.
A
We
have
changed
our
methodology
very
rapidly
over
the
last
few
months.
In
fact,
the
transitional
methodology
is
the
second
new
methodology
we've
got
in
six
months
as
a
response
to
the
pandemic,
so
we
are
working
very,
very
hard
behind
the
scenes
to
to
be
able
to
adapt
the
new
challenges
and
to
make
sure
that
we're
as
proportionate
as
we
can
be
with
our
new
methodology,
but
a
very
good
point.
We
are
listening.
We
are
trying
our
best
to
to
move
that
forward
as
quickly
as
possible.
So
thank
you
for
the
question.
B
A
A
It's
then
cancer,
mental
health
and
learning
disabilities
and
we've
published
our
state
of
care
report
which
has
got
the
information
about
the
the
first
range
of
reviews
and
we'll
continue
to
publish
those
that
information
and
it's
all
available
on
our
website.
But
those
are
those
are
really
capturing.
The
important
role
of
primary
care
in
in
the
wider
system
and
the
innovations
that
are
happening
and
some
brilliant
stuff
we
heard
in
the
first
the
first
round
of
primary
care
reviews.
A
For
example,
you
know
some
some
great
stuff
about
how
local
gps,
I
think
it
was
in
slav,
for
example,
had
worked
with
local
faith
groups
to
make
sure
the
testing
was
available
and
appropriate
to
meet
the
the
kind
of
the
the
requirements
of
the
local
population.
So
some
great
examples
have
a
look
at
those,
but
it
is
something
we
do
need
to
consider,
given
we're
not
going
to
be
going
back
to
our
routine
inspections.
B
Thanks
rosie
there's
also
a
bit
of
a
reflection
in
the
chat
about
how
we
might
need
to
be
flexible
in
our
approach
in
some
areas
going
forward.
So
in
particular
someone
talks
about
focusing
on
safety
and
how,
while
one
approach
might
be
safe
for
a
certain
population
group,
it
might
not
be
safe
for
another.
Do
you
want
to
talk
a
bit
about
how
how
we
might
have
that
flexibility
going
forward.
A
Yes,
it's
a
really
good
question
as
well,
and
we
do
need
to
find
a
way
and
part
of
what
we're
looking
at
at
the
moment
is:
how
do
we?
How
do
we
develop
our
approach?
If
we're
going
to
look
at
inequalities?
How
do
we
start
to
look
at
how
we
understand
what's
happening
in
one
area,
that's
similar
to
what's
happening
in
another
area
and
the
challenges
that
might
different
populations
might
need
might
might
have
to
to
meet
the
needs
of
their
population.
A
You
know,
starting
to
then
be
able
to
compare
areas
where
there's
similar
demographic
profiles,
areas
with
similar
track
challenges,
we're
not
there
yet,
but
that's
where
we
would
like
to
get
to
and
part
of
our
work
around.
Looking
at
how
people
move
through
the
different
systems,
it
will
look
and
the
provider
collaboration
reviews
have
started
to
explore
this,
we'll
look
at
actually.
How
do
we
understand
what
those
population
needs
are?
How
do
we
understand
how
practices
are
working
with
their
local
communities,
how
the
voluntary
sector
are
involved?
A
How
we're
working
with
the
higher
trusts
are
working
with
primary
care
all
of
those
type
of
things,
because
I
think
all
of
those
it's
going
to
be
a
necessity
going
forward.
If
we're
really
going
to
look
at
tackling
inequalities
as
a
whole
health
and
care
system,
then
actually
we
need
to
make
sure
that
there's
that
really
good
understanding
by
all
parts
of
the
health
and
care
system
about
what
their
population
needs
and
how
they're
adapting
to
do
that.
B
A
So
that's
what
we've
been
doing
so
far
and
whilst
there's
there's
still
a
lot
of
a
lot,
we
can
do
in
that
area.
There
has
been
improvement
over
the
last
two
or
three
years
in
that
area,
but
this
is
a
real
opportunity
with
the
new
transitional
methodology
with
our
use
of
technology,
we've
got
a
whole
series
of
work
underpinning
the
new
transitional
methodology,
which
involves
new
I.t
platforms,
which
will
enable
us
to
have
a
much
better,
consistent
approach
with
that
enabled
by
technology.
To
do
that.
A
A
B
A
Fantastic,
thank
you.
So
if,
if
steph,
you
could
move
just
to
the
next
slide,
here's
a
variety
of
ways
you
can
get
involved.
We
really
really
do
want
to
hear
from
you.
So
there's
a
citizen
lab
platform
where
you
can
share
all
sorts
of
thoughts
and
ideas
and
that
we
do
our
regular
bulletin,
which
you
should
all
get
if,
for
any
reason,
you're
not
getting
that,
please
let
us
know
we
send
out
to
all
providers,
and
likewise
we
include
blogs
which
give
an
update
of
what
we're
doing
with
that.
A
We
have
a
twitter
account
and
we
also
have
a
series
of
podcasts.
So
have
a
look
at
all
of
those
and,
like
I
said
earlier,
the
other
option
is:
if
you
want
feedback
on
any
service
that
you
or
your
family
are
using
good
or
bad,
or
you
know
any
feedback
at
all.
Please
use
our
give
feedback
on
care,
which
also
is
an
opportunity
for
you
to
feedback
to
us
about
the
services
around
you
or
that
you're
you're
involved
in.