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From YouTube: Integrated Care System and Local Authority assurance coproduction: what we heard, what we're doing
Description
In March, we held a series of coproduction sessions to help the development of our approach to Integrated Care System oversight and Local Authority assurance.
In this session, we playback what we heard through those sessions, highlight how that feedback has informed and influenced our thinking so far, and outline next steps.
A
I
would
like
to
start
by
introducing
myself
and
mandy.
I
don't
many
of
you
will
not
have
met
us
before.
My
name
is
mary
kridge,
I'm
the
interim
director
for
adult
social
care
and
I'm
leading
for
my
part
of
the
business
on
local
authority
assurance
mandy.
Would
you
like
to
introduce
yourself
hello.
B
Everybody
and
thank
you
for
coming
and
joining
us,
so
I'm
mandy
williams
and
I'm
the
interim
director
for
integration,
inequalities
and
improvement.
So
my
role's
very
much
about
leading
the
the
assessment
processes
for
the
integrated
care
systems.
A
Okay,
thank
you.
So,
as
we
said,
thank
you
very
much
for
coming.
I
wasn't
at
the
we
weren't
at
the
sessions
that
where
the
feedback
was
given,
but
we
understand
they
were
fantastic,
and
this
is
all
about
letting
you
know
what
we've
done
with
that,
how
it's
influenced
our
thinking
and
our
decisions.
A
So
far
on
all
of
this,
I'm
going
to
kick
off
with
the
local
authority
assurance
and
then
we'll
hand
over
I'll
hand
over
to
mandy
for
the
ics
side
of
things
we've
put
an
hour
and
a
half
in
the
diary,
because
we
wanted
to
make
sure
there
was
enough
time
for
questions
and
discussion
and
so
on,
but
similarly
recognizing
the
pressure
that
everybody
is
under.
If
we're
finished
before
that,
and
can
give
you
some
time
back.
We'll
of
course
we'll
do
that.
A
But
but
let's
see
how
we
go
so
today
is
all
about
what
were
the
themes
that
we
heard
and
what
we're
doing
with
that
feedback
and
we're
setting
out
next
steps.
A
So
we've
had
two
product
co-production
sessions
and
over
400
people
registered,
so
we
really
got
both
the
volume
and
breadth
and
quality
of
feedback
which
was
fantastic.
This
isn't
it
it's
not
over,
so
we'll
be
doing
further
engagement
as
we
go
along.
So
please
don't
think
this
is
the
final
opportunity
to
influence.
A
So
I'm
going
to
talk
about
the
overarching
themes
that
we
heard
is
it
set
out,
as
you
can
see,
set
out
here
on
the
screen,
so
very
strong
message
that
we
should
use
what
currently
exists
and
are
reliable
and
only
go
looking
for
different
thing,
but
for
the
gaps.
So
if
it
doesn't
exist
and
we
feel
it's
necessary,
we'll
need
to
stand
that
up,
but
very
much.
Please
use
what
already
exists
and
we
certainly
would
not
argue
with
that.
A
A
And
that
that
was
across
both
local
authority
and
ics
work,
and
we
had
some
suggestions
about
considering
peer
review,
perhaps
bringing
in
leaders
from
other
parts
of
the
country
to
help
with
that.
To
give
that
sense
that
we
would
understand
really
what
we
were
looking
at
for
leadership
and
a
sense
about
report
being
proportionate.
A
A
A
What
will
be
the
relationship
with
reports
and
how
this
will
interact
with
existing
internal
reporting
cycles,
so
really
that
the
how's
it
going?
How
is
it
going
to
work
in
practice,
feedback
wanting
us
to
take
an
holistic
approach
and
give
equal
weight
to
quantitative
and
qualitative
data
and
consistency
and
no
duplication
again,
you
know,
I
think
we
can
all
sign
up
to
that,
so
that
those
were
the
the
key
messages
we
had
back
around
data.
A
It's
a
co-production
wanting
us
to
use
all
channels,
not
just
digital
and
look
at
how
local
authorities
are
using
experts
by
experience
and
others
in
that
co-product
co-production
business
of
identifying
needs
and
considering
how
best
to
meet
those
needs
and
wanting
us
to
involve
local
charities
in
reaching
out
to
people
again
in
a
proportionate
but
proactive
and
targeted
way.
So
we
are
making
sure
we're
reaching
out
to
those
who've
got
something
to
say
about
the
issue
that
we're
trying
to
get
information
on
so
strong
theme
on
co-production,
which
was
great
so
lots.
A
We
heard
lots
about
ratings
and
reporting
so
feeling
that
the
report
should
be
set
in
the
context
in
which
local
authorities
are
operating.
A
So
wanting
us
to
be
cognizant
of
that
and
take
that
on
board
when
we
are
rating
and
reporting
a
sense
that
these
scores
and
ratings
might
be
unhelpful
and
that
it
might,
there
might
be
some
loss
of
nuance
if
we
haven't
got
the
context
right
and
avoiding
ranking
of
local
authorities
in
any
way,
that's
an
interesting
one.
