CQC Board Meeting 27th March 2024 - Wednesday 27 March 2024, 2:00pm - Care Quality Commission

CQC Board Meeting 27th March 2024
Wednesday, 27th March 2024 at 2:00pm 

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  1. Ian Dilks
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  1. Mr Ian Trenholm
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  1. Ian Dilks
  2. Mr Mark Sutton
  3. Ian Dilks
  4. Mark Chambers
  5. Ian Dilks
  6. Chris Day
  7. Ian Dilks
  8. Stephen Marston
  9. Mr Ian Trenholm
  10. Ian Dilks
  11. Mr Ian Trenholm
  12. Ian Dilks
  13. Mr Ian Trenholm
  14. Ian Dilks
  15. Network Rep.
  16. Mr David Croisdale-Appleby
  17. Network Rep.
  18. Mr Ian Trenholm
  19. Network Rep.
  20. Mr David Croisdale-Appleby
  21. Network Rep.
  22. Mr Ian Trenholm
  23. Ian Dilks
  24. Chris Day
  25. Ian Dilks
  26. Kate Terroni
  27. Ian Dilks
  28. Ian Dilks
  29. Stephen Marston
  30. Charmion Pears
  31. Ian Dilks
  32. Ian Dilks
  33. Ian Dilks
  34. Ian Dilks
  35. Mark Chakravarty
  36. Ian Dilks
  37. Mark Chambers
  38. Ian Dilks
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  1. Kate Terroni
  2. Ian Dilks
  3. Stephen Marston
  4. Charmion Pears
  5. Stephen Marston
  6. Charmion Pears
  7. Charmion Pears
  8. Prem Premachandran
  9. Charmion Pears
  10. Stephen Marston
  11. Charmion Pears
  12. Ian Dilks
  13. Mark Chakravarty
  14. Ian Dilks
  15. Ian Dilks
  16. Ian Dilks
  17. Network Rep.
  18. Ian Dilks
  19. Network Rep.
  20. Ian Dilks
  21. Kate Terroni
  22. Ian Dilks
  23. Mark Chambers
  24. Ian Dilks
  25. Mr David Croisdale-Appleby
  26. Mr David Croisdale-Appleby
  27. Mr David Croisdale-Appleby
  28. Ian Dilks
  29. Tyson Hepple
  30. Ian Dilks
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  1. Mr Ian Trenholm
  2. Ian Dilks
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  4. Ian Dilks
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  6. Ian Dilks
  7. Ian Dilks
  8. Mr David Croisdale-Appleby
  9. Network Rep.
  10. Ian Dilks
  11. Christine Asbury
  12. Mr Ian Trenholm
  13. Ian Dilks
  14. Christine Asbury
  15. Mr Ian Trenholm
  16. Tyson Hepple
  17. Ian Dilks
  18. Belinda Black
  19. Ian Dilks
  20. Ian Dilks
  21. Mark Chakravarty
  22. Ian Dilks
  23. Mark Chambers
  24. Ian Dilks
  25. Stephen Marston
  26. Ian Dilks
  27. Stephen Marston
  28. Charmion Pears
  29. Ian Dilks
  30. Ali Hasan
  31. Ian Dilks
  32. Joyce Frederick
  33. Ian Dilks
  34. Kate Terroni
  35. Ian Dilks
  36. Chris Day
  37. Ian Dilks
  38. Mr Mark Sutton
  39. Ian Dilks
  40. Tyson Hepple
  41. Ian Dilks
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  2. Ian Dilks
  3. Stephen Marston
  4. Ian Dilks
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  6. Ian Dilks
  7. Stephen Marston
  8. Charmion Pears
  9. Ian Dilks
  10. Mr David Croisdale-Appleby
  11. Mr David Croisdale-Appleby
  12. Ian Dilks
  13. Joyce Frederick
  14. Chris Day
  15. Ian Dilks
  16. Joyce Frederick
  17. Ian Dilks
  18. Mr David Croisdale-Appleby
  19. Ian Dilks
  20. Joyce Frederick
  21. Mr David Croisdale-Appleby
  22. Ian Dilks
  23. Joyce Frederick
  24. Ian Dilks
  25. Christine Asbury
  26. Ian Dilks
  27. Joyce Frederick
  28. Ian Dilks
  29. Mark Chambers
  30. Ian Dilks
  31. Joyce Frederick
  32. Ian Dilks
  33. Chris Day
  34. Ian Dilks
  35. Ali Hasan
  36. Ian Dilks
  37. Joyce Frederick
  38. Ian Dilks
  39. Ian Dilks
  40. Joyce Frederick
  41. Ian Dilks
  42. Ian Dilks
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  1. Mr Ian Trenholm
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  1. Tyson Hepple
  2. Ian Dilks
  3. Mr Mark Sutton
  4. Ian Dilks
  5. Charmion Pears
  6. Prem Premachandran
  7. Ian Dilks
  8. Mr David Croisdale-Appleby
  9. Network Rep.
  10. Ian Dilks
  11. Mr David Croisdale-Appleby
  12. Mr Mark Sutton
  13. Ian Dilks
  14. Stephen Marston
  15. Ian Dilks
  16. Mr Ian Trenholm
  17. Ian Dilks
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  1. Ian Dilks
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  4. Belinda Black
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  4. Christine Asbury
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  1. Webcast Finished

1.0 Opening matters

Mr Ian Dilks - 0:00:00
it’s working good afternoon, everybody, and, for those dialling in, welcome to the public board meeting of the Care Quality Commission on the 27th of March. We have published all of the papers on the web as usual, but there was a slight change to the
agenda format that I’m going to mention in just a moment. Before that that let me deal with the formalities of the meeting if I could. So firstly, in terms of welcoming people, we have a Prem Premachandran over there, so welcome, Prem thank you very
much, deputising, probably for a number of people in practice, but we have no Chief Inspectors here today. Rupinder over in the corner, there is representing our networks as usual from the Race Equality Network, so welcome, thank you and for those that haven’t met Ibrahim,
who recently joined CQC and will be trying to make sense of what we say in the minutes that he recalls from this meeting, so thank you very much indeed. In terms of apologies we have two, Sean O’Kelly, unfortunately is still not well, so not
able to join us, and James Bullion had a prior commitment at a an excellent event today, so wasn’t able to join us but as I say, others, including Prem, can stand in as necessary. Can I firstly check if there are any conflicts of interest

1.1 Chair’s opening remarks, Apologies

1.2 Declarations of Conflicts of Interest

1.3 Any urgent business

for this meeting? No, thank you very much. Is there anything urgent anyone else wants to put on the agenda that we haven’t picked up? No good, thank you very much. So I did mention an agenda switch. We had proposed later on today to have
what was called an LAICS update, it was paper 3.3. In fact, local authorities would have in any event or it is going to be covered in other sessions. The ICS update we won’t be covering today, as I think you know or anyone listening this
is one of those areas of responsibility under the new legislation, where the approach we adopt has to be signed off, as determined signed off by ministers, and not CQC. It had been our intention to start that work on the 1st of April which is
why originally the papers were available on the website and it was on our agenda for discussion. However, we heard earlier this week that the Minister, would like more time to consider the approach, so the consequence of that is the discussions with DHC are continuing.
As to what that means in practice, but we’re not going to be ready to start work on the 1st of April, so it didn’t seem sensible to discuss something this afternoon that hasn’t yet been agreed and signed off by the Minister. We’ll keep you
