CQC Board Meeting - March 2026 - Wednesday 11 March 2026, 2:00pm - Care Quality Commission

CQC Board Meeting - March 2026
Wednesday, 11th March 2026 at 2:00pm 

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  1. Webcast Finished

1.0 Opening and Welcome

Good afternoon and welcome to the Care Quality Commission's public board meeting of the 11th
of March, 2026.
I am Sir Mike Richards, the current chair of CQC, but as many of you will know, I will
be standing down soon.
We are waiting for a new chair to be appointed.
and just while I say that, can I hand over to you, Kay,
because I think you know as much as anybody does
about the next steps.
Thank you, Mike.
Yes, just to update everyone,
the appointment of the new chair
is with the Department of Health and Social Care.
We have been assured this has been progressed quickly,
but we do not have a definitive timeframe at the moment.
If I may, Mike, I'll also do a similar update
on the chief executive appointment.
I'm sure people are interested in that as well.
The approvals for the chief exec to start recruitment
not within our gift.
This has been with the Department of Health
and Social Care since December.
The risk of starting recruitment
without the required approvals has been considered
by the CQC board, but we have concluded
the penalties would be unaffordable.
We are in weekly contact on these matters
and we press the importance of resolution.
Risk around organisation stability, leadership and ability to drive change are higher as a result.
So just please everyone be assured we are doing what we can within the CQC board remit.
Thank you very much.
We have two apologies this afternoon.
Arun Chopra, our interim chief executive officer, and Alex Karetz, one of our non-executive
directors.
and then in place of them we're very delighted that Chris Usher is going to
stand in for Arun, Chris is our interim deputy chief executive so welcome
Chris to that role this afternoon just
absolutely right Chris Badger is also not able to be with us so that's another
apology, just saying that Richard Barker is with us but he's technically an
associate non-executive director because he had to stand back from being a full
non-executive director when he was working on the merger of NHS England and
DHSC, but the full intention is that you will come back to being a full NED
very very soon. We are also joined today by Paul Kirby from the Gender Equality
Network just to let you know that Paul does have hearing loss problems and so
he's accompanied by two British Sign Language interpreters who are also in
the room with us and they're going to swap round every 20 minutes or so in
terms of who's doing the sign languaging. And then last but by no means least are
trade union rep today is Sooz Ceska and she's from Unison. So I think that's in
terms of the roll call for the day. Conflicts of interest I haven't had any

1.2 Declarations of Interest

notified to me that are new from anything before. No, no new conflicts of interest

2.0 Governance Matters

so we can move on to item two which is governance matters and first of those is
for us to approve the minutes of the previous public board meeting that was
held some while ago that was the 26th of November 2025 and so people have got
the public minutes available.
First of all, are there any matters of factual accuracy?
Sooz.
Hi, I realise that me and Deirdre McEvoy
trade this seat on a rotational basis,
but I've looked at the notes
and there's some inaccuracies.
There's a number of these comments
and that might be a little bit picky,
but we are very nuanced in the language we use
and some of that nuance wasn't captured,
So it might be more beneficial in the future to submit all three questions or three statements
After the fact and I can send through the actual detail that I've got helpful afterwards in the same today for our key points
Amazing thank you
Any other comments on the minutes of the last meeting
So I think with that we can approve the minutes. Thank you very much. And that takes us on to

2.3 Action Log

the action log and agree with the proposed outcomes for each action. Are there any actions
here that we need to be taking on board? I don't think there are to be honest because the ones
we've got are complete. Good. And that then takes us to the decisions log which we

2.4 Decisions Log

are asked to to note the decisions which were all taken actually back at the
last meeting in 2025. Because this is the first meeting of 2026 there are no
decisions recorded for this year so far but were there any points there we
considered these earlier as private board meeting is there anything here
that people wanted to raise no? I think that's good we'll take those then as

3.0 Committee Reports

3.1 Audit & Risk Assurance Committees (5 December 2025, 5 February 2026 and 24 February 2026)

accurate and that takes us on to item 3.1 which is the orders and risk
assurance committee and there have actually been three meetings I think of
that the 5th of December, the 5th of February, and the 24th of February 2026.
Can I hand over to Kay as chair of the Audit and Risk Committee?
Thank you, Mike. Yeah, I will summarise the three meetings sort of thematically. There are six
areas. First of all, the Audit and Risk Assurance Committee has been looking at the progress on our
annual reports and accounts from 24/25.
There is continued delay to these,
primarily due to the impairment work on technology assets.
And recent discovery work has necessitated revisiting
some of the valuations that were in train.
Esther will touch on this more
when we go to the executive report.
And we'll report on the annual report at the next meeting.
One of the disappointing knock-on effects of this,
it means we are unlikely to get back into a more usual
or timely annual report sign off for year end,
for the 25/26 year end.
We're probably going to be in recovery
for two years instead.
A large amount of committee time has been spent
on the refreshments of risk management
and the strategic risks,
with the board assurance framework coming twice
to meetings in February.
The latest version has also had been improved again.
Other reports have shown that the number
of strategic risks that are high risk and out of tolerance.
So while the committee's commended the executive colleagues
for honesty, it does lay out starkly how much
fundamentals need to be put in place to mitigate risk
and provide assurance that CQC is on the right
recovery track.
And the shift to delivery at pace is absolutely front
and centre of all the discussions.
We are expecting to see over the next quarter
development again and putting in more assurance processes required for the transformation programme, given how critical and complex unnecessarily - unnecessary this programme is.
In terms of internal audit, there has been some slippage, which is outside of CQC's control.
Some of that has been in the technology assurance space and we are pushing for a very fast start
to Q1 again to have recovery there.
There was one limited assurance report on programme and project management governance.
Again, there's a theme here that's very, very important to where we are at the moment.
The field work was last year.
We did receive the report in December,
but not with the action plan.
The action plan was received in February.
It's been taken on board with a lot of the setup
of the portfolio office, but with delivery being
so paramount, we need to, and we will continue
to look at this in terms of making sure
that the lessons have been learned
and are built into future programmes.
We're very conscious of our assurance role
for the teams and functions that CQC has
within the CQC family, so we've had reports
from Health Watch England, National Guardians Office,
and the Maternity and Neonatal Safety Investigation Unit.
Some really great understanding about risks,
including transition risks in there,
and where we might ensure that we are knitting together
the sort of whole organisation in a more seamless way.
Finally, we have a standing item now,
which is - outstanding items, which are very,
because we're very keen to learn from incidents.
So one is on counter fraud.
And what we are seeing is it's reassuring
that there's a much more proactive work
to create an anti-fraud culture.
Inevitably, when you do that,
you see more cases coming to light.
Those are being scrutinised very carefully,
including looking at actions to tighten controls.
and there were some very sort of clear signals in that. And finally with freedom
to speak up we now have a report each time including reporting on themes so we
can drive continuous improvement culture. Those reports continue to be
evolved but they're really really important as part of our assurance. I'm
happy to take any questions. Thank you very much indeed Kay. But questions to Kay?
Not seeing any, there you are. That's fine in which case we can go on to item 3.2

3.2 Regulatory Governance Committee (15 January 2026)

our report from the regulatory governance committee that was held on
the 16th of January and I chaired that meeting and there were five I think
separate items that we covered. At that meeting we got the initial response to our consultation
on the assessment framework. I think we'll be saying more about that later in this meeting,
but it was very encouraging that we've had a very large number of responses, I think
over 1700 responses to that consultation. But at that stage back in January we knew
that further analysis needed to be done, which has now been done, and there was
further work to be done on exactly for those complex trusts like hospitals and
mental health trusts, how we rate locations and how we take that
forward. And those things, it was already apparent from the consultation.
There were more mixed results on that and we are working through how best to
do that now and we will be going out to consultation again on that. And then the second key item
that we discussed was registration, where people will know that there have been delays
in registration, although very considerable improvements have been made. And getting the
backlogs down, part of that session was really hearing about the complexities of registration
and what it actually involved so that all board members or all RGC members
were fully aware of that which was a very useful session. We then had updates
reports from the four chief inspectors. We briefly touched on the maternity
review and again we may hear more about that and the next steps in that later in
meeting and we also discussed the new regulatory powers which will be coming
the way of CQC things like cosmetic surgery and registration for temporary
events. So the plan is that from the regulatory governance community I will be standing down from that obviously,
And as soon as Richard Barker has been confirmed as being the back to being a full -dead, he
will also take on the role of chairing RGC.
Any questions to me on the Regulatory Governance Committee?