We
rarely
rank
at
cqc.
You
know,
we've
never
done
that
in
quite
the
way,
but
when
we
publish
stuff
the
press,
do
it
anyway,
so
but
a
sense
cqc.
A
A
And
I
just
asked
people
to
bear
in
mind
the
outcome
from
some
of
the
the
adas
survey
last
week,
the
the
majority
of
local
authorities
only
assessing
where
there's
a
safeguarding
or
other
significant
issue.
So
some
of
this,
what
what
this
work
will
be
doing
will
be
making
stuff
putting
stuff
in
the
public
domain
that
perhaps
folk
aren't
aware
of,
and
what's
going
to
be,
the
impact
of
that
understand
that.
But
this
is
what
this
is
regulation.
A
Okay,
so
fourth
feed
theme
on
leadership
look
at
peer
review
methods.
I've
already
touched
on
because
that
that
came
across
both
for
local
authority
and
ics,
and
we
should
look
at
what
people
actually
do,
how
are
people
actually
treated
and
cared
for
and
that
we
need
to
look
at
elected
members.
This
got
democracy
in
play
here
differently
from
the
nhs
very
good
points
and
that
culture
and
honesty
should
be
at
the
heart
of
any
framework
framework.
Well,
no
argument
here.
Integrity
is
one
of
our
core
values
at
cqc.
So
absolutely
culture
and
honesty.
A
A
I
think
learning
is
a
continuous
thing,
isn't
it,
but
we
heard
that
very
much
that
that's
what
folk
want
and
to
understand.
The
feedback
was
understand
that
local
authorities
are
one
partner
in
a
complex
system
and
some
will
be
working
with
multiple
ics's.
So
absolutely
we
hear
that
and
we
need
to
understand
that
in
the
context
of
this
work.
A
A
So,
on
leadership,
a
decision
that
we
will
include
elected
members
and
overview
and
scrutiny
committee
members
in
seeking
feedback
so
we'll
make
sure
they
they
absolutely
play
their
part-
that
we
will
use
the
outcomes
from
the
existing
peer
review
arrangements
to
inform
our
assessments
and
that
evidence
relating
to
culture
and
values
will
be
used
to
form
assessments
and
that
will
include
looking
at
well
the
whole
the
whole
approach
of
what
of
all
the
evidence
we
get
but
really
honing
in
on
where
that
speaks
to
culture
and
values.
A
We
want
to
see
those
values
passionately
held
in
action
and
seeing
that
influencing
the
way
people
are
working
and
their
decisions,
so
that
that's
the
response
all
work
in
progress,
of
course,
but
that
that's
the
definites
on
the
leadership
feedback.
A
So
rating
and
reporting
so
this
is
still
very
much
under
discussion.
I
haven't
got
a
settled
position
to
share
with
you
all,
but
in
those
discussions
we're
very
much
using
the
feedback
that
we've
heard,
so
there
will
be
a
narrative
report
at
the
end
of
assessment,
so
alongside
maybe
not
at
the
same
time
as
the
scores
still
under
discussion.
As
I
say,
but
hearing
what
folks
say
about
context.
A
This
will
be
the
opportunity
to
exp
to
set
in
context
and
to
explain
our
our
findings
and
that
will
we
will
score
the
appropriate
evidence
categories
under
the
quality
statements
to
achieve
a
headline
rating.
So
it
won't
be
a
blunt
one.
Overall
thing
there'll
be
scores
for
different
elements
that
will
contribute
to
the
overall
rating
so
that
that's
the
story
so
far
on
ratings
and
we'll
keep
you
appraised
of
that
journey
and,
of
course,
where
we
get
to.
A
So
co-production,
so
the
assessments
will
definitely
look
at
how
local
authorities
are
using
co-production
and
the
difference
it's
making
in
terms
of
of
planning,
designing
and
delivery
of
services.
A
We
will
definitely
seek
feedback
from
people
via
local
representative
charities
and
organizations
which
why
wouldn't
we
really
important
that
we
we
get
the
information
to
inform
a
proportionate
and
accurate
assessment,
and
we
are
looking
at
ways
to
explore
how
we
can
use
experts
by
experience
in
our
assessment
work.
A
I'm
sure
many
of
you
will
be
familiar
with
that
phrase,
but
experts
by
experience
either
somebody
with
lived
experience
or
a
carer
in
that
area
have
been
a
part
of
our
work
at
cqc
and
have
been
a
tremendous
addition
so
important
that
we
have
that
framing
when
we're-
and
you
said
that
too,
so
we're
absolutely
keen
to
do
that.
A
B
Thank
you,
mary
thanks
and
unsurprisingly,
there
are
a
lot
lots
of
commonalities
around
what
we
heard
in
regard
to
local
authority
assessments
and
for
the
integrated
care
system
assessments,
but
I'll
run
through
them
in
the
in
the
same
way
as
mary
had
in
what
we
heard
and
what
we're
going
to
do
so
data
again,
you
know,
don't
duplicate,
please
only
use
existing
sets
where
the
quality
is
good
and
only
ask
for
for
new
data
sources.