updated and will also be writing to ICBs’, ICS’ who might have been expected to start work too and let them know what happens, but I don’t think there’s much more to say at this stage, nothing too dramatic, but it just didn’t seem sensible having
that discussion today. However genuinely, quite coincidentally, we had a meeting this morning and we always consider when we’re discussing things in private, whether things couldn’t be better or more sensibly discussed on the public board, and there was one item which is the progress on
our equality objectives and delivery priorities. We thought that was a matter of public interest and debate. We have for anyone listening to the webcast we have actually managed to put the papers for that up available under AOB should anyone want to see them. But
in terms of the meeting, I’ll pick it up on the ICS section which, as I’ve already explained, is now not going to happen. So with that, Ian can I hand over to you, thank you. Thanks Ian and good afternoon
Mr Ian Trenholm - 0:04:06
everybody. I want to kick

2.0 Strategic Discussions

off and talk about the matters arising from the executive team report and kick-off, and talk about people. As a number of pieces of work that our academy have been leading I just wanted to highlight to colleagues. Firstly, there’s the inclusive leadership pathway that’s a
leadership pathway, that’s been designed for people from ethnic minority and disabled backgrounds and is part of our overall attempt to make sure that those individuals have the best possible chance of thriving in the organisation. We recently concluded the programme and 31% of the delegates
have been promoted, which I think is a really positive story for a number of colleagues. I spent some time talking to each of the care wards is really impressive, group of people and it’s interesting some people, were really keen to be promoted and then
the work that they did on the pathway helped them with that. Some people decided to take their careers in different directions which again was a really positive outcome for those people, so a really good path, a really good programme, I’m sure we’ll be repeating
that with other cohorts as well. Second thing I wanted to draw to people’s attention to was the successful manager pathway. Again I think this is just a reflection of the fact that we think that particularly first line managers are a really important group of
people in terms of the work that we do on a day-to-day basis. This is a pathway which is aimed at all managers at a number of different levels, and there’s a series of cohorts and really the aim is to focus on supporting managers in
the development of culture and to build management competence and consistency right across the organisation. We also got another programme around inclusive mentoring and again this is designed to make sure that leaders, at all levels, have exposure to people from both ethnic minority and disability.
To mean that leaders are able to make better decisions based on understanding, the experiences of more junior colleagues from a range of different backgrounds. And then finally, I want to just on this section, I just wanted to talk about the race and inclusion learning.
Again, there’s another, big programme of work that’s going on to again on the back of our listening, learning, and responding to concerns review. We wanted to make sure that as an organisation we were both race and disability competent in the way that we go
about our work internally but also the way that we, consider things externally as well. Updates from the Chief Inspectors, as Ian said, there’s just two points. There’s two issues on the on the report there on local authority assurance and ICS assurance is covered both
of those items so I won’t repeat them. We’ve got within the paper on pages 10 onwards, I think there’s some, a number of important pieces of work there that are very much externally facing. I’m conscious that sometimes we spend a lot of time talking
about internal activities that are around the board, but I just wanted to remind colleagues of some really powerful work going on at local authority assurance. We talked about Regulation 9A and its companion regulations around things like visiting is a really important piece of work,
a really important change to fundamental standards. The national maternity programme, where we have inspected maternity services right across the country and then there are follow-on pieces of work that are aiming to share the learning, share the good practice and make a difference, frankly, for
women, who are using those services. As well as the work that Prem leads on urgent and emergency care, where again we were trying to use the work that we do to identify good practice and then to circulate that back into services that are struggling,
creating products that they can use and that frontline practitioners can see real value in working with Royal Colleges and others again, is a really important piece of work that does that provides the public with assurance but also contributes to improvement as well. The independent
care, education and treatment reviews, I think that’s later on the agenda as well, but again it’s a really important piece of work. And I also wanted just to touch on the maternity and newborn safety investigation programme. Colleagues from MNSI joined us at the beginning
of October and we’ve been working hard with them to integrate them within our work. They obviously have to maintain a degree of independence, but I think we’ve got much more collaborative in the way that we’ve worked over the last few months and they currently
have 366 investigations in progress, and I want to be starting to think as we move out of our transformation activity, how we can start to integrate them more and start to think from an improvement perspective, how we can start to bring together our maternity
inspection programme with the work that the MNSI team are doing again to make a real difference for the women who are using these services. A number of number of communications issues are raised on page 12 and onwards around responding to consultations, and the only
thing I really wanted to pick up from that page was some really important provider engagement that we spent a lot of time over the last few weeks. Looking at talking to providers around our new single assessment framework approach. Chris’ team have been coordinating the
contact we’ve had, identifying the key themes, and then bringing the providers together either in groups, going back to talk to individual providers or representative groups, as well as using the information that we’ve had to create blogs and other material that we’ve been publishing on
our website. That’s an activity which we will continue, and there’s been some real benefits to that. That activity has meant we’ve been able to make some changes as we’ve gone along and there’s a number of changes we’ve identified, we can continue to make and