3.3 Executive Report to the Board

No, in which case we can go on to item 3.3, which is the Executive Committee's Reports
to the Board, and this is going to be taken by Chris Usher.
So over to you, Chris.
Thank you, Chair.
So we've broken the report down into three sections around our people, performance and
and external landscape.
So just talking through the people section,
first thing to talk about is our people survey.
We've just closed our first people survey since 2024.
We've had a really good response rate, 75% response rate,
which is fantastic.
Results are expected through April,
so we'll eagerly await those.
I think from the last survey,
hopefully we can see positive changes being delivered,
but I think we're probably realistic,
there's still a lot of work to do,
so we'll see those results as they come through.
We've listed in the paper some key leadership appointments
that we've made, or in the process of making,
really strengthening our leadership,
senior leadership, CADRE, with some key appointments there.
I'll not list through all of those,
but you can hopefully see really strengthening
in our leadership space.
Another bit to pull out is some work we're doing
at the minute around modelling.
So resource modelling across our frontline
inspection directorates.
This will really help us understand
what our current capacity can deliver.
Also the quantifiable impact of the things
that are slowing us down at the minute.
And then provide us with a model
that we can scenario plan around.
Where we anticipate gains to come in through new technology,
ways of working, and then the level of resource
that we'll need once those are factored in
to really address the demand that is placed
on this as an organisation.
The final bit to mention in this section
is just around the CQC way, which we launched last summer
with a set of values and behaviours and commitments.
We've underpinned that with seven priority areas
that each of the executive team have taken ownership for.
We're making good progress delivering on this,
but there is still some work to do
and setting out a clear roadmap around those seven areas.
So we're tracking that closely.
In terms of performance, we've been focusing on things
that can make a difference now to help support colleagues
and help support delivery.
Set up a multidisciplinary approach with a 12-week project
to look at immediate changes.
We've listed some of those out in Appendix A,
as you can see.
Alongside this, we're also looking at what we can explore
with use of AI and what capability that can bring.
Also testing things like shorter reports
and Esther might want to say some more
on some of these bits when I finish speaking.
And then finally on this external landscape,
couple of bits to bring out there.
National Maternity and Neonatal Investigation,
so chaired by Baroness Amos,
has published an interim report on insights gathered so far.
I think that was quite clear that the system is not working for those that it's there to
provide care for.
And Arun, Toli and Samyka set to meet the investigation team as part of the next phase
of evidence gathering.
And we've also listed a lot of upcoming legislation.
And it seems a lot of activity working through their primary legislation, secondary legislation,
and policy changes.
Also, in addition to that, how we can support the shift in neighbourhood health as part of
the 10-year plan.
I think the key thing for us with all of that is just prioritisation.
I mean, there's a lot of activity there in amongst the work we're already doing, so how
we prioritise that work is crucial.
That was all I was planning to cover, Chair.
I think Esther was going to say a bit on some of the work we're doing in the AI space as
well.
Esther, over to you.
Thanks, Chair, and thanks, Chris.
So just a couple of other updates for me to bring some of this to life.
First of all, colleagues, I'd just like to formally thank
Mohamed Imran Noorgat, who has been providing interim
leadership in the director of technology space.
As the report shares, and as Chris has just updated,
we have now appointed an external colleague to come
and join us early in April, so that colleague's name
is Sunny Singh, who'll be joining us in early April,
but I just wanted to formally thank Mohamed Imran
and also other colleagues within Mohamed Imran's team
for their work in the interim leadership space
because it has been absolutely vital
to our continued sustainability and success
from an IT operational perspective.
So just then bringing out some additional points
around the work, Chris, that you mentioned
around tactical fixes.
Colleagues will be aware, as well as anyone listening,
that I made some personal commitments last year
to improve things now for colleagues
with the challenges that colleagues
are still experiencing in using our regulatory platform.
So over the last few months, the multidisciplinary team
that Chris mentioned have reviewed over 3,500 requests
for change that have been submitted
to improve our current regulatory platform.
That team have triaged and prioritised those down into 44,
which we are working through.
Some have already been delivered.
and again our papers provide more information on that but that is a real
a real kind of improvement as to where we were perhaps this time last year and
my hope is that those improvements will continue and colleagues will start
feeling the benefit of those. Just in respect of AI then again the papers
outline some work we are doing in the AI space and all of this work will go on to
inform our future rebuild programme. A couple of ones to bring out specifically
and again my thanks to colleagues internally who have been actively
participating and piloting this new technology. We are piloting a chatbot
across our guidance, our many pieces of guidance for inspection, inspectors and
operational colleagues on the ground. We are piloting a chatbot that we have
developed to support the speed in answering our colleagues' questions,
and early indications on that have been very positive,
and we'll be including that in a formal evaluation going forwards.
The one I particularly wanted to mention was our work with ambient voice technology.
So the board will be aware, as colleagues and others listening may well be aware.
We were awarded some funding under the Regulatory Pioneer Fund
to pilot the use of ambient voice technology
whilst on site during our inspections.
And so we are piloting that in a project
that is due to complete in May
with a number of providers from our primary care,
community care, and hospitals and specialist care sectors.
And again, that work will inform our future rebuild
and of course the necessary consents,
as you would expect, are in place as part of that process.
I also just wanted to mention the 250 colleagues
that we have piloting additional co-pilot functionality.
I'm very mindful, I often get asked questions about
is this going to continue, please don't take this away.
So for assurance to those colleagues,
that is absolutely part of the work we are considering
as executive team this month with a view to
scaling and spreading that work across other areas
and teams to make sure colleagues can be
as productive as possible.
So for internal colleagues listening,
We have developed some comms around this.
We will be developing more,
and so that will be coming your way.
But my thanks to everyone that has been involved
in those pilots, including the providers
that are helping us with ambient voice technology.
Thank you very much indeed, Esther.
So now I think we can open this up to questions
either to Chris Usher or to Esther.
Mel.
So Chris, can I just ask about the relationship
between the CQC way and the staff survey?
So the CQC way I recognise is much broader
about the way we conduct ourselves,
where we go about our business,
and build our relationships.
But staff voice and colleague experience
is a big bit of it, so how are we going to be
using the staff survey to build that set of objectives?
I think that would be a good asset test of where we're at.
I think the survey will tell us where we need to do more,
where we're progressing well,
I think we need to play those results in
as part of the work we're doing around the CQC way.
We've already started setting out a plan
around how we address those seven priority areas
of the CQC way.
As I said, I think that staff survey
will just help validate that.
And hopefully we're on the right track
and we know the things that are coming out
of the staff survey,
but I think it'll be vitally important to test
and also help us set some measures and metrics
of how we can test improvement over time.
And we will in due course be bringing the results of the staff survey back to the board,
which is really important.
Any other, Sooz, yes please.
Thank you.
Just one tiny minor comment is that my union colleagues would boast me if I didn't say
it's the Employment Rights Act, as I keep saying Bill, and have been corrected by every
national officer.
And so I just want to make sure that we're using the right language in this.
And the second one is just on the CQC way.
I think it is a pertinent time to have the staff say results to see that asset test,
or that test of where we've gotten to and where we need to focus more effort energy.
I think just to champion the voice of members that it's to see the detail behind the plan
and the rebuilds in our organisation and especially the things that link to the way
as we approach the one year since the launch, it would be good to see some detail
and some momentum around that and some tangible what we have done and measurable successes or
areas that are priority to ensure we're embedding this change because the cultural change is
very much needed and isn't always being felt and so how do we close that loop where we can.
That's all, thanks.
Any other questions or comments on the report we've heard from Chris?
We're still in your court though Chris we come on to item 4.1 rebuilding

4.1 Rebuilding Portfolio Update

portfolio update and I think we're also going to be joined by Fiona Dolman.
So we'll just wait for Fiona to join us.
Yes, so I mean we could go straight on to item 4.2, the quarter three performance finance