B
If
there's
real
gaps
in
what's
available,
try
and
look
for
some
measures
that
will
drive
integration
and
inequalities
in
the
data
and
for
us
to
really
be
ambitious
in
how
we
use
that
pull
that
data
from
a
whole
variety
of
sources
from
from
from
wherever,
wherever
we
can
so
use.
Multiple
sources
in
in
the
data.
B
There
was
general
consensus
that
it
was
really
too
early
to
rate
ics's
as
they're
really
going
through
that
developmental
stage.
At
the
moment
there
was
a
bit
of
a
mixed
feeling,
though
some
people
felt
that
ratings
could
be
a
really
good
driver
for
improvement,
but
there
was
a
really
clear
message
that
we
needed
to
be
consistent
with
how
we
judged
and
and
rated
the
ics's,
using
the
same
quality
statements
to
measure
performance
and
to
drive
that
improvement.
B
So
you
know
the
the
the
characteristics
of
that
goody
leadership
working
as
a
team
towards
that
really
clearly
defined
strategy
being
supportive,
really
pushing
that
learning
culture
having
in
place
measures
so
that
barriers
can
be
over
overcome
to
achieve
good
outcomes
and
really
putting
the
needs
of
the
local
population
at
the
heart
to
to
address
the
inequalities
and
improve
experience
and
outcomes
for
all
the
residents.
B
Proportionality
in
our
regulation,
so
a
real
ask
that
it's
very
our
ratings
and
our
assessments
are
proportionate,
that
we
don't
lead
the
rating
of
the
ics
by
the
provider
ratings,
so
provider
ratings
are
separate
and
will
be
separate
and
that
we
should
only
consider
them
in
the
determiner
of
how
well
the
ics
is
responding
to
the
ratings
of
all
the
providers
in
in
their
footprint.
B
B
Person-Centered,
so
needing
to
look
we'll
be
looking
to
see
that
the
ics's
undertake
person-centered
assessments
and
use
that
to
inform
the
views
and
experiences
of
the
local
residents
and
that
they're
making
meaningful
co-production
undertaking
meaningful
co-production
to
inform
the
work
that
they're
delivering
and
as
with
the
local
authority
assessments,
we
will
be
continuing
to
engage
and
develop
our
own
co-production
as
we
develop
the
evidence
requirements.
B
So
we've
we've
we've
drafted
quality
statement,
descriptors
that
sit
beneath
the
quality
statements
and
they
make
really
clear
the
context
in
which
in
which
they
sit
and
they,
the
quality
statement
descriptors,
really
demonstrate
how
the
single
assessment
framework,
which
we'll
be
using
across
cqc
in
its
entirety,
from
from
from
providers
upwards,
how
that
can
be
used
in
the
context
of
assessing
the
ics,
we're
aiming
to
start
a
baseline
of
all
ics's
from
april
2023,
but
really
recognizing
that
they'll
be
in
different
stages
as
far
as
maturity,
formation
and
progression
with
their
plans
are
concerned.
B
So
ratings,
as
I
say,
really
clear
that
ratings
shouldn't
be
the
rating
of
an
ics
shouldn't,
just
be
an
amalgamation
of
all
the
ratings
of
the
providers
that
sit
within
that
footprint,
but
needed
to
be
clear.
Providing
a
real
signal
of
the
overall
leadership,
the
integration
and
the
quality
of
that
system
and
how
they're
driving
improvement
and
one
of
the
things
that
we're
actively
looking
at
is
how
any
ratings
could
be
accompanied
by
a
direction
of
travel
statement.
B
So
that
would
give
that
additional
context
away
from
just
that
pure
rating
and
bringing
the
nuance
to
that
judgment.
B
Really
important
that
we
listened
to
that
proportionality,
our
intelligence
about
providers
will
be
considered,
but
isn't
you
know,
wouldn't
be
the
the
key
determinant
that
we
would
be,
including
other
sources
of
evidence
that
are
shared
through
our
co-production
that
will
take
into
account
other
other
regulators,
other
sources
of
information
work
collaboratively
with
with
partners
so
that
we're
avoiding
duplication
and
really
looking
at
that
relationship
between
ics's
and
provider
collaboratives
as
well.
B
And
so
our
next
steps
over
the
the
coming
months,
we'll
be
piloting
our
approach
and
then
we're
wanting
to
do
some
real
evaluation
of
those
pilots
to
learn
from
it
and
evolve
our
approach
over
the
coming
months.
We're
going
to
continue
to
have
some
ongoing
stakeholder
engagement
at
some
key
forums
and
events
continuing
to
talk
to
the
expert
advisory
group
and
having
a
real
focus
on
where
there
may
be
gaps
identified
from
the
pilot
so
that
come
the
23rd
of
april
come
april.
23.
B
So
that's
that's
the
what
you've
you've
said
to
us
and
and
how
we've
listened
and
what
we're
intending
to
do.