there are still a number of issues which we can talk about later on in the agenda around what we’ve heard from providers. Ian I think that’s all I probably wanted to draw out from the material at the moment, unless there’s questions from colleagues, thank
Mr Ian Dilks - 0:10:33
you. Thanks Ian so, Mark you wanted to add. Thank you, could I just
Mr Mark Sutton - 0:10:38
add, apologies this wasn’t in the report, but I wanted to highlight the accessibility hub that launched yesterday. This is a permanent hub that we’ve created in the Stratford office, which showcases
a variety of technology, assisted technology solutions, that we’ve got for colleagues with visual impairment or hearing impairment or physical disabilities or neurodivergent colleagues, really well attended, showcases some of the great investment that we’ve done into accessibility here and with the successful launch of that
we plan to launch another one in our Newcastle office. And also have a portable service that we continue throughout events and training courses that we have. Thanks for mentioning it Mark, I was wondering
Mr Ian Dilks - 0:11:25
if you were going to raise it under AOB, because most
of the NHBs were here yesterday, and I think and I think most had the chance to visit the hub. I have to say, I was very impressed, I mean as an employer what we’re doing it’s great. But also the enthusiasm of the individual I
met running it, I noticed the passion she showed to care for the people that we employ. It’s very impressive, so I congratulated her, I congratulate you or anyone else involved, but well done. I can see my colleagues nodding. Any questions? Mark you’re first. Thanks
Mr Mark Chambers - 0:12:04
very much. We heard a bit about provider engagement there and we’ve obviously got an item that goes to employee engagement later on. Can you talk a little bit more about public awareness and what we’re doing to take the public with us through this stake?
Mr Ian Dilks - 0:12:24
Chris Day - 0:12:25
So that’s a really important point Mark. There is a strong trust that we build and maintain, with both providers, people who use services and our own colleagues. Through our work, we’ve just recently relaunched the way in which we engage with public groups around, give
feedback on care, and we’ve engaged really well with colleagues in Healthwatch, but also colleagues in 15 national charities and some other groups. And what that helps us do is to increase, and you’ve probably seen in some of the papers, the increase in the amount
of feedback we’re getting from people who use services. And I’m really conscious that it’s important that we can demonstrate that we’re acting on that feedback and our inspection activity reflects people’s concerns. Clearly the news this morning, of the social attitudes survey of health and
care is a cause for concern and I think it’s important that we can harness really good indications of where care needs to change, that we can help both providers and in fact, ICS’ change their approach. So we’ve been engaging heavily on the roll-out of
the single assessment framework and we’ve also been engaged with them on particular topics that we want to be able to cover, maternity obviously been one, but we want to look particularly at issues around cancer, around dementia, as we approached State of Care this year.
So there’s been really good support so far from organisations that represent people use services, will maintain that support as we go into what will be a productive summer and hopefully by the July Board will be able to show you what that looks like on
Mr Ian Dilks - 0:14:15
Mr Stephen Marston - 0:14:17
a regional basis. Thanks Chris, Steve. Thanks Ian, I just wanted to draw out and strongly welcome what’s said on page 10 about the national maternity programme, because a team of CQC colleagues have devoted huge amounts of time and skill and care and effort to
undertaking a large scale review of maternity. I think we’re sort of we’re wondering how are we going to make sure that as that programme comes to an end we learn all of the lessons from that, so it’s really good news and very very welcome
that actually there are several different exercises, I think, now going on, to make sure that we do draw out the learning of that for frontline delivery staff in providers, for managers in providers and for our own staff in future inspection review teams so that
we don’t lose what that team of colleagues have, won for us, which is a good understanding of risk factors, indicators, what to look for, what good practice looks like and all of that I think is a very powerful piece of work for improvement in
this critical service area. Thanks Stephen, I think I’d definitely
Mr Ian Trenholm - 0:15:30
Mr Ian Dilks - 0:15:32
welcome what you’ve just said. I think there’s a number of strands
Mr Ian Trenholm - 0:15:33
that come off this work. The team of have built up some significant amount of expertise in terms of inspections. The inspections themselves will
lead to follow on work, particularly where there’s warning notices or follow on work required and that will move into our normal set of priorities that Tyson will touch on later on in the agenda. The individuals have also acquired a number of very important skills
and they’ll be able to share those with their colleagues and separate to that we’ve also got the bringing together all of the those inspection reports to create a larger report that focuses on improvement, as well as work that the Chris Day and colleagues have
been leading around bringing together practitioners to learn some of those lessons. So there’s a number of things that are coming on the back of the work that team have done, but you’re absolutely right, it’s a really impressive piece of work. Thank you. And is
Mr Ian Dilks - 0:16:31
this a model for things we should be doing elsewhere? I think it is, but you might like to talk about future plans, give the success of it.
Mr Ian Trenholm - 0:16:39
I think it could potentially be a model. I mean, I think to, Prem is with us today
and I think the work that Prem has done in the past around urgent and emergency care, he’s managed to take a number of quality statements from the new methodology and overlay them on the work that he’s done in the past. That means we can
both look for improvement and add regulatory value at the same time, and I think that’s the real power of the single assessment framework. I think there’s some real opportunities to do that sort of bespoke work quite quickly if we feel we need to around
specific topics and we know, we’ve just done a piece of work in Nottinghamshire, around mental health services and again I think that has raised some questions in our mind around how we might follow that
Mr Ian Dilks - 0:17:25
up in mental health terms. Thank you. Any other, David.