4.2 Q3 Performance, Finance and Risk Report

and risk report because that's still in your court, Chris, and then when Fiona joins us
we'll go back to item 4.2.
Thank you, happy to.
So colleagues, we have the quarter three performance reports for you, as well as an update on risk
and finance.
So just key bits to pull out from performance in quarter three, starting with assessments.
So we set a target 9,000 assessments by September 26.
We've completed just over 4,500 to date, which is above the target we set at this point in
time of 4,256, so we're also on track to hit the 9,000 target we set.
I think it's fair to say it's something we probably need to be level-headed about.
From where we've been as an organisation, this is real progress, steady improvement,
and it's meeting the targets we set out.
In terms of where we need to be and to meet demand, we need to hit higher levels, and
that is what our change plan is around.
and that is the work that Fiona will talk to
in a moment around.
So it is good progress so far.
Within that, there's probably a varied position
across sectors, so AFC, oral health,
are examples of sectors that are expected to meet targets.
Other sectors, such as mental health, secondary care,
have been under target this year.
We're seeing improvement, but we know there's work
to do in those areas.
CIs might want to mention more on that.
Registration is another area to pull out.
We track the volume of registration applications
received that are over 10 weeks old.
Overall, the volume is reducing,
as is the volume over 10 weeks old.
We've now got just over 1,800 applications
over 10 weeks old.
That's dropping at a rate of about 30% every quarter.
so it's rapidly coming down.
Our KPI is to clear and be at zero over 10 weeks old
by the end of March, hence the red status for this.
It's unlikely we'll do that, but that does probably miss
the significant progress we've made in year
around our registration volumes,
which is a testament to those teams.
The other area I'd just like to pull out
is information of concern.
So just a reminder, information of concern
is feedback received directly from staff,
information about people's experience
or information from partner organisations.
We get about 200,000 a year.
We did a lot of work early in 2025
to really clear a backlog of cases.
We've worked through that and since then
we've been trying to revert to more
business as usual way of working.
In hindsight that was probably ambitious,
but it is vitally important work
so we're keen to set that out.
We're starting to see performance head in the right direction.
Priority two, priority three, information concerning hitting targets in December for
the first time.
Priority one, priority two is slowly moving in the right direction.
We don't have an amber rating for priority one or priority two.
It's either red or green, just to note.
Other positive bits of performance just to pull out would be our performance in MNSI,
contact and trust in families, noting the completion
investigations metric is not always in our control,
which is currently read.
NCSC call lines have been steadily hitting targets
all year, which wasn't always the case,
and the work they've done this year has been fantastic
in terms of operating the call lines.
And our local authority assurance site visits,
we've delivered all 153 site visits at end of December,
which was our plan, and now just working through
publication of those reports. In terms of risk, we're in the process of
introducing and cementing a board assurance framework and in the process
reviewing our corporate risk register. Our risk register has 24 risks with the
majority being higher rated than we want. There's been a considerable amount of
work since December, since this reporting period, working on our
risks and I think we'll see a revised updated that at the next report we bring
through, but happy to take any questions on any of the risks we've got there.
Finally, on our finance, at the end of quarter three, we had a 2.2 million surplus with a
4.9 million underspend forecast for the year.
Our depreciation is playing a pivotal role in our financial position this year, so of
that underspend forecast, about 3.2 million of that is around depreciation, which is driven
by impairments to our regulatory platform and also low capital spend.
Also had lower spending plan in certain functions,
notably technology and a slight favourable variance
on income.
And the last point would be we've had minimal capital
spend to date.
Looking at plans for the year, but we're expecting
about 3.8 million underspend on our capital budget.
And I will pause there, Chair.
Thank you very much indeed, Chris, for that.
So open to questions.
Bola.
Apologies.
Thank you, Chair and Chris.
Just to voice over in terms of the performance report,
I want to record my thanks to Chris Gendall,
who is Director of National Ops
and has also been covering primary care
and community services for the central region.
Chris oversees the oral health team,
and you can see how their performance has more than held up
despite that expanded portfolio that he has covered for us.
So I just wanted to draw the attention of board to that.
And secondly is to say that the performance
that we are seeing in primary care and community service
is still some way to go.
However, the progress we are seeing
is a combination of a number of things.
Performance recovery plans are now in place
for each of our regions.
We have a weekly director-led performance review,
which is enabling us to see
where the particular challenges are.
In addition to that, we've also been looking
at internal challenges in relation
to specialist advisor capacity and capability,
which has adversely impacted our productivity
and performance, and we are also thinking
about creative ways in relation to the utilisation of SPARS, which we hope will give us even
better productivity going forward.
But just want to acknowledge the tremendous amount of work that colleagues are doing to
try and make sure that we are doing the right thing by patients and service users.
Thank you, Chair.
Thank you, Bola.
Any other questions on Chris' report?
Yes, Paul.
I hope this works.
Thank you, Chair.
Chris, just a response.
A deaf man trying to control my microphone.
Just a response, a couple of things on that paper, which jumps at me, is how confident are we given inspectors are retiring,
and as we have still got significant numbers to recruit, onboard, and induction, which takes time,
because being an inspector, it would take a good year/18 months
to be a fully fledged inspector.
So what plans in place for that to progress that forward?
And the second one is obviously the reason
that the assessment being stuck.
So what work is behind in unstuck that situation
and moving that forward?
I'll try.
So on the first one, Paul, we have live inspector campaigns on at the minute, and I think we'll
probably need them if they're not already a rolling campaign of those campaigns.
And in terms of, there was another point, I've forgotten the second half of the question.
The one that says that the community regions are stuck.
No, sorry, it was your point about how long it takes to onboard colleagues.
I think, yeah, I acknowledge that.
I spent time with a group of inductees yesterday,
so I'm familiar with the time it takes,
and I think we need to be mindful of that.
That's probably also part of the issue
in terms of the performance in certain sectors,
the time it's taking to onboard colleagues
to make sure they're fully ready and operational.
But I think that the live inspector campaign
is where we need to be on with, which I know is in place.
In terms of the stuck assessments,
I mean, Chris will probably talk that.
we're down to two now, which is the live position
from 500, which is great, but in terms of how we got there,
Chris can probably answer that.
I think there's two things to say.
First of all, the original 500, we are down to two,
and those two organisations are,
because the assessment itself is quite old,
we're going back to do further assessments
on those two organisations.
In terms of what having that backlog taught us,
we've now got a much more sophisticated set of KPIs
that both director colleagues, deputy directors,
and actual operational inspectors can see
where different reports are
and why they are where they are.
And we're much more able to hone in on areas
where we need to put additional resources into support.
Part of the reasons why reports
continue to be somewhat delayed
is the making sure we can adequately go back
on the FAQ comments that we get from organisations
and making sure ourselves that the report writing
is a sufficient quality for it to go back out to organisations.
So I think we've made an improvement
in terms of the original 500,
and we've got now KPIs agreed with each CI area.
And more importantly, everybody can see where the issues are,
and they can hone in and provide additional resource
to support to make sure that reports of the stroke today
don't stay stuck at infinite.
Thank you, Toli.
Thank you, Chair.
And just to update on performance for the hospital sector,
as the report highlights,
we have been consistently under target this year.
We're very cognisant of that
and have plans in place for improvement.
We have a regular performance oversight and regulatory risk meeting chaired by our directors.
We now have two of our substantive directors in post and we're looking forward to our third
director coming in April.
And since we've gone back into sectors, it's also been really helpful to have performance
reports that we all have now at deputy director level, which allows them the oversight of
that.
And we have done a priority plan for 26/27.
So, scheduling now - our scheduled planned inspection activity, allowing capacity for the unannounced
that we'll need to do.
And that will help get us back on track as well because we recognise how important this
is for patients and providers.
Thank you.
Thank you, Toli.
Sooz.
Thanks.
I'd be remiss if I didn't ask whether the switch
in assessment targets is realistic based
on the current headcount acknowledging the vacancies
that are reported in the papers for today.
And just I assume there's a lot of technology action
that's trying to improve the speed of our assessment
process.
And just I would sort of guess the question
is how are we translating those new tools and tips
and efficiencies to the people on the front line who
are so busy doing the job they often
don't have time to read the materials that
might make their job easier.
So just going back, that balancing performance,
the quantity of performance with the well-being
of the people we're asking to go above and beyond
and sometimes just do more.
I think sometimes the message that has landed
when the target changes, that we don't have any more people,
so individuals just have to do more.
So how do we, again, close that loop
about giving them the tools they need
and any new tools we have consistently
and in a supportive way?
Thanks.
Chris.
Just the first thing I'd say Sooz,
would be the targets we've set factor in resource levels,
so it's not with a full establishment.
It factors in colleagues in post.
And a lot of the vacancies we have,
whilst we do have inspector vacancies,
they're spread across the organisation.
So just to give assurance, it's not setting targets
based on aspirational levels of a resource.
It is cognisant of what resource we have in place.
I think Chris and Esther were gonna come in as well.
Thanks, Chris.
It's a really helpful question, and I suppose some of the conversations we are having with
operational managers and our inspectors around the targets, it's more about actually why
we have these targets.
It's not the focus on targets, really.
The focus is on understanding the experience of people in care and having those conversations
with operational managers in terms of the conversations they are having with the people
they manage in terms of thinking of people's well-being,
thinking about actually what else can we do
to mitigate some of the challenges we've got,
for example, with the technology,
like Esther just said earlier on,
when there are issues, they know exactly whom to go to
to have those conversations.
Because what we are trying to do is
not necessarily about meeting the target,
it's about actually improving people's experience
and understanding people's experiences
and also the conversations we are having
are more supportive and understanding as well
the challenges that people are facing
as we try and rebuild what we need to rebuild.
Yeah, thanks, Sooz.
So what we're trying to do is support colleagues now
by making things safer and less challenging for them
whilst giving them the tools to improve
how their processes work.
And I suppose that the fixes that I talked about earlier,
there's a lot of fixes in there that support colleagues
from health and wellbeing perspective.
and we will be monitoring the impact
on productivity and performance.
But I won't suggest that that is the panacea
to all of our issues around processes
and regulatory platform.
They are improvements rather than fundamentally
changing how we work as we know.
With respect to tools, just linking this back
to my previous comments, there are a number of colleagues
that are using AI and additional functionality
to support them.
and we've got some particular activity in that space
which is being supported by the Test and Learn team
in adult social care.
What we are looking at is then how we spread that
across the organisation and also from an educational
perspective how we support our inspectors
and our operational colleagues to understand the tools
that are available to them now that perhaps
aren't being used well.
So we have got some activity in that space
that we are working on and that will be coming through
in the next couple of months.
Thanks, Esther.
Sooz, do you want to come back?
Yeah, just very briefly, as thank you for the clarification,
Chris Usher.
I think, just acknowledging the context of my initial question
really wasn't clear, is the previous targets
were set on our current establishment.
And it's in areas where they haven't been achieved
that I think that pinch is being felt.
Yeah, but thank you for the clarification.
It's going to be very clear where it's come from.
And the other one was to Esther as well,
I think UCBI is really great or has a great opportunity potentially.
But I think I would exercise some caution to ensure that the information we are feeding
it based on if we are feeding it current inspection reports, that they are of good quality so
we're not building in problems of the system.
I know that you're aware of this.
I can see you nodding.
But again, I would be remiss if I didn't pass on that little bit of concern from members
about technology running away from us.
If we haven't got the foundations right, we're going to create more problems down the line.
Thanks.
Just one thing to bridge your points,
both points you've made, Sooz, would be
we've got new induction processes going live April,
which hopefully create a better process for onboarding.
I do think there is something we need to look at
about when is an inspector kind of oven ready,
for want of a better term, because the time,
having a new starter is not the same as having somebody
ready to operate and I think as part of the modelling work
I talked about we need to just consider that timeframe
and when someone's affected from it,
which I think probably does play in a bit
in terms of the sector variances we're seeing
where we're doing big recruitment drives.
So just that nod in that point.
Thank you, Chris.
Richard.
Thanks, Mike.
I'm just wondering if Chris or perhaps other colleagues
can just elaborate a bit on the registration statistics. It looks all red in the report,
but if you look beyond that, we're about 25% higher rate than this time last year, and
we've effectively halved the number of registrations that will be on 10 weeks. So I think that's
probably an amber really in terms of how well that's going compared to last year. But our
target is to get to zero 10 weeks by the end of the year. That possibly looks a bit ambitious
but perhaps we're going to make a big dive for the line.
Which one do you want to comment on that?
Yeah, you're absolutely right Richard.
I think it is with hindsight,
it was probably an ambitious target.
And we've been pure to that RAG status.
It's red, we've not got to where we need to be.
But in doing so, we're doing ourselves a bit of a disservice
with this significant reduction we've made,
both in overall volume and the over 10 weeks old.
So we've kept it as red just to stay pure to that.
But I think it does, we have made significant progress
in the year and will probably be just under 1,000,
I think, by the end of the year, not zero, 750, 900 -
somewhere around that.
But so, you know, I think it was about 4,000
at the start of the year, so it has really come down
and the rate it's coming down is kicking in.
So it's good.
Well thank you all for those comments. Thank you Chris for leading us on that.