So
now,
I'm
just
really
opening
the
floor
to
to
these
discussion
points
as
to
whether
the
themes
that
mary
and
I
spoke,
of
whether
they
resonate
with
you,
whether
they
resonate
with
what
you
heard
and
what
you've
said
and
whether
you
think
there's
anything
missing.
B
You
can
put
comments
in
the
chat.
If
that's
easier
to
you
raise
hands.
There
are
a
number
of
colleagues
from
cqc
on
on
the
call
as
well,
because
I
think
there's
about
100
of
us
and
I
think
for
mary
and
I
to
feel
the
hands
and
the
comments
would
probably
be
too
big
and
ask
so
we're
ably
supported
so
open
the
floor
to
you
all.
C
Thank
you
and
I'm
just
going
to
take
the
slides
down
so
that
we
can
see
people
and
we've
got
a
hand
up
from
sharon.
So
we
can
come
to
you
first.
D
A
Yeah
so
provide
if,
if
I
I
have
a
go
at
this
and
the
policy
colleagues
of
the
call
might
want
to
join
in
okay,
so
the
we're
looking
at
different
for
the
provider
and
for
ics
and
laa
we're
looking
at
different
responsibilities
there.
So
the
provider
is
our
sort
of
has
been
our
standard
business.
We
have
our
requirements
to
register,
monitor
and
rate
on
the
provider
side.
A
So
that's
that's
sort
of
slightly
to
one
side
now,
of
course,
we'll
need
to
take
when
we're
looking
at
an
area
either
through
the
laa
or
ics
lens,
or
a
combination
of
the
two,
of
course,
we'll
take
account
of
what
we
know
about
providers,
but
what
we're
not
doing
is
amalgamating
ratings
from
providers
and
saying
look.
The
sum
of
the
parts
gives
you
an
overall
view.
It's
it'll
be
more
complex
than
that,
so
it'll
be
information
from
the
provider
side
alongside
any
other.
A
We
might
have
some
clues
from
that
provider
work
as
to
how
well,
if
we
were
talking
about
social
care
providers,
for
example
how
well
their
relationship
is
with
the
local
authority,
the
support
they
get
etc.
So
we'd
have
insight
from
that
and
on
the
nhs
side
of
things,
we're
already
looking
at
how
the
leaders
of
nhs
trusts
are
working
with
stakeholders
and
partners.
So
we
will
have
that
sort
of
lens.
A
So
I
think
the
the
bit
that's
not
yet
completely
resolved
and
that
we're
working
through
is
the
relationship
between
the
local
authority
assessment
and
the
ics
now
hearing,
which
we
completely
endorse.
All
the
all
the
issues
about
duplication
and
so
on.
We
want
to
avoid
any
sort
of
repetition
duplication,
but
when
we
think
about
an
ics
area,
the
local
authority
assurance
obviously
will
be
a
part
of
that
sort
of
thinking.
A
One
one
will
inform
the
other,
but
as
to
their
actual
direct
relationship,
I
think
we're
still
working
that
out,
but
I'm
going
to
pause
there
and
invite
any
policy
colleague
who's
on
the
call
to
add
to
what
I've
said.
F
Up
yeah,
I
I'm
just
just
going
to
add
mary's
explained
that
really
clearly,
but
just
a
couple
of
additional
points
that
might
highlight
some
of
the
issues
so
in
relation
to
providers,
we'll
still
have
the
five
key
questions,
so
we
will
consider
is
I:
is
it
safe,
effective,
caring,
responsive
and
well
led
for
an
ics
assessment.
F
There
are
three
themes
that
are
on
the
the
face
of
the
act,
which
are
around
leadership,
integration
and
quality
and
safety,
and
then
for
the
local
authority
assurance.
The
legislation
is
quite
specific:
around
com,
compliance
with
the
care
act,
duties
and
obviously
an
assessment
of
a
local
authority
is
only
sort
of
a
one
component
of
place
when
we
think
of
the
number
of
other
partners
that
form
a
place
but
completely
understand
the
points,
and
I
think
they're
really
they're
questions
that
we're
grappling
with
ourselves
in
terms
of
things
like
sequencing.
F
That's
one
of
the
main
reasons
for
doing
pilots,
because
you
know,
we've
been
very
clear
in
terms
of
the
principles
that
we've
set
out
that
we're
not
wanting
to
cause
burden
or
duplication.
So
we
will
be
aiming
to
test
some
of
this
in
our
thinking.
I
think
there
was
another
point
in
the
chat
about
which
which
assessment
should
come
first,
so
sequencing
will
be
a
really
important
part.
So
hopefully
that
just
adds
to
some
of
the
points
mary's
already
helpfully
outlined.
G
G
Thanks
so
much
both
great
questions
from
my
colleagues.
Sorry
great
answers
from
my
colleagues
and
a
great
question
too.
The
only
thing
I'd
add
is
this.
This
is
particularly
complicated.
Whilst
we
establish
this
baseline
that
we've
talked
about
this
first
two
years
where
we
need
to
understand
exactly
where
ics's
local
authorities
are
in
terms
of
quality
of
delivery.