Network Rep. - 0:17:31
I wondered whether there was any linkage between our programmes in
Mr David Croisdale-Appleby - 0:17:38
terms of our inspections as those are developing, and those of others who inspect, such as the GMC. Is there any exchange of pattern of inspections or exchange of information about that? Very much so,
Network Rep. - 0:17:55
we have something called an emerging concerns protocol, and what that
Mr Ian Trenholm - 0:17:58
means is if a regulator within the emerging concerns protocol group identifies any issue at all, we can trigger the emerging concerns protocol, that we then look at our respective regulatory powers and decide whether
we might want to take action, and so that happens as a matter of routine. It isn’t triggered every day as you might imagine, but I can think of a number of examples where exactly that has happened. So we may have a concern from a
provider point of view, GMC may go in and look at training standards, perhaps for doctors, those sorts of things, so that would give you an example of where that’s happened. But on a more routine basis, we speak to other regulators or arm’s length bodies
about their concerns and that again feeds into our thinking on risk and that indeed may trigger an inspection in some cases. And Ian is it
Network Rep. - 0:18:50
Mr David Croisdale-Appleby - 0:18:53
reciprocated or is it always in one direction? Oh no, absolutely
Network Rep. - 0:18:55
Mr Ian Trenholm - 0:18:57
reciprocated so again, if our inspectors see an issue with
an individual practitioner, then they will then report that to the
Mr Ian Dilks - 0:19:07
GMC, so yes, there’s a well-trodden path in each direction. The question of detail, do you want to talk about the final guidance on visiting and accompanying care homes? We’ve talked about that a number
of times, you say the final guidance is due to be published in early
Chris Day - 0:19:25
April, so is that roughly the timing? Yes, an on-track obviously, just going through the final conversations with stakeholders, so that people understand it lands well, but on track for just a
Mr Ian Dilks - 0:19:37
few days after Easter. Any other questions for Ian? OK well, thank you very much Ian, let’s move on. We have a session now on the draft business plan measures, something we’ve discussed quite a bit over the years, and I suppose you’re not explained the
detail, Kate or Christine have faced some fairly significant changes we’ve tried to make to the quality of information that the Board receive so this I think, is a proposal for what will see in the future. Presumably Steph is going to join us for this?
We’re not running ahead of time, but we’re on time maybe that threw her. Kate, do you want to kick off? Welcome Steph. Thank you, so,
Ms. Kate Terroni - 0:20:33
colleagues, what you have in front of you is our proposals around how we anticipate measuring the impact of our
business plan that is currently in draft. So we’ve got a business plan that’s been worked up. We’ve had lots of valuable input from colleagues from around the room and colleagues from across the organisation, and we will be discussing that with the Department and that’ll
be ready to share soon, and what we have in front of us is a set of proposals about how we measure the impact of that business plan, on the work that we do and the delivery of our strategy. So without further ado, I will
Mr Ian Dilks - 0:21:07
hand over to Steph. Thanks Kate. So as Kate said, we’ve been working on our new business plan for the next financial year and whilst we finalise that internally and with the Department of Health, what we wanted to do with sharing draft with Board colleagues
today and wider colleagues across the organisation, how we propose to report on that moving forward. So the question for Board today, or discussion point is if there’s any feedback around those metrics. Just to add that where we’ve put RAG statuses that is just provisional,
to show what it would look like in our future reporting. And also what we’re proposing is that, as the next board meeting is in May, that would normally be our year end but what we will do is bring a year-end pack and month one,
so that you see both this pack and we close the financial year off at the same point as well. The important thing to note is that it’s structured in two halves, so it’s really important to us around the delivery and outcome of our strategy.
So there’s something around the performance objectives which set composite indicators and then are aligned to our strategy. The second half is a balanced scorecard and that is more around the organisational business delivery which captures some of the enabling drivers so around our people, sickness,
health and safety metrics et cetera. That is really important for us as an organisation. So it was just any comments or feedback, appreciate we have had a number of discussions, so thank you for any
Mr Ian Dilks - 0:22:36
that we’ve already had. Charmion, and then Mark. Thanks Steph
Mr Stephen Marston - 0:22:41
and team, I think fantastic work on progressing to where we are and I know, we’ve appreciated the time we’ve taken to work with us on it.
Charmion Pears - 0:22:47
Just a couple of sort of remaining points from me and we talk about the volume of colleagues speaking
up which is really important but so is whether or not they felt well heard, then I think if we can look at some kind of, I know the staff survey is annual but maybe some kind of pulse to give us an indication. In relation
to health and safety, welcome those measures, we’ve got the incidents and accidents if in the commentary we could draw out, specifically also any redours that occur, I think that would be really important and using that commentary box to really highlight where things are red
here and instead of the ends so that comes with the indicators will be
Mr Ian Dilks - 0:23:32
really important, but thanks for the work. Thanks Charmion, I
Mr Ian Dilks - 0:23:36
absolutely will include those redours, and the intention is that those
Mr Ian Dilks - 0:23:40
commentary boxes do not only draw out what we want to
ensure that Board colleagues are aware of, but also any actions, any
Mr Ian Dilks - 0:23:52
work we’re doing, any projected impacts as well. So again, thank you,
Mark Chakravarty - 0:23:56
really good progress in terms of both being comprehensive, but also having the simplicity, so we can see what really matters here
and I, like the layout, is very good. Couple of additional suggestions, one is again just making sure that over time we’re seeing whether we are getting leading indicators to indicate that those actions that we can take versus just lagging indicators to show that we’ve
either hit or missed something. The other one, that sort of strikes me as, as we start to get towards measures that can be tracked, where there is a prediction, or there is a forecast for where we should be, maybe a visual presentation also helps
us actually just sort of see what that looks like rather than the numerical one. So maybe thinking about not changing the metrics but saying, is there a visual display that sometimes would support some of those key indicators and the last one is our focus,