4.1 Rebuilding Portfolio Update

But we'll now go back to item 4.1 and welcome to Fiona. This is the item on
rebuilding the portfolio and updates on that. Are you going to kick off and then
hand over to Fiona? Well I'm starting to get sick of the sound of my own voice so I'll just
pass straight to Fiona if that's alright to run through.
Of course.
Good afternoon everybody.
My name's Fiona Dolman.
I'm the Interim Programme Director
for our Rebuilding Portfolio.
It's nice to meet you.
So you've received the paper,
but I thought what might be useful to do
is just talk you through some of the key points
in the paper.
I'm very conscious that it's four months,
probably five now, since the last public board.
So just to bring everybody up to speed
on where we are with our rebuilding portfolio,
I thought would be a helpful thing to do.
So we published our roadmap and we did a world tour,
it felt like, in November throughout the country,
taking that around our organisation
and to key stakeholders as well.
Shared that roadmap to demonstrate
that we've got a view of the work
that we need to undertake across the organisation to rebuild.
Since then, we've set up our rebuilding portfolio,
we set up our programmes of work, and we've delivered a number of milestones, and I thought it would be useful just to talk you through some of that.
We've set up our rebuilding portfolio with three critical programmes and with a very strong
technical kind of structure and managing successful programme structure, which is like the government standard, very very deliberately.
We've made sure that we have oversight across the portfolio,
that we're applying good programme governance
and good portfolio governance.
We're implementing project level governance as well,
getting all of that technical stuff in place
so that the organisation can feel confident
that we're managing risk well,
that we're understanding our key milestones,
and that we're making sure that we deliver
on the recommendations from the DASH.
I'm gonna, Mike forgive me, the Richards review,
the other two, the Care Providers Alliance review,
and the Independent IT review,
so that we can demonstrate a golden thread
from those recommendations through to our deliverables,
through to our outcomes.
And we feel that's an incredibly important thing
for us to do, both for provider and public confidence,
as well as for confidence of colleagues
across the organisation.
We've established three programmes and for each programme we've established an executive sponsor.
Those programmes are rebuilding our regulatory services and the exec sponsor is Toli and
Toli will talk a little bit more about that in a moment. The focus of this programme is about
strengthening our regulatory process from end to end all the way through from registration to
assessment to enforcement. Rebuilding our organisation is sponsored by Chris
Usher and this programme really focuses on aligning our organisation to support
effective regulation. So we have the four chief inspectors, we need to make sure
the rest of the organisation is aligned to serve those inspectors and their
teams because we're all here to support our frontline at the end of the day. And
then we have Rebuilding our Digital Future and Esther is the exec sponsor
and this focuses on building the digital and data capability that we need to make
sure that we can support our work in the way that Esther's just described. So we
felt it was really important that we learn from the transformation programmes
that have been here before and have perhaps not been successful. So we are
deliberately layering into our work that learning and again demonstrating the
learning from the previous transformations in the work that we do so
we can evidence we've addressed it. That feels like a really important thing for
us to do. In December 2025 our private board approved the strategic outline
case for the rebuilding portfolio. So that's a funding envelope of about eight
million pounds to enable us to do the discovery work, to enable us to get to
the outline business case, which then enables us
to proceed into development and delivery.
So that was a challenging piece of work,
but really important to get us into governance.
That's been approved, and so we're now
working towards our ABCs and more detailed work.
We've got really clear governance arrangements
in place now.
As I said, we've got executive sponsors.
We have senior responsible officers.
Again, this is all managing successful programmes
kind of language so forgive me I appreciate it's a bit lingo-y but it's
really important that we do this. We've got SROs in place who are about to be
appointed to enable us to have the right oversight, the right leadership and to
really be able to demonstrate that we are able to realise the benefits of the
work that we're doing. We've got programme boards set up and underneath those
programme boards where it's appropriate we've got project boards set up as well
and we're providing, as I said, regular oversight
of progress and risk and delivery.
And the final thing that I would say
that I think is really important
is we've worked really hard to develop
a comprehensive approach to co-design for the organisation
and to find one way of doing this for the organisation,
whether we are in a transformation space
or a business as usual space,
rather than different approaches for different times.
My team and Chris Day's team have worked really hard on this together.
It's just going through all our governance at the moment to get it approved.
And we will be looking to roll that out from April.
The underlying principle of that is that we are able to be inclusive and hear the voices of colleagues across the organisation in a really representative way.
So when we have different pieces of co-design work, we can draw in the right people with the right experience,
the right expertise as well as lived experience of the reality so that we can
make sure we are designing solutions that are fit for the organisation and
fit for the future. So I thought it's really important to mention that piece.
I will pause there and I will hand over to Toli and then Chris and then Esther
for their brief updates on their programmes. Just thank you very much
before we hand over for all the work you're doing on this but then let's
go straight to Toli. Thank you chair, thanks Fiona for the headlines. So the
programme I'm going to speak to is rebuilding our regulatory services. As
Fiona says it runs end-to-end across all our process but the main focus of the
update today is around one of the four primary work streams. So there are four
work streams within that programme but the one that we're focusing on here is our future
assessment frameworks and I present this information on behalf of all four of our
inspectorates and with thanks to our policy colleagues who have done all the
drafting on those assessment frameworks and have a lot of significant and very
helpful feedback from operational teams. As you mentioned chair when we were last
at public board in November we were part way through a public consultation and it
was a really gratifying response,
and particular thanks to all the public,
the stakeholders, providers, internal and external,
who fed back to us and really influenced
our thinking on this.
The consultation looked at how we
proposed to develop our frameworks and our guidance
on assessment, and also how we should
change our methods for inspecting,
and how we award ratings.
And we also sought consultation during that,
around whether we should consider any changes or not
to how we rate NHS trusts.
So going through all that feedback,
we have private board in February
and we agreed some proposals,
which I'll specify here.
So we have agreed to reintroduce
sector-specific assessment frameworks
and that was hugely supported by the consultation.
And we will go out again to consult now
on four draught frameworks, one for each sector, adult social care, mental health, primary and
community, and secondary and specialist care, the hospital sector. But we recognise that we may not
end up with four, we may end up with more than four, depending on what this next phase of the
consultation comes out with. Again, highly supported in the last consultation was the
reintroduction of ratings characteristics.
So what does good look like?
What does outstanding look like?
And so on.
And there was also strong support
for moving away from quality statements
back to a supporting question format.
So we're not returning exactly to the previous key lines
of inquiry that we had before.
But colleagues will recall how popular and well understood
the Chloe's were.
We have agreed to remove scoring from the assessment methodology. It was well
intentioned, but it did not improve the quality of our assessments and therefore
did not drive improvements in care. So we will be removing scoring and we will
make our ratings judgments directly at the level of the key question level,
key question not beneath that as we have done with our quality statements. So the
next stage of the work will be the publication of the initial four draught frameworks for targeted