G
We
need
to
establish
that
baseline
from
there
on
out
we're
kind
of
in
this
more
agile
iterative
process,
and
we
can
be
much
more
kind
of
flexible
to
the
issues
that
are
happening
so
that
the
actual
order
beyond
that
period
is
less
important
and-
and
actually
it's
much
more
about
what's
going
on
in
this
area,
what
do
we
need
to
follow
up?
What
evidence
do
we
need
to
gather,
but
but
yeah
we
do
need
to
work
out
for
that
baseline
period.
What's
the
best
way
of
what's
what?
What
is
the
ideal
order?
G
C
H
Hi
good
morning,
thanks
very
much
neil.
My
question
is
about
timing
and
shuttling
of
the
inspection
so
for
it
for
a
local
authority
in
practical
terms.
H
A
Thanks
shall
we
dave,
do
you
want
to
come
in.
G
Yeah
sure,
thanks
thanks
for
that
question,
we'll
know
more
once
we've
piloted
we're
about
to
pilot
with
with
two
local
authorities
to
to
test
this
process.
I
I
I
it
won't
be
all
all
at
once.
That's
for
sure,
so
it's
a
bit
like
with
the
previous
response.
G
We
need
to
work
out
what's
the
best
way
of
of
using
our
the
resource
that
we've
got
available
to
us
to
do
this
work
there'll
be
some
distinct
stages,
though
so
we'll
be
very
clear
way
ahead
of
when
we
switch
this
on
on
what
the
evidence
requirements
are
for
each
of
these
quality
statements
and
we're
working
at
the
moment
with
we've
been
working
with
a
couple
of
local
authorities
in
detail,
as
well
as
with
lga
and
adas
on.
G
I'm,
I'm
being
really
clear
what
the
evidence
is
for
those
quality
statements,
so
you
will
know
as
a
local
authority
what
it
is
that
sits
under
the
safeguarding
aspect,
for
instance,
we'll
also
be
really
clear
what
it
is
that
you
can
supply
to
us
ahead
of
you
know
what
I'll
call
inspection,
I
suppose
to
use
the
air
bunnies
ahead
of
any
kind
of
direct
engagement
or
on-site
activity.
We
might
need
to
do
there'll
be
a
chance
to
to
submit
any
documents
that
are
relevant.
G
Also
self-assessment
would
be
a
key
part
of
this.
Any
peer
review
that
might
have
happened.
We
really
want
to
to
harmonize
with
what
already
what
already
works
in
terms
of
secular
improvement
and
actually
just
see
where
we
can
add
value.
So
how
can
we
fit
into
those
rhythms
what
already
exists,
and
then
it's
simply
a
question
of,
and
what
else
do
we
need
of
of
our
published
evidence
requirements?
What
is
it
that
we
must
get
from?
G
Let's
say
an
interview
with
the
das
or
or
by
attending
local
groups,
where
we
can
meet
people
that
are
using
services
and
get
their
they
get
their
experience.
So
it's
it's
welcome.
Is
it's
already
there
and
then
what
do
we
need
to
do
to
top
that
up
and
but
we'll
be
able
to
say
more
after
we've
done
the
pilots
as
to
how
long
we
think
those
things
will
take
and
and
and
who
needs
to
be
involved
and
we'll
be
able
to
say
more
about
that
in
in
a
few
weeks.
I
Yeah,
thank
you
that
was
really
clear
and
I
think
good
to
see
lots
of
the
kind
of
points
that
I
and
I've
heard
on
the
raise
others
raised
during
the
sessions
and
other
sessions
come
through,
so
very
supportive
of
most
of
it.
I
think
question
around
accountability.
Is
it
was
good
to
see
that
you
kind
of
mentioned
this
under
the
proportionality
theme
it'll
be
good
to
see
this
come
through
quite
strongly
in
the
kind
of
guidance
and
the
handbook
that
systems
and
providers
will
receive.
I
I
think,
obviously,
there's
a
lot
to
work
through
in
terms
of
how
do
you
actually
in
terms
of
ics
ratings
and
assessment,
look
at
the
added
value
of
icss
and
I
think
that's
where
the
four
purposes
comes
in.
It
was
good
to
also
see
that
mentioned
under
the
co-production
theme.
I
think
there's
a
lot
of
support
for
for
the
floor
purposes,
there's
a
lot
of
kind
of
energy
behind
them,
and
I
think
I
hope
this
comes
across
quite
strongly
across
the
piece.
I
I
I
think
a
bit
expecting
the
messenger
of
you
to
kind
of
say
you
know
system
is
a
a
task
focus,
but
actually
you
know
regulation
has
to
make
sure
that
they're
they're
unable
to
move
towards
outcomes,
and
that
is
a
system-wide
challenge
and
again
that
was
mentioned.
I
think
in
relation
to
leadership
and
data,
but
yeah
again.
Another
thing
that
I
think
could
could
be
good
to
come
across
across
all
the
themes.