quite rightly, is on our strategic priorities in terms of how we advance the mission and purpose of the organisation. The one that’s not called out inside of that, which I think is really critical and we discussed later in the people report is our own
internal organisation and culture. One of the things that I don’t think we’re yet measuring underneath culture and people is the leadership and the Executive impact that we’re having. We have got a nice statement in there a metric for line management, but I think actually
given the, and maybe it’s something that we reflect on and close the loop after we’ve had the conversation about the people report, but is there a metric that we want to look at in regards to leadership to make sure that we’re putting a sharp
Mr Ian Dilks - 0:25:32
focus on that? Thanks Mark, I think as a recommendation people are
Mr Mark Chambers - 0:25:43
nodding. Other Mark? Thanks and thanks Steph, because we know how much work has gone into this and we know where we’ve come from at the start on this journey. This is really tremendous
progress. It will be attractive, and I think it’s great that we’re just sort of starting with the best that we’ve got, and some of these measures are not necessarily going to be, the ideal measures. Some of them are quantitative and we want to get
to the qualitative measures, but we’ve got to start somewhere and I think this really great. I like the simplicity of this as well and we’ve got to be careful as we get to better measures what we’re doing is replacing measures not adding to something
that starts out of the dashboard and then becomes a compendium, that would be unfortunate. I am pleased to see just one small thing in here, but I am pleased to see mandatory training featured here. I think that is a key control for us in
terms of the target culture that we’re trying to achieve here and the controls that we’re trying to embed in everyday behaviours. We don’t have good visibility on it, and so this will help enormously, so thank
Mr Ian Dilks - 0:27:04
you. Thanks Mark. Any other? Just two or three really quite detailed
points from me. Steph there’s an awful lot TBC so I think this is going to be fixed over the next few weeks but just confirm there’s a few places in here where you talk about improve on 23/24. I think to give the context of
that it’d be helpful to have the 23/24 baseline. Because when you say increase by 5%, there was a question mark as to does that mean 10 to 15 or 10 to whatever it is, but nevertheless there’s a heck of a difference in the achievability,
or otherwise it would increase, depending on your starting point. And then on pages 22 and 23 of our pack, two and three of your list on business processes. This is shown as being monthly, I just wondered as a matter of practicality, firstly, whether the
budgets even face that level of detail, but if it is whether it’s a good use of time measuring monthly. I mean it’s an open question but an awful lot of these things, I suspect don’t really change much, much by month or if there was
and the whole point of this or they’re going to ask you to comment and change was certainly if it’s only one month the answer would be well, but it’s only one month. So I think you may want to look monthly, so you can spot
trends, but I would have thought for the Board, probably something like quarterly reporting for these would we be good enough? If colleagues agree, I don’t think we need to get involved in the detail of monthly, but I can see why you might. So we’re
being asked to kind of agree, and you’re right Mark and made some great points about it’s iterative, but you know let’s work on the basis of replacement rather than undermine a good start by making it too long, but I think if we could work
on the basis that is fixed for this year, minor additions may be, but we’ve had an awful lot of discussions on this. I think it’d be great, that I would be very grateful we don’t have further discussions on the principle. But can I also
just add my thanks for what’s gone in and I know you’ve talked to all of us, I think we’ve got the amount of time you put in and you know I think we’re going into 24/25 in a much better place to be able to
measure what’s going on than we have been previously, so thank you for that. So I think you’ve got what you need. Kate, Chris, Steph, so thank you very much indeed about that. Moving on to the quarterly people report Kate, I think you can lead

2.3 Quarterly People Report

on it, but we’re probably expecting Jacqui five minutes ahead of schedule. Hopefully Jacqui is around. Okay, I’ll start with introductions if that’s alright? Happy Chair if I make a start? We’re a few minutes ahead of schedule, welcome Jacqui. So Kate, Jacqui over to you.
Ms. Kate Terroni - 0:30:13
So thank you, so we’ve got three people-focused items that we’re going to cover now. We’re going to start off with our regular quarterly people pack, we’re then going to talk about our people survey and then we’re going to finish off with an update on
our culture plan. So just want to start off with a quarterly people update and just want to link this item to the last item and say Mark, we were talking about mandatory training so you now have mandatory training included in this pack. Some of
the figures aren’t where we would want them to be but what I would say is that a lot of these are, the deadline is the end of this financial year, so 31st of March. So, for example, we’ve got some hot off the press, data
that shows that from the middle of March to the 26th of March, a number of these completion rates have gone up by about 18%. So we will continue to monitor this because we want to see really good completion of mandatory training as well. But
that pack is now included. That date is now included in your pack as well, and as we’ve noted on previous occasions, the pack kind of follows the lifecycle of the employee, so where we are with recruitment, how we are doing with vacancy, sickness rates
and turnover as well. But without further ado I’ll hand over to Jacqui for a couple of headlines and then we’ll open up the questions. Great thanks, Kate. I think we’ve said before this pack is evolving. I think that you know any feedback that we
get we try and incorporate to a point where it keeps a balance, that it’s not so big that we can’t have a good conversation, but it does capture the lifecycle and the detail that will capture centrally. So I’ve pulled up a few things but
obviously I’m sure colleagues will have observations or questions around specific areas. So if we think about recruitment, there’s been some really really busy campaigns, and some of the campaigns have seen applications of over 400, which is quite unique in terms of the numbers and
the number of campaigns, so that is encouraging but also we’re also mindful around the work for colleagues in terms of what that looks like for short listing. I think about how we can support more. The independent panel member, we’re still hitting 100% of representation
across interviews and again looking at when some of the transformation work concludes as to how we can roll that out across other grades, but again just mindful of the resource that will need to do that, so you know, timing is everything with that one.