consultation and that is scheduled for the 24th of March and that will offer further opportunities
for engagement and feedback publicly and from our internal colleagues as well who still have great
ideas and thought to share and that will cover not only the content of the frameworks but also
whether indeed the sector split that we've described is correct or whether
for example we should look at having separate frameworks for primary care
and community care and so on. And then we will also publish a detailed response to
that extensive consultation last year and that will explain what has led us to
the decisions we've made to date. So that's the main update from that programme.
Thank you.
Thank you very much indeed, Toli.
Maybe just are there any specific questions on that before we move on to Chris?
Now I think all that seems clear, so Chris over to you.
So my programme is, that I'm responsible for, is around rebuilding our organisation.
So this is really around making sure we've got the right
ways of working in place to really support our
regulatory focus.
This will be around, predominantly around,
how our enabling functions, how our supporting functions
are set up and have clear ways of working.
So the things that we've been looking at really are
our roles and responsibilities clear and understood.
How we got teams or multiple places
where the same work or similar work has been delivered
and is any of that unclear.
Where we might need to do design work with some teams
and where we need to look at some external benchmarking
to understand how our teams compare.
We haven't really got far beyond just scoping
at the minute, if I'm honest.
so probably haven't got as lengthy update
as Toli went through there.
We're still in the place of just scoping out
what we need to look at and what is a priority,
what's an immediate priority,
what are things we need to look at next
and what are things we need to look at later.
So we've just been scoping around that,
haven't got as far as making any decisions
or present any options around that.
And we've had one meeting as a programme board so far.
So I think that work will start to ramp up
and it'll be really important to make sure
that colleague voices included in that work
as we bring that forward.
And the co-design approach that Fiona set out be crucial.
That's all I was gonna cover at this stage.
Thanks very much indeed
Chris will no doubt be hearing more about that
in due course.
So probably unless there are any questions on that
should we go straight to you Esther
to talk about building the digital future.
Thanks, Chair, and thanks, Fiona.
So colleagues and people listening will recall from our last public board meeting
that we talked about an aligned portfolio plan,
which Fiona has really helpfully spoken to today.
So as part of that, we set out our digital roadmap,
which really focused on addressing the current pain points first,
and that was for a very good reason.
And again, just to set the context of that,
our colleagues working with our inspection
and assessment functionality are particularly impacted
by the current challenges.
And so we set out a roadmap to release new functionality
in the assessment space from quarter three this year,
swiftly followed by our registration functionality,
and then onto our other areas of functionality
in our digital systems.
We aren't ignoring the other areas colleagues, as you know,
but we wanted to address the pain points first.
And that supports our conversation earlier
that we had around performance and supporting our challenges
from an operational perspective.
So in terms of a progress update,
you'll read our update in our papers.
But again, just to bring that to life,
We are in the first phase of our digital rebuild programme,
which is effectively our discovery phase.
We have the support of an interim IT supplier
who is supporting us in that discovery work.
The reason why we have an interim supplier
is because we didn't want to delay work in the discovery space
because we have committed to doing this as quickly
and as high quality as possible.
and I'll speak a little bit about our procurement approach
in a moment around our wider kind of piece.
But from an update perspective, our interim supplier
and the discovery work is supporting us
with three proof of concepts.
Now these are not prototypes for rebuild,
they are not in any way a finished product.
What they are is proof of concepts to help us test
whether we have our settings and our configuration
and our approach right.
So what we are doing is taking a complex use case from a registration perspective, a complex
use case from an assessment perspective, and also working through from a data integration
perspective how that all fits together.
And those proof of concepts will give us a tested and kind of trialled and tested approach
to our system configuration and our architectural approach as we go forwards.
That work is progressing really well and we'll be doing some show and tells on that work
for internal colleagues at the right time actually in the very near future.
But that work is going really, really well.
The second thing I wanted to raise was in our discovery approach we have been reviewing
and reaffirming, as I've just said, our settings and our configuration for our new rebuild.
And as part of that, linked to the comments Kay made earlier from an audit committee perspective
and Chris made in his finance update, we've effectively reaffirmed the need to rebuild
our current systems using the platforms that we already have procured.
So this is a really important decision that we are making.
It needs to go through our formal governance, but effectively this is the most, the quickest
and the best way of achieving a new digital functionality
supporting our colleagues work on the ground.
And so that needs to be worked through from a financial perspective
and an audit committee perspective.
But that is the approach that will be recommended
as part of the discovery.
And then we also just need to be mindful colleagues and board members
that accessibility and our adherence to government digital standards
was a real challenge for us last time.
So our support and our principles around
adherence to standards, including accessibility,
is a key part of the approach we are taking
and is being reflected in the current proof of concept work.
So then just onto our kind of wider work,
we have released the invitation to tender
for our strategic IT supplier.
The window for clarification questions for suppliers
to ask us questions has now closed and we are progressing with the procurement process
in line with our requirements as a public sector organisation and also the process that
we set out in our invitation to tender. One of the key pieces or evaluation criteria for
any supplier will be fit with our values and our ways of working as an organisation and
that's really important considering the challenges we've had in the past. We
expect to be able to award a contract to that supplier once we've gone through
that procurement and evaluation process in June and again just for the board to
note all incumbent suppliers that we are currently using including our interim
supplier to help us with the discovery work have all signed an ethical walls
agreement and safe bars are in place to ensure a fair and equitable procurement process.
And then finally, just by way of an update, very happy to answer any questions after this
chair. You may well recall one of Peter Gill's recommendations in his independent review
of our IT was to seek external assurance on our design and build for our systems. And
that is progressing our approach to that is being developed and we'll be approving that
through our normal cabinet space.
Thank you.
Thank you very much indeed, Esther, for that.
And thank you to all our presenters of this item.
But so it is open to questions either to Esther
or back to anybody else or to you, Fiona.
Oh, it seems to be a quiet afternoon.
So, oh, there is one.
Sorry, yes, Sooz.
I feel like I'm a chatty person,
but I just wanted to say, Fiona,
it's a pleasure to have you here,
and it's great to hear that there's a focus
on just demonstrating that we're doing things differently,
because I think we very much are,
and all of the work is really positive,
but I think for some people, there's still a nervousness
that a small thing that looks like how we did it in the past
is a sign that we are still doing that,
so I think it's really clear to how we demonstrate that
to staff that we're doing it differently,
and especially the renewed focus on benefits realisation,
because I think success measures are something
that we didn't really have tightly in place before,
and I am an analyst when I'm not uni-ing,
so I am all about how do we measure it,
show me the data, and yeah, that's how we really see
where we're getting that value for money,
so I think this is really good, just great work.
Pleasure to have you join CQC.
Thank you for that.
So I think that brings to an end that item on the agenda.
I know, Bola, you have to leave at this point
for an important engagement so we'll let you go but we will then move on I think