I
I
think
there's
just
another
point
around
the
fact
that
this
is
a
very
different
way
of
working
and
relating
to
those
who
you
will
be
assessing
so
kind
of
the
tone
with
which
this
framework
comes
across.
I
think
system
leaders
will
be
really
useful
kind
of
partners
in
this
co-production
phase
to
provide
examples
and
sort
of
the
depth
of
sophistication
of
of
these
new
structures
that
we're
working
in,
and
I
think
for
you
and
also
for
nhs
england.
I
It
will
be
about
kind
of
asking
the
right
questions
and
about
kind
of-
and
I
know
this
is
sort
of
the
approach
we're
taking
but
not
prescribing.
You
know
what
an
ics
is.
What
an
icb
is,
what
icp
is
how
they
do
that
co-production
of
communities,
but
actually
you
know
asking:
how
are
you
doing
this
in
your
place
and
then
you
know
doing
the
assessment
from
that.
I
From
that
point,
I
think
in
terms
of
the
sort
of
implementation
of
the
framework
it
needs
to
be
kept
permissive
and
nuanced,
with
lots
of
different
approaches
to
implementation.
There
isn't
just
one-
and
I
think
again,
that's
something
that
you're
considering,
but
just
to
kind
of
reflect
feedback.
I've
heard
from
system
leaders
I
think,
especially
in
year,
one
I
would
support
you
know
not
having
ratings
and
when
you
do
look
to
produce
ratings
in
the
future,
because
they,
you
know
they
do
have
a
useful
purpose.
I
I
think
it
will
be
working
with
system
leaders
on
the
best
way
to
do
that
as
well,
and
what
else?
Oh
yeah
also
good
to
see
the
mention
of
peer
review,
something
that
at
the
nhs
confederation
we're
often
we
have
our
peer
support
offer
and
it's
something
that
we're
looking
into
a
lot.
I
think
icb
leaders
are
very
keen
to
take
part
in
cqc
inspections
of
specialist
advisors.
I
So
it's
just
about
kind
of
getting
that
in
diaries,
and
maybe
thinking
of
some
rules
around
that
so
you
know
do
we
have
people
going
into
a
different
geographical
areas.
I
think
you
mentioned
so
yeah
very
supportive
and
just
a
few
things
to
add
color
to
what
you've
said.
Thank
you.
B
Thank
you
annie
can
I
can,
I
just
add
something
on
the
the
the
peer
review
bit,
because
actually
it
you
know,
we
are
really
keen
that
there
are
senior
executives
from
each
ics
put
forward
to
to
come
and
join
our
our
specialist
pool
so
that
when
we
do
these
asset
assessments,
we
are
accompanied
by
somebody
from
outside
of
that
area.
B
To
do
that
that
peer
review
to
to
to
support
to
challenge
and
to
help
to
spread
learning
and
improvement
so
for
them
to
take
things
good
things
back
into
their
own,
their
own
ics.
B
So
that's
very
much
the
message
that
we're
spreading
it
with
as
we're
we're
doing
a
sort
of
a
virtual
walkthrough
of
all
ics's
at
the
moment
talking
to
them
about
the
proposed
processes.
And
our
message
is
we
want
somebody
from
each
ics
to
to
join
us
so
that
we
could.
We
can
use
that
as
a
really
good
tool
to
provide
peer
support,
peer
scrutiny
and
shared
learning.
E
J
Hi,
yes,
so
it's
just,
and
you
might
not
be
able
to
answer
this.
So
it
goes
back
to
the
earlier
question
in
terms
of
the
interdependencies
around
the
ics
assurance
and
the
local
authority
assurance,
and
I
guess
it's
something
just
to
bear
in
mind
if
it
can't
be
answered
at
the
moment,
but
you
would
expect
similar
responses,
hopefully
to
come
from
each
around
things
like
partnerships
and
how
they
work
together
and
safety,
etc.
J
So
if
they
are
not
done
kind
of
side
by
side
say,
for
example,
you've
done
the
local
authority
assurance
and
then
sometime
later
you
do
the
assurance
of
the
ics.
Would
you
then
go
back
to
review
the
local
authority
narrative
or
rating
whatever
it
might
be?
If
there
was
a
substantial
difference
in
terms
of
what
you're
finding
when
you
actually
did,
the
assurance
of
the
ics.
G
Can
I
say
I
think
it
would
depend,
I
think
it
really
would
depend
on
on
on
the
individual
case
and
does
it
does
it?
Does
it
wobble
what
we?
What
we've
said
already
significantly,
does
it?
Does
it
call
that
into
question,
and
really
that
is
a
key
aspect
and
benefit
of
the
model
we
want
to
eventually
step
into
once
with
baseline?
Is
that
we're
able
to
be
reactive
and
unable
to
respond
to
things?
Without
you
know
kind
of
previous
regimes
it
would
have
been
well.
G
E
Yeah
stuart's
asking:
are
we
still
on
target
to
publish
the
local
authority
methodology
in
september.