I think, linked to recruitment, I think we’ll see the data start to even out and become, sort of better in quality when we get through transformation and corporate service review because at the moment have a lot of colleagues who work fixed term contracts. The
reason for that was the decision around the workforce controls at the start of transformation that, until we knew what structures looked like a big majority of the roles would be offered on a fixed term contract whether that was held against permanent roles or if
it was work that was actually linked into the transformation. As we work through this across the whole organisation, we’re seeing colleagues take up permanent roles, apply for new roles and be successful with them, and there will be some colleagues where their work has come
to an end because it was time-bound and will see them exit the business if they haven’t secured or taken the opportunity to secure a role. So I think, really post-June, a lot of the exit data and the structural data will become more static, as
we see colleagues being confirmed into positions. And then the other area just wanted to think about, was the support that we’re looking at in terms of how we support colleagues who maybe have stress, or long term illnesses and again looking at the wellbeing offer,
mental health offer and how I resource that to provide support to Line managers and leaders. So they were just a few of the things I just wanted to highlight and I think you know, the transformation and the structural changes will really impact a lot
of threads that run through our people data, as colleagues are confirmed in roles, are confirmed into new roles or the working environment changes and they’ve got clarity, and I think that will
Mr Ian Dilks - 0:35:28
help a lot of the areas that are defined in here. OK, thanks
Jacqui. Questions or comments - Charmion. Thanks Jacqui. I found the report really useful and the quality of the data very helpful. Just a few questions if I can. Kate reflected on mandatory training, I think now for me there are some areas that are missing.
We need to pick out when we’re looking with our policies we’ve got all
Mr Stephen Marston - 0:35:47
the mandatory training, we should be having adequately captured, and I
Charmion Pears - 0:35:55
think getting really clear on the fact it’s not acceptable, not to get to compliance is really important, particularly when we
look at areas such as health and safety. We were at 66 that shouldn’t be OK for us as the leaders of the organisation, so I’m glad to hear mandatory training is coming along. The second was a point of clarification around the sickness data and
there was a chart on page 38 of the diligent pack where, if I’m correct and reading this and you, you might clarify for me please that if we work generally a five-day week and were saying that 321 of our people take more than 20
sick days in six months, are we saying that a month in every six we
Mr Stephen Marston - 0:36:41
have some people taking sick leave? Yes. We are, so that’s a high
Charmion Pears - 0:36:46
sickness for certain of our colleagues, and I would like to understand what mechanisms we have to look
at sick and how that is being managed by the managers and the organisation. So I think there’s a few things just to reflect in the data. Colleagues who have reasonable adjustments can have the absence increased by up to 50% of tolerance which will also
be captured in there and also within that, there is action taken in terms of support, understand the reason for absence at day 5. So even though the data, it’s stark data, there is activity throughout that in terms of absence review meetings, formal absence review
meetings and then and then beyond, and that obviously is overlaid by the support in terms of the cause of the absence and the support mechanisms that we put in. We’re happy to share, the key points of the policy that I think talk to each
point in our management of absence, because I think the data looks stark, but there’s a lot of activity sits behind that. I think coming
Charmion Pears - 0:38:09
to terms with it and understanding the causes of sickness and how that’s manageable is absolutely vital. The third point for
me was it was quite stark how many people were leaving our organisation in short order. It could be, as you say, that it’s to do with the number of people on fixed term contracts. If, like we’ve just talked about some of the sickness as
reasonable adjustments that would be helpful to extract. Likewise, it would be useful for us to understand what proportion of those people, high proportion of people leaving within two years, are on fixed term relates to people who have joined us and have found that culturally,
we were not quite where they would expect us to be, which is what we should be covering and discussing here. Yes, I think the other thing to mention with levers, which is just specific to the data that we’re looking at over the last few
months and probably the next few months is it also includes redundancies as well, and that will clearly you know peter of from June onwards. So I think in terms of going forward I think the data that we look at will be the real, genuine
data of the workforce and not the tail end of transformation. So there
Prem Premachandran - 0:39:26
was one more, I think, what we see across all the reports that have
Charmion Pears - 0:39:30
Mr Stephen Marston - 0:39:31
come through is the really important, the value that comes out of
Charmion Pears - 0:39:33
triangulating your sources of people data. So
we have been lucky enough within this month to see our staff’s colleagues survey results to see as some of the ER environment and some of the sickness results together, and I think when I pulled those together I think it warrants looking at certain groups
such as those with a disability that feature in all three groups and understanding why that might be because we get quite rich data when we’re able to triangulate so that one can be picked up by the team. I think that would be beneficial. I
Mr Ian Dilks - 0:40:04
think Mark was first.Sorry, there’s two Marks. Mark, Mark and David.