4.3 Q2 & Q3 People & Culture Report

it is to item 4.3 which is the quarter two and quarter three people and culture
report and it's back to you Chris. Thanks chair. So the packs included I'll just
run through some of the headlines covering off the key slides and then
and happy to take any comments or questions.
So starting with the first page, just the overall metrics,
we're seeing positive progress in representation
of ethnic minority colleagues, disabled colleagues,
and colleagues from the LGBTQ plus community.
Senior representation isn't where we want it to be
for ethnic minority colleagues,
it's dropped since the previous reporting period
12 months before, and disabled representation,
whilst improving is still below active population statistics.
So acknowledging those areas, we've got work to do.
Moving on to recruitment.
It's really positive fulfilment rate.
Just over 91% showing improvements
in our hiring process.
Diversity in roles offered is showing 22%
for hiring of ethnic minority colleagues,
17% for hiring of disabled colleagues,
11% for hiring colleagues from LGBTQ plus community.
I think however, it's hard to see past the fall
on that page of colleagues offered
from ethnic minority backgrounds
compared to the percentage of applicants.
And that is a key conversation we've been having internally
as part of our people committee.
We need to look at the effectiveness of our interventions
and track progress.
This is over the last 12 months,
So I'm hoping if we were to break this down,
we'd show progress being made,
but we need to keep a close eye on that one.
Moving on to workforce.
Our vacancy rate's 10.5%, which is higher than target.
The picture is a bit blended across the organisation.
We've already touched on this in places.
We've got significant vacancies in Esther's data
and Insight, for example, has had high attrition and a lot of hard to recruit roles, which
is probably the outlier across our vacancies.
We've also got a number of vacancies within ASC and Inspector, which is the point I was
making before, but live campaigns underway for those.
The remainder of the vacancies we're seeing are kind of blended across the organisation
without any major outliers.
and some of those vacancies and that vacancy rate
is intentional, it is managing positions.
We have for example within Health Watch
a National Guardians Office which take up
a chunk of vacancies.
Absence is 3.9% compared to 4.8 previously,
so tracking in a good place.
Turnover, just jumping ahead, a slide is 7.5%
which is below 10%, KPI and again steady
and the decrease from previous years.
And then moving back a slide, required learning.
We've changed our approach this year
and we've moved to a quarterly delivery approach.
So asking colleagues to tackle
mandatory training on a quarterly basis.
So eight modules across the year.
We've made steady improvement here.
It's probably still not where we want it to be
in terms of percentage completion,
but I think the approach of breaking that down is having a benefit from what we can
see.
And that was all I was going to cover, I'll take any questions.
Thank you Chris for the lowdown of that report.
I've got a couple of questions with the recruitment of successful managers.
I know there's a low of ethnic minority groups as well as disability.
Is there any work that the organisation can work with again, and raise equality, to do
a simple questionnaire on if you had a chance to go for the manager role or the senior role,
what's stopping you, what's the barrier?
And I think that's where we need to look for is there's loads of successful people in this organisation but there's something that's stopping them and we want
to know what's stopping them to progress.
That's something maybe as an organisation we can explore
from the other side instead of just open up the invitation
to apply what are the barriers.
On the recruitment side, in experience working
with colleagues across the organisation.
I hear a lot of people apply to work for CQC,
successfully got a job for CQC, but never really joined
CQC about a year and six months in.
So there's a gap in when they applied, accepted and go on our induction programme.
I'm wondering that's great that they go live but
How do we keep the process work with HR, getting people coming in?
I mean, you might have five.
I appreciate some people have three months notice, six months notice, the year notice.
I think I've come across so many people that have been waiting for a year to come on board
to induction.
A long time.
as I'm wondering why, what can we do to speed that process up?
And the last thing for me is apprenticeship, which obviously the government drives at the moment about apprenticeship.
What we're doing at CQC to advertise some work of apprenticeship,
it could be a three year apprenticeship, five year apprenticeship.
I know we do have a graduates team for the other areas.
I'm wondering where we can explore more about advertising for an apprenticeship role across CQC,
because I don't normally see a recruitment page
with a lot of apprentices roles in there.
So I'm wondering if there's something
maybe we need to explore.
That's my question for that one.
Over to you, Chris, on that lot.
Thanks, Paul.
On the first bit around
how we make opportunities for colleagues,
I think there's probably a few things.
I think we've got the Inclusive Leadership Programme,
which offers a real opportunity for colleagues,
but I think it's probably more than that.
I've been doing quite a lot of work in my director
in corporate services, just thinking about
how we open up opportunities,
and how do we really harness talent that we have,
and how do we avoid the same people being picked
for projects and the same people being taken forward.
So I don't have an immediate quick answer for that,
but I think it's definitely something that we are looking at
and considering how we, as I say,
open up those opportunities for colleagues
and think about how we harness talent
and develop our colleagues.
I can probably bring something back at a later date
about that, actually that might probably be helpful
to think about and couple with the other bit.
I've heard the same stories about recruitment processes.
I mean some of this is notice periods
that colleagues have got as you say
and some of it is onboarding processes
which aren't always in our control
the time it takes colleagues to get back
but generally there's a sentiment.
I know Carla and the team have done a lot of work
around recruitment, we've had an external review
about recruitment processes, and it is also one of the
things that we would be looking at in the CQC way
in terms of our employee life cycle.
So there's probably more we can do in that space as well
that we can showcase an update on.
The last bit you mentioned, the apprenticeships
is an interesting one.
I mean the levy we've got access to that we pay into,
We probably pay in way more than we get benefit from,
but that's very much about training and support
apprenticeships rather than the salaries of apprenticeships
if you like, it's supporting colleagues
through apprenticeships, but I think we can definitely
open up more opportunities there.
I don't think we're exploiting that as much as we can.
But where we can, we have been bringing in apprenticeships.
I know we've had a lot of work and a lot of success
and Esther's space around graduate analysts
really making a difference.
So I guess as part of our work I talked about before
on the programme I'm leading on,
it's probably a good point of consideration
where we could do more apprenticeships for.
Hopeful.
Esther, let's bring you in on that.
Thank you, Chair.
Thanks, Chris and Paul.
So just on the apprenticeships piece,
is linking it with the piece that Chris called out
around the vacancy rate.
So colleagues who perhaps have my background
or similar in the NHS are used to a pay framework
that allows incremental pay progression
as you increase your experience and skills
in certain areas.
We don't have that in the CQC.
And so the two reasons why we tend to have
raised vacancy rates specifically
in highly technical skilled areas
One, because exactly as Chris has just explained, we recruit colleagues from apprenticeships
or during that process.
They gain experience with us and we struggle then to pay industry standard rates.
And so that's one reason why there is some high attrition.
The second is from a difficulty in attracting external support to come and work with us
again because of our struggles to match industry pay.
So we're doing some work particularly in our technical
digital and data space around whether we can adopt
different frameworks to help us with this.
And that's kind of a live conversation at present.
And my thanks to Jackie, our director of people
and her team for helping us with that.
We haven't reached a conclusion on that,
but we are working on that because that also supports
progression and attraction and retention
as well as kind of motivation.
And from our perspective at the moment,
we often have to fill established roles
with contingent labour or effectively agency staff
because we can't fill them more permanently,
which obviously has a cost implication for us.
So that was my piece around that.
I have got another question around the report, Mike.
I'm very happy to hold it if you would like me to.
Go for it.
Thank you. So please forgive me because I have raised this before.
So I do think that we conflate, when we report on our people,
that we conflate sexual orientation with gender orientation.
So if you look at our paper, we talk about the statistics
reporting on our trans colleagues,
but actually if you look at the actual report,
it's based on sexual orientation and not gender orientation.
So we do think we need to provide some clarity
on that and consistency.
My mind then goes to where do we look at our kind
of statistics from a transgender perspective
and how would I feel if I was one of our employees in that space.
And so I just think we really need to bring some clarity
into into the lens that we look at this from.
And Paul, I wonder if yourself and other chairs of staff networks
could perhaps help us with this, about how we get this right. Thanks.
And nodding there from Paul.
So thank you very much, Paul, for that.
And thank you, Esther, for raising that important point. Sooz.
I wouldn't be doing my job if I wasn't going to come in on the people pack.
So there's a few things from this.
It was really interesting to see.
So the first off, I want to echo some comments
from our joint national consultation committee
of one of our national officers
acknowledge the shift in tone of discussions
and how brave it is to openly and transparently
highlight the potential inequalities
in our recruitment process.
I'm not trying to say there's causation there,
but we know that from the Listening, Learning, Respondent
Concerns Independent Review in 2023,
that this was an area of focus for the organisation,
and it is pleasant to see a shift
in how that's being discussed and more transparent.
Just opening of we don't have the answers,
but that is a thing that we are keeping our eye on
rather than trying to put a positive spin on something
that is an area of concern for the organisation.
And the other parts of the report is that well-being
is listed as one of the top three reasons
for people leaving.
And I just want to hark back to Dee McEvoy's comments
at the last board session and the challenge around
looking at how we are evaluating the well-being initiatives
across the organisation and ensuring we're getting value
for money and the impact on our colleagues,
especially if that's contributing to what I would say
is unavoidable leavers.
That suggests that we're not taking,
I'm not working there,
that people aren't feeling taken care of
by their organisation.
Now my last comment is around the gaps
in the required learning.
So I have first off a question as an eagle eyed analyst
as that the number for the bullying harassment training,
the overall total figure of completion is different
to all of the other modules on that slide.
So all the other modules have 3604,
and this one has 3393,
which if the 3604 is accurate,
the percentage is quite far off
and would bring it down to 82.9% rather than 88,
which makes it less healthy.
So that's one point of clarification, if possible.
And the second is just asking what we are doing
to bridge that gap, because although the statistics
and the percentages look positive,
when we look at bullying and harassment,
which is something that we have a zero tolerance
approach for at CQC, there's still 401,
just put to my mind, over 400 individuals
who haven't completed that, and so if there was
a people in leadership roles or with a sphere of influence,
I think there's more of a cultural risk
for that not being done, and I've been asked to,
alongside that, not just what are we doing,
how are we supporting individuals?
So it's not just asking have they done it,
are we giving people the space to really focus on this,
because I think that our cultural improvements
will only be successful if we're bringing everyone along with us at the same pace.
And having stragglers might be slowing down our progress in an area that we know is already
slow to change. Thanks.
Thank you, Sooz. If there are questions about numbers, we may not be able to answer them
immediately. But at the same time, we ought probably to take those away and make sure
we can reconcile the numbers wherever possible.
Okay, I think that now takes us on to item five on the agenda, which is the trade union
and equality networks updates.