G
That's
not
a
timeline,
I
recognize,
but
yes
we
are,
we
are,
I
think
I
I
know
plans
are
still
developing
but
yeah.
I
you
know,
I
think
we're
really
keen
to
publish
as
soon
as
we
can,
because
there's
a
otherwise
the
risk
of
a
vacuum.
So
absolutely.
K
K
I'm
really
pleased
that
you
have
recognized
that
we're
going
to
be
in
different
stages
as
we
develop
in
its
early
days
and
particularly
for
the
initial
baseline
and
how?
How
then
do
we
get
parity
of
assessment,
given
that
everybody
is
going
to
be
at
different
stages
of
that
process
of
integration,
so
that
it's
not
a
subjective
statement?
K
If,
because,
undoubtedly,
whether
we
like
it
or
not,
people
are
going
to
compare
results
of
ics,
even
if
they're
completely
different
in
their
makeup.
So
how
are
we
aiming
to
get
that
parity
so
that
it
is
almost
done?
Apples
and
apples.
B
B
B
That's
that's
all
that
people
will
see,
but
the
the
direction
of
travel
is
the
really
important
thing
I
think
to
be
for
us
to
be
reflecting
back
in
in
the
outputs
dominique.
I
don't
know
if
you
want
to
add
anything
to
that.
F
F
It
is
cqc's
role
to
offer
that
independent
assurance
to
the
public,
so
you
know
there
will
be
and
we
recognize
there
will
be
that
geographical
variation,
but
I
think
it's
making
sure
that
the
assessments
have
a
value
add
within
the
context
of
of
where
things
are
at
the
moment
and
that's
why
we're
so
keen
to
have
a
chance
to
pilot
our
approach
rather
than
just
jump
into
the
process
without
having
thought
all
these
issues
through.
F
It's
really
helpful
that
a
lot
of
the
questions
you're
raising
are
are
things
that
we
have
in
mind.
So
that
means
we're
not
too
far
off
the
mark
in
terms
of
how
we're
developing
going
forward.
K
Thanks
and-
and
it's
not
also
so
for
me-
it
wouldn't
just
be
about
geography,
so
if
I
think
of
my
own
ics,
integration
technically
should
be
easier
because
it's
only
two
local
authorities,
but
my
ics
next
store
is
seven
local
authorities.
So
it's
not
it's
not
just
about
geography.
It's
about
complexity,
isn't
it
yeah,
and
I'm
really
sorry
if
I
missed
them,
but
it
would
be
really
helpful
if
you
could
share
the
draft
quality
statements
again.
That
would
just
be
really
helpful.
Thank
you.
H
Hi,
neil
thanks
thanks
again,
my
question
is
really
related
to
the
last
discussion
about
context,
which
I
think
it's
every
local
authority
would
can
make
a
strong
case
that
they
all
we
all,
have
unique
context.
H
H
You
know
you
know,
geography
or
you
know
it's
quite
a
broad
concept
context,
and
I
just
wondered
whether
there'd
been
any
thinking
at
all
about
what
the
indicators
might
be,
because
leadership,
arguably,
is
an
element
of
that
context
as
well,
and
those
democratic
structures
are
also
part
of
context.
So
how?
How
would
that
inform
any
consideration
of
ratings.
G
I
can
I
can
try
and
answer
that
thanks
thanks
great
fred,
absolutely
context
to
be
really
important
and
as
part
of
that
initial
information
that
we'll
be
looking
for
local
authorities
to
send
you
know
there'll
be
documents
to
send
to
us,
self-assessment,
as
I
said
in
any
peer
review
that
might
exist.
Also,
crucially,
the
context
and
anything
that
you
feel
as
a
local
author
is
important
for
us
to
take
into
account.
G
There
has
been
some
work
done.
I
don't
think
we
have
any
colleagues
from
our
data
and
insight
team
with
us,
but
has
been
some
work
done
to
start
to
map
out
a
more
detailed
level
what
the
indicators
might
be,
the
building
on
what
we
did
with
our
local
systems
reviews.
Essentially,
so
it
is
very
much
about
the
local
context
and
the
demographics
and
deprivation
and
those
kinds
of
things.
But
again,
I
think
that's
something
we
can.
G
We
can
come
back
to
through
our
engagement
sessions
and
make
sure
we're
capturing
those
in
the
right
way
and,
and
certainly
the
kind
of
the
political
and
leadership
aspects
are
something
we've
heard
as
being
important
to
take
into
account.
G
And
then
I
think
how
that
plays
into
ratings
is
something
that
again,
as
we
pilot
we
can.
We
can.
We
can
test
that
out.
I
think,
there's
a
there's,
a
balance.
Isn't
there
between
needing
to
be
consistent
and
are
kind
of
applying
a
standard,
but
at
the
same
time
recognizing
the
situation
as
it
may
be
on
the
ground
which
brings
us
on
to
another
benefit.
G
I
suppose
of
of
this
duty
that
we've
been
given,
which
is
where
issues
are
effectively
out
of
control
of
the
local
authority
where,
where
the
circumstances
are
such
that
they
are
doing
the
best,
they
can
that's
a
really
important
message
for
us
to
be
able
to
play
up
to
to
government
and
to
policymakers.