Mark Chakravarty - 0:40:14
So again thank you for your great report, really clear to read as well. The other one that just sort of stood out was leaver diversity with the ethnic minority turnover rate. That one looks
like it’s quite a lot out of tolerance at 18.4% versus an 11.5%. Is there any more behind that, have we looked into that to see what’s driving that and if there’s something that we should, is it a signal,
Mr Ian Dilks - 0:40:41
is it a one-off? When we’ve
looked into this, this is where it talks to the point of transformation because there was in excess of 20% of ethnic minority colleagues came in for transformation or on fixed term contracts. So as there was fixed term contracts come to an end, obviously seeing
some leave, as some colleagues are still waiting to have confirmation of roles. So again we are tracking that in terms of where we are, but I know that it’s been slightly distorted by the prolonged period of fixed term contracts we’ve had even if they
were against full-time roles. It’s probably gone on longer than we would anticipate, so I’m saying I think the next pack should see some stability in there, in data that we can really critique in terms of what this is telling us and what our action
needs to be. There’s some areas, that’s still a bit opaque until we
Mr Ian Dilks - 0:41:54
finish the corporate service transformation. Sorry, do you wish to
Mr Ian Dilks - 0:41:58
comment? Thank you in terms of recruitment and retention of colleagues of ethnic minority and those with a disability, the stats here clearly
Network Rep. - 0:42:13
show that there is an issue. In that there are stress levels that are quite high, leading to sickness absences and invariably that affects staff morale for those colleagues who remain to cover for those who are away and just the overall productivity of the organisation
goes down. What plans do you have to work with the networks, to identify these issues so that we can have a working mechanism to drive up retention of ethnic minorities? You mentioned that during the transformation process, that’s where people of ethnic minority, the large
numbers came from. If we looked it into the data on why we have the majority of colleagues coming in on short term fixed contracts rather
Mr Ian Dilks - 0:43:11
than permanent roles. So if I start at the bottom, so organisationally, there was a decision taken to implement a
workforce control committee, and this was as part of the transformation decision. So that actually until the new structures, that most colleagues would be offered fixed term contracts. While the new structures were being designed and like I say it has probably gone on longer than
we would hope, but in terms of everybody was in that pool in terms of the fixed term contract element. So I think we are seeing now some stability but we still need to look into it, as we go forward, to make sure that this
isn’t a pattern, and this can be at this point some of it assigned to where we are organisationally, but I think that’s probably going to take another couple of months. But actually absolutely will be working with the networks and with trade union colleagues on
the staff survey data, on this data, and there are quite a few projects in place around looking at our recruitment offer and how we approach that and what we can do differently in more of, and all of this will be discussed with colleagues, more
broadly, to get input because that’s the only way it’s going to succeed. Thank you for that and just one final comment. How can you
Network Rep. - 0:44:47
reassure our network members, in terms of the listening engaging and responding to concerns, that due to the poor results of
the people survey, that the senior leadership team and the Board are actually listening to colleagues in that you are going to make some changes where needed for the organisation to move forward. OK, do you
Mr Ian Dilks - 0:45:18
want to come in? If I may say thank you
Ms. Kate Terroni - 0:45:23
so much Zee for those questions. So we absolutely need to keep a really close eye on the number of ethnic minority colleagues leaving the organisation. We have the data that tells us that we’ve had large numbers coming on fixed term contracts and technology data
and insight, be it in transformation, but we need to keep a really sharp eye on that. We also need to keep a close eye on you’ll see elsewhere in the pack how we give out rewards, how we recognise colleagues and whether we’re making sure
we’re doing that well across all different groups as well. And then finally we’ve got our people survey results. We haven’t yet got it cut by protected characteristics and you’ll know from previous surveys this gives us really rich insight into particular challenges or issues different
groups of colleagues might be experiencing, Charmion’s point that we need to try and get at all of this. So that’s a really good challenge on what we’re doing on that front. A couple of other bits, and then we’ll just come back to the people
survey. Just talking about reasons for leaving, so obviously some colleagues are leaving fixed term contracts or various other reasons. On page 43 of your pack, we do exit interviews as a matter of course, with colleagues leaving the business and you’ll see from the word
bubble that there are many reasons why people leave the organisation, but things such as career progression and higher salaries is something that career progression is something to celebrate, so think about Ian’s earlier comments about colleagues who have been through programmes such as inclusive leadership
programme, and they’ve gone on and found promotions elsewhere, which is fantastic. The higher salary benefits, again that’s a theme that comes out when you look at the people survey results as well, so again something that we, it’s really important, we keep a close eye
on as to how people are exiting. And then just one final additional comment to what Jacqui was talking about earlier. It is fantastic that people want to continue to come and work for us in the organisation, and we’ve had a large volumes of people
responding to these campaigns. I think it is worth recognising as well as the kind of pressure on managers that also means that there is quite a challenge of getting people in in a timely way, and we know we’ve had many times, from particularly operational
colleagues about the need to get in people, to recruit people, and to get them out delivering our kind of core business. So as well as the review Jacqui’s doing around recruitment, we also are committed to looking at how timely we can go from advertising,
interviewing, and getting a person in in the role. If you’re happy Zee, I think we need to answer that question about how we respond to people survey, I wonder whether we just park it for one more agenda item and we cover that offer in
our comments then is that okay? Thank you. Thanks Kate, so I think
Mr Ian Dilks - 0:47:50
Mark Chambers now and then David. Thank you Ian. Again on mandatory
Mr Mark Chambers - 0:47:57
training sorry, the headings that we’ve got here don’t map to individual policies, which is fine. The mandatory training is an
opportunity to be broader than that, and I’m sure things like the information, knowledge and information management one covers acceptable use, health and safety will cover all of the key messages, but the one I always worry about his dignity at work, and our survey scores
that we’ll see later on indicate that things at the top of the list are things that people need, help to understand their impact on others, so it’s tonality of e-mails. It’s excluding people from social gatherings, it’s how performance management and expectation of workload and
stuff like that which, you really need the training to bring that to life. It, we don’t have to do it now, but offline it would be good to understand the mapping, because I’m not sure that anti-bias and fairness looks like the closest heading. I
haven’t done the training, maybe I did it three years ago, and maybe I should do it again, but the I want to make sure that we’ve got all the key workplace behavioural policies mapped and appropriately addressed in this mandatory training, because I think we’re
going to be looking to this in our rack as being a sort of key
Mr Ian Dilks - 0:49:29
control. Can we capture that as an action to come back on because I think it’s a very good point Mark? David. Thank you, Jacqui mine is a
Mr David Croisdale-Appleby - 0:49:39
methodological question which
is how do you ensure the validity of the exit interviews? Do you ensure that they’re triangulated, or what to ensure that, they’re really useful in terms of the learning that we want to take from them, because in other organisations I have just seen it
conducted by the immediate line manager, or someone of that sort, which isn’t really authentic? So at the moment we have a two-step approach. So the line manager would initially ask for a meeting regarding an exit interview. If the colleague, for whatever reason, didn’t want
to discuss the reason for exit with their line manager they could speak to somebody else in the area of the Commission, and then I’ve got a team that would contact colleagues after they’ve left, approximately two weeks after they’ve left to talk about, because quite
often once colleagues have got a reference, they’ve maybe started a new job retired, whatever it might be, they’re often freer to speak. So we have a second chance by, giving that ex colleague a call to discuss the reasons for leaving and any feedback in
a template format, so then we can capture the data. So that’s the way we approach it at the moment. So just to help me with that Jacqui,
Mr David Croisdale-Appleby - 0:51:23
roughly what proportion of people would have that second interview? Well, everybody who doesn’t, everybody that doesn’t complete
an exit interview before they leave, we would contact after they’ve left. Some people who don’t get in contact with and some people the ship has sailed, but we always go to everybody. That’s very helpful. I
Mr David Croisdale-Appleby - 0:51:50
will follow it up offline if I may. Any
Mr Ian Dilks - 0:51:53
other questions? Just one from me Jacqui on the covering paper, you have an analysis of leavers by length of service and operations I mean, it’s the biggest area, so the numbers were always bigger of course. But it’s interesting how it’s skewed, I mean, on
the one hand you’ve got 62 only just joined, we’ve talked earlier about people not staying very long but query why is that? What can we learn from it, but then also a very big number at the 10 plus, and I initially when I read
this, I thought well gosh, that’s an awful lot of experience going out of the door and is that a worry, particularly when eight, six and seven and nine are high, so it is a lot of experience. On the other hand, I’m aware that many
of our people in operations have had previous careers and might, for example, be their last jobs. So it could well be, a question, that actually, quite a bit of this is just, people have reached the end of their, people coming up to retirement and
moving out. So do we have any observations, so it’s partly for you, but Tyson may wish to comment because it’s in his area. What we read into an awful lot going at the beginning and end, is it a worry that we’re losing so much
experience, but that there’s a mathematical point in my correct in thinking, that quite a few of the leavers might be retirees? I don’t know who wants to kick on. Shall I pick that up Ian? Yes I think your
Mr Tyson Hepple - 0:53:21
analysis is right. I think those,
they’ll be a proportion of those who are leaving after a short period of time, who will have been on fixed term contracts and in some of our areas such as registration and the NCSC. We have had a lot of people on fixed term contracts
that’s now starting to change, so I’m hoping that data will change. I think at the other end of the scale you’re right, there will be people who have retired, there will be people who, I think, the figures will still cover some of the compulsory
and voluntary redundancies as part of the transformation programme, and some of those people will have been in the organisation for quite a long time. So I think if we were to look at that data again in 12 months’ time I would expect to see
Mr Ian Dilks - 0:54:04
both of those figures go down. Obviously just thinking of, I wouldn’t want to extrapolate from one or two other people I know, but two or three people I dealt with in the organisation are going actually retiring, quite young, but that’s because they’ve got caring
responsibilities or that sort of thing as well, so there are many drivers. If there are no other questions, thank you very much indeed for that Jacqui, and has been said before and we’ve said several times today, when looking at the quality of information, it

3.1 Our People Survey 2024 results

has gone a long way over the last year or so, thank you for that. But moving on we’ve got the people results survey so, Kate, do you want to pick this up and then Jacqui? We’ve all read it, obviously we’re concerned, but we’ll go
to questions after you. So thanks, Ian. So firstly a big thank you to colleagues for completing the survey. You’ll notice there’s a completion rate of 78%, which is a significant completion rate, and I
Mr Ian Trenholm - 0:55:04
think it’s something which is which is par for the course
colleagues, colleagues often fill, these forms are those sorts of rates which is really good but an enormous thank you for taking the time to to fill in the survey gives us a level of richness of data which is really important. I think, as I’ve
said or as I said on and in the internet article, when we publish this to colleagues, I think I’m really disappointed with these these results, I think they, though there are some, there are some bright spots here, but there’s also an awful lot to
to be concerned about. I think it is fair to say we are in the middle of significant change. All colleagues are going through significant change. However, I think it is him I don’t I don’t think that is that that is the full story. I
think simply sort of saying is change is too simplistic. A way of viewing this, and whilst I recognise that operations, colleagues are in the middle of the most significant change in the sense they’ve moved to new teams, they’ve gotten, many of them got new
roles about using new technology and they’re using a completely new methodology I, I think it, it would be, it would be far too simplistic just to write this offer has changed as much more to this and it was much more nuance and subtlety deteriorate.
than then that. I think it is, I think, a reflection of the fact that our people deeply care about what they do, our people deeply believe in their purpose and obviously a change of this level of significance, unsettles people, and that starts to be
expected. But there is a challenge for us as leaders to get people to a place where they are much more confident, much more comfortable and much more confident, in what they’re doing and that they continue to believe in what they’re doing as a as
a contributor to our overall purpose. So I think we have seen some improvements with the way that people feel about their day to day experience, there is some, big improvements in the relationship between people’s managers and the relationship between colleagues, and I think that
day to day experience point is it really important one. Also I think there’s been improvements in the way that people feel that they are treated fairly at work and there have been increases in people talking about their health and wellbeing and the way they
feel that’s being, where they’re being looked after. But I think it is true to say that people don’t feel well enough supported by us as a senior team. There’s a sense that people don’t feel that we are living the values that they would expect
us to believe and that definitely gives us significant pause for thought as a senior team. There are some improvements in the way that people see the strategic direction of the organisation, which I think is a positive. And it is definitely some issues around people
being uncertain about some of the details around changes as we’ve talked about before, but I think that strategic direction point gives us a potential opportunity to build on that. People do believe in our overall direction of travel. The question is, how do we get
there? Pay of course remains a very specific concern, but again I think there is a definite difference between people’s concerns about pay versus they feel better about the wider flexibility offer that we offer. I think we’ve seen that in previous surveys as well as
people do value the flexible way in which they are able to operate here. I think now we’re moving towards the end of the transformation programme, the substantial rollout is now complete and we can start to, use the time that we’ve now got to work
with colleagues to work through the detail of what’s in this survey and work through what the survey is really telling us. One of the important pieces of work that we’re doing is refreshing our values and the way we talk about our purpose. There’s a
set of events that are running out from later this month over the course of the summer, and there’ll be a Board paper back. I think it’s in the July Board where we’ll talk about the results of that piece of work. I think in terms
of our response to the the survey, I think there are probably two groups of activities that we that we see in that response, one group of activity I suppose is fairly technical in one senses, it’s about making changes to the systems, it’s about making
changes to processes and addressing some of the tangible things that in terms of customs and practice and ways of working and so forth but