5.0 Trade Union and Equality Networks Updates

And I think, Paul, you're going first on the equality networks.
Just remind people, Paul is co-chair of the gender equality network, but is actually going
speaking here on behalf of all the Equality Networks.

5.1 Equality Networks Updates

Thank you, Chair.
From my background with the Equality Network, I was the Den Chair for six years previously,
successfully working with the Exec team as well as CQC.
I stepped down to encourage new leaders to take the role.
The reason I got involved with gender and I realised that gender equality,
the CQC, obviously there's more female in the organisation and a percentage low for
a male situation. My task with the gender network is trying to get more male involvement.
I've been involved in the menopause presentations and I've learned a lot because my mum had
menopause, my wife had gone through menopause, and a colleague of mine probably said it means
to be educated what it's like to have menopause or going to be medical. The other thing is
recently we just had the cervical cancer, you know, understanding the impact of the
drugs and everything else is like, wow, I'm educated by that. But there was only two males
in that session. And the percentage of males in this, I'm trying to build a bridge because
the male and female in our organisation could be supporting each other. So my task really
is trying to get that education.
I would like to put it to the board that some of the board members are male here.
I would like you to participate in some of the actual events to showcase your profile
and say that you want to learn.
And the other aspect of the men is obviously the high rate of men's suicide and the things
that we're trying to encourage to openly -
We have to -
Chris White is one of the inspectors at CQC
So we work together to try to do the men's group,
but we don't want too much of a men's group.
We want to have a men's group,
but we want to invite females in the group.
And next week, we're doing a misogyny session for the men
to actually know what they hear about it,
how we can stamp out in the organisation
where there is misogyny happening.
And that's kind of the work we're doing with the networks.
Great work with menopause, great work with everything else, but we're trying to bring
the male and also non-binary as well because they are part of the gender network as well.
So that's kind of what's happening with our network.
One of the extra bit is the parenting thing.
So about maternity, you know, for example, if you have a adoption, you know, parenting
in timing, death during pregnancy, you know, the extension of that. So we're working closely
with HR with a policy on the parents and it's like carers but at the same time it's about
parents. So it could be both parents of the same sex and things like that. So how we can
support parents in the organisation with the policy. So that's the next step the Gender
Network is working on. On the wider scope, we had the Black History Month in October,
We've got the LGBT plus history month, which has been successful.
And we're in international women's history.
And we had that on Sunday International Women's Day.
So a celebration for independent women in our organisation as well as outside organisation.
My my plea for the board is very important for you to work with the network.
Not only we have barriers of CQC, but we also have barriers outside of CQC.
And to us, we always reach out to different communities, different networks, different
to get answers, get support.
We are the users in the community.
We attend hospitals, doctors, you know, no different to anybody else, although you might
be a regulatory role.
But come to us.
There is that fear element where, be careful what to say, what not to say.
We're about psychological safety, safe space.
You know, it's just good to have that openness and transparent and not to be afraid to say
it, because once you've been educated and you realise I've said the wrong thing, I shouldn't
have made an assumption, you're learning from it.
And I think that's a culture we're trying to invest in the network.
Intersectionality, you know, people see me as a deaf person, you know, but I'm also male,
you know, also have a disability, also -
So it's just thinking about different people that actually involved in different protective
characteristics.
And my involvement with the Equality Act, and if you remember if you work in the industry
of the NHS, you remember the Independent Advisory Group?
They were involved, and the people from the community to set up the Equality Act 2010.
After the Equality Act, we're not wanted anymore, you know, we've kind of
done the policy and moved on.
But I want to bring that back, because we are the policy, we are the people, and we
are here to make a difference.
I've been here for 10 years.
I've seen a massive improvement over the years. Yes, there's some blips, but all organisations
the same, but the access, co-pilot, you know, sometime I find it hard to interpret the language
with English and BSL, but bullet points and co-pilot, they give me a guidance. I get independent
instead of relying on another source. So accessibility is increasing. Well, what I like to see more
about is talent. There's so many disabled colleagues, ethnic minority, LGBT, they are
talent, but the baggage or fear of historic is still carrying with them. So I think we
need to work with these networks and say, how can we remove those barriers? How can
we make it accessible? For example, the recruitment drive, recruitment questions are all competence based
And if I be successful, I can talk the language. I talk how I talk, and I'm not going to flower
it because I want to say how I deliver. I don't want to say it and I can't deliver.
And I think that's sometimes a barrier for some people with disabilities and also ethnic
minority groups don't want to progress or pressure. So I think, just giving you an overview,
you need us as well as we need you. So the more you work with us, there are boundaries,
of course you've got your professional standards, you've got to maintain confidentiality, but
I'd like to see more networking involved, especially the chief inspectors involved.
I know some of you are sponsors and Bola is our sponsor for the gen and new inspectors.
So hopefully we get that relationship going. So we feed back to you to share it with the board
and feed that back. So, so you need us as well as we need you. And over the years of the Equality
network. I've seen so many changes. I have seen so many landscape changes. I want to
continue with that because I've noticed a few years back, it went back into the sort
of pigeonhole. I need to get back into this. I think COVID play a big part of all these
changes and I think hopefully we go back. So that's all I want to say about that network.
We're working together, which is like Joyce's Network meeting, which I couldn't attend
once here. So we're trying to work together and have a project. And I did want to put
the tables have a year conference with all the chairs with the chief inspectors and some
of the board members and see what business plan what the drive forward how can we change
because we can change the equality act here. Imagine what we can do outside.
You know, I would like to have an internal independent advisory group from people from
different areas from dementia UK and what's going on in the landscape and their feedback
what we can do to help out and that works but I know it's time money we've got different
priorities but we need to engage the community and I hate the word when they say hard to reach
no we need to reach that's the other people that reserve but that's me done thank you Paul thank
you very much for that and really for reminding us that we need each other I think in this
and just remind people that because of Paul's deafness
he's got BSL interpreters working
just the other side of the room.
So are there any particular comments or questions
people wanted to make back to Paul?
Yes, Toli.
Thank you, Chair.
Thank you, Paul. I thought that was brilliant.
And I had the great privilege last week
of being invited by your network,
Gender Equality Network, to talk about endometriosis
because my clinical background is gynaecology.
There were some really inspiring colleagues on that call
who shared their stories and their struggles
with this long-term condition.
And it really allowed other people on the call
to share theirs.
And you talking now has just struck me.
I'm going to be really cheeky now
because I haven't asked either of them.
But when you were talking about, you know, for men,
we do have the chair of the National Screening Committee
and what he doesn't know about prostate cancer
isn't worth knowing actually, he might perhaps come and talk.
And our chief executive is a consultant psychiatrist,
who again will be hugely informed about the serious issue
of suicide in men.
So I just wonder if they might dip in.
And you talked and I mentioned on the call last week
about misogyny and a discussion on medical misogyny.
I think it's important actually that women should be
part of that because women can be misogynist
just as black and Asian and minority ethnic people
can be racists.
And sometimes women don't realise
that we're being misogynists because we're women.
So all the more reason to educate us on that one.
But yeah, those are the great networks.
And that's really struck me since coming to CQC,
how strong the networks are, so thank you for that.
Thanks, Toli, and thanks for arranging an invitation for me.
I did notice that.
But at that point, let's hand over to Sooz, who's trade union representative for Unison,
but actually here on behalf of all trade unions.
Thanks, Chair.
I will say on behalf of the five slash six trade unions, as we do work together as one
an almost informal collective,
but it is key to know that we are individual
and some things we are very much within our own unions
for things like closures or some of the more formal things.
But I'm pleased to be here to represent
five slash six unions at CQC.
So, as usual, we'd like to give three key messages.
So that's our format.
So this board session, I'd like to discuss
employee life cycle.
Our members are our members and I will say our colleagues
because our members are employees at CQC,
So it always feels a bit odd to just call them my members
or our members.
They're keen to see the detail underpinning the employee life
cycle workstream or hexagon at the autumn event,
as they're still feeding back a range of concerns
around how it feels to work for CQC.
This is especially felt or acute in temporary roles,
as we understand why there's a business need for flexibility
and for budgetary constraints and temporary roles to be
in place.
Could you please slow down?
Apologies.
Because I'm blinking fast.
If you manage to get Sooz to slow down, you're doing very well.
You're the only one that will be able to do it.
So I think with thanks to Paul, we'll get Sooz to slow down.
Any time it's required, I'm just a northerner that speaks very fast.
If you don't speak fast, you might not get it all out.
So there are definitely some areas where we think that we could be doing better in terms of how it feels,
or how colleagues feel they have been treated by the organisation.
So this is around fixed-term contracts and secondments.
And while people in those roles acknowledge the temporary nature of the role they've undertaken,
what can we do to wrap around that to make them feel supported for the contribution they've
given?
And that is about giving better notice for changes to their contracts, about giving clear
and consistent information rather than assurances informally that don't materialise formally,
about ensuring that our sign off for workforce controls
are in line with contracts ending,
so we're not creating a pinch point.
I know there's been some recent changes
to the induction programme, so I think that would be key
to see how that is being, the efficacy, sorry,
and impact is being tracked and measured,
as there's been a lot of feedback around inductions,
and we want to ensure that we are setting our colleagues,
our new colleagues up to do their best work at CQC,
and to hit the ground running
when we feel they're able to do that.
It's quite interesting from the papers to read that 48.4% of our leavers have less than
two years of service.
I know that when we've looked at recruitment data, we don't have a concern about being
an attractive employer, but that figure does make me question how well are we able to retain
the skills and experience that we are attracting to the organisation.
Our second point is around culture, and while there are still reports from our members about
hotspots of pure culture across the organisation.
It is good to see that some of the change in that.
There is some really good leaders
demonstrating some very good behaviours
and some of the co-design work making people feel included.
We're looking forward to seeing the staff survey results
and working with leaders in different areas.
Chris said it's a great sense of where we've moved the dial
and where we need to renew our focus,
but we would advise some caution
around interpreting any of low scores
is simply being due to change activity.
The organisation's gone through a mass amount of change
and will continue to go through change.
And so I think it's better for us to focus
about how we manage change better
rather than fighting off people's experiences
simply because of change.
And to underpin that, I think clear and consistent
communication is key to supporting our colleagues
well through change whilst enabling them to continue
with their regular focus, as that balance is really key.
And our last point is just a shout out to say that we will continue to work with the
People and Culture Directorate around embedding the restorative just culture principles and
the freedom to speak up recommendations, and we are looking forward to embedding the changes
from the Employee Rights Act.
And we would just open up an invite to any leader across the organisation to get in touch
with the trade unions to see how we can help with any change, whether it's – we are engaged
in consulting as part of formal change, but sometimes informal changes would really benefit
from trade union input.
We can often be an extra avenue of support,
a point of clarification and information,
and a feedback loop for leaders to hear
where things maybe aren't going as smoothly as they planned
and to bridge that gap where people still
are reporting that they don't feel safe to speak up or feel
heard.
There is, again, movement in that.
I don't want to be negative.
But whilst we still see hotspots,
I think the unions have a key role
in helping us to move the dial forward in a number of areas.
That's it.
Thank you.
Thank you, Sooz.
Kay.
Sooz, I'll preface this.
This is a slightly mean question,
but we do ask the exec this all the time,
so it's not just for you.
Sometimes I feel the CQC,
at the moment,
it's a forest of spinning plates
of all the things we need to do,
and we are spending a lot of time
talking about prioritisation,
and I just feel
almost impossible sometimes as a board member.
What's the one thing you would tell us to focus on?
I feel like that is a very challenging question.
It's the holy grail.
I think actually underpinning it all
is listening to our people and being curious
when we hear them.
So not just hearing the words,
but having that dialogue to say,
and why is that important, and what does that mean?
Because somebody speaking up and just saying I heard you,
that's often where people feel like they've hit a brick wall
and they're not being engaged with by their organisation
or don't feel part of the changes that are to our regular focus.
I know that a lot of the union input is often internal
because we are supporting our internal colleagues.
But I just, yeah, a part of that is that our internal colleagues
are really renewed on our public duty
and are serving the public in that way.
And some of the internal issues hamper them to just do their job.
And some of the internal not being heard
makes them feel that they're not being supported
or put at their best to go out and be the ambassador
for CQC to have those professional conversations
on inspections to engage with providers.
So let's be a little bit more curious.
If someone's speaking up, if they're coming to the unions
and not coming to a leader, my first question is,
why don't you feel able to go directly?
Why am I required as an intermediary?
Thank you, Sooz.
Thank you for taking on that challenge
that was thrown at you.
I think that brings this bit of the agenda to an end.
That takes us to any other business.