That's
that's
a
really
important
part
of
our
role
here,
using
our
independent
voice
and
to
set
out
the
kind
of
challenges
I
suppose
but
yeah.
G
The
context
needs
to
be
weighed
in
as
we're
considering
as
we
come
into
those
judgments
for
each
of
the
topics
that
the
quality
statements
describe.
B
Are
there
any
other
questions
that
anybody
got
any
other
burning
questions?
If
not,
I
think
it
maybe
is
coming
to
its
natural
clothes.
What
I
would
say
is
that
we've
noted
everything
that's
been
shared
in
the
chat,
and
so
there
are
questions
around
wanting
timelines.
You
know
when
publishing
methodologies
and
so
on.
All
those
have
been
noted.
We've
recorded
this
so
we'll
be
able
to
to
reflect
back
on
on
the
questions
that
you
asked
and
make
sure
that
they're
being
taken
into
consideration,
and
this
isn't
this
isn't
the
end.
B
As
we've
said,
we
want
to
continue
to
engage
and
iterate
our
processes
to
make
them
a
really
good
product
for
when,
when
we
start
in
earnest
next
year,
I
can
see
there
is
another
hand.
L
I
was
just
wondering
if
you
considered
what
the
mix
of
virtual
meetings
and
physical
meetings
will
be.
Will
you
actually
be
on
the
ground
in
the
authority
visiting
places
or
or
we
just
be
attending
virtually
as
that
mix
kind
of
been
worked
out.
A
It's
a
very
good
question:
matt
we
haven't
worked
that
out
we're
very
keen
to
test
that
on
the
pilots,
but
we
we
we
don't
want
to
come
in
and
move
in
for
a
week
with
things
that
work
well,
virtually
we'll
we'll
be
wanting
to
do
those
virtually
and
things
where
it'd
be
better
to
be
in
the
room
and
hear
direct
and
talk
direct
then
we'll
do
that,
but
we
yeah
we,
you
know
we
we
want
to
get
that
right.
Proportionality
really
important
here.
Thank
you.
B
Yeah
yeah:
it's
not
going
to
be
prescriptive,
matt
and,
as
mary
says,
we're
not
going
to
turn
up
in
a
bus,
but
there
may
there's
likely
to
be
a
combination
of
the
two
for
ics.
You
know
some
time
on
the
ground
doing
some
face-to-face
work
and
you
know
we've
always
got
to
be
flexible,
for
when
key
individuals
aren't
able
to
be
available
so
that
you
know
it'll
be
a
mixture
of
the
two.
J
I
think
yes,
so
obviously
you
mentioned
the
focus
around
care
act,
duties
for
local
authorities
and
also
you
made
reference
to
the
recent
ada
survey.
So
when
obviously
you've
done
a
number
of
local
authority
assurance
visits
or
inspections,
whatever
they
are,
will
you
be
pulling
together
any
sort
of
key
themes
to
sort
of
escalate?
So,
for
example,
you
know
some
of
the
stuff
that's
come
out
of
the
ada
survey.
You
would
notice
if
you
visited
any
one
of
those
individual
local
authorities.
G
So
yeah,
I'm
sorry,
absolutely
absolutely
debbie
I
mean
we
will
be
sharing
our
our
findings
with
the
department
as
we'll
be
required
to
do
so.
There's
always
that
line
there
and
I
think,
what's
worked
so
well
as
we've
developed.
This
is:
is
that
genuine
kind
of
partnership
across
lga
that
adas
and
and
the
department
of
ourselves?
I
think
we
want
that
to
continue
as
this
goes
live,
but
definitely
working
out
the
best
ways
to
to
group
together
this
this
our
findings,
and
so
it
has.
G
The
maximum
impact,
is
something
we'll
be
wanting
to
do,
and
certainly
obviously,
as
a
minimum
as
part
of
our
state
of
care
reporting,
but
also
other
means
as
well
to
really
shine
a
light
on
the
issues
that
we're
finding.
J
B
And
and-
and
the
same
really
goes
for
for
ics
assessment,
so
you
know
we're
wanting
to
be
driving
improvement
on
those
local
ics's,
but
we'll
also
be
pulling
out
themes
and
have
that
escalation
route
and
to
be
able
to
give
that
independent
voice
of
of
the
the
state
of
the
state
of
care,
if
you
like
across
the
whole
country.
So
where
we
see
commonality
themes
we
will
we
will
be
able
to
speak
out
about
that.
B
Think
we
are,
I
think
we
are
so,
as
I
said,
take
a
note,
and
you
know
this
isn't
the
end.
This
is
still
a
part
part
of
the
the
road
to
get
to
get
to
where
we
all
want
to
be.
So.
Thank
you
very
much
for
your
time
and
and
for
attending
today,
and
for
all
of
your
input
and
from
me
have
a
have
a
really
good
rest
of
the
day
and
I'm
sure
the
same
from
mary.