6.0 Any Other Business

First of all, is there any other business from members around the table?
If not, we then come on to the questions submitted by members of the public.
One of our regulars, Robin Pike, has asked some questions.
He's actually asked three, but I think we will have to defer one of them
because it's really a question for Bola, who's had to leave.
and so the one about GP practises,
we will make sure we bring that to the next meeting.
But the first question was about mental health.
So how do inspectors engage with patients
in mental health clinics?
I'm - Chris Dzikiti, can you tackle that one?
Thank you, Chair.
And I think that the best place to start
is just a bit of a context in terms of our approach as CQC,
which is underpinned by a constant principle on people's lived experience being part and parcel of our
inspection process. So across
mental health services, inspectors are expected
to actively seek people's voice as part of the inspection methodology to assess where the services are
self-effective, caring,
responsive and well-led.
So real engagement for us is therefore
pinned on being planned, purposeful,
and making sure we're including those voices in what we do.
Just to say maybe three ways we do that engagement
is by direct conversations with patients during inspections.
So our inspectors, when they visit services,
they spend time actually speaking to patients,
trying to understand patient's experience
of care on day-to-day basis, also whether they feel safe, they feel respected and
listened to, and also most importantly do they feel involved in the care which is
being delivered to them. The other way we also engage patients is through our
Mental Health Act monitoring visits, so we've got people who go into services to
speak to people who are detained under the Mental Health Act and part of
that really is to understand people's experiences of being detained under the
Mental Health Act and also making sure that we understand whether people do understand
their rights when they are detained under the Mental Health Act and whether they are
being given care and treatment that supports their journey to move from inpatient services
into community services.
And then the last thing we also do as part of us engaging with people in mental health
services is looking at the complaints that come through to us for people who use services.
and we also do some surveys, like for example,
the Community Mental Health Survey,
where we ask patients to tell us about their experience
of using mental health services.
So those are the three areas we sort of do
to actively engage people in mental health services.
Chris, thank you very much indeed for that.
So we engage patients a lot, actually in all our sectors,
but in mental health, that's a really good example of that.
The second question that we want to answer
To you, Toli, when hospitals are inspected, how is the nature and quality of
information provided to patients assessed? Thank you, Chair. We assess the
information provided to patients and service users under our responsive key
question and we have a specific quality statement headed providing information.
Under that quality statement we're looking to see that services are
providing appropriate, accurate and up-to-date information in formats that
are tailored to individual needs. And what we mean by that is including making
reasonable adjustments for disabled people, providing interpreting and
translation services for people who don't speak English as their first
language and for people who use British Sign Language. People who have difficulty
with reading, writing, using digital services also need to be supported with
accessible information. So in practise that means the inspection team assessing
a range of materials that are provided to patients depending on the service
type and that would include the inspector and possibly specialist
clinic specialist advisors who are clinicians. There is a wider description
to what I've given now on this quality statement and that can be found on our
website under the section guidance and regulation and specifically around
providing information. Thank you. Thank you Toli. So I think that brings the
the business of this meeting to an end. Our next meeting is scheduled for the
3rd of June and at that point I just want to say thank you to everybody for
today and indeed for everything else. Well there is another point. Kay. Mike we
couldn't let you go without saying just in case this is your last public
board meeting. As I said it's not in our gift but what is in our gift is to express our deep
appreciation for everything you've done for the CQC. So to chairing the organisation over the last
year we are very appreciative and be very clear that we will be taking on the torch of the Richard's
review. You may still be taking on the torch next time, who knows, but if everything goes to plan,
hopefully you'll be running pubs somewhere as well as all the other important things you do,
but a big thank you on behalf of everybody for your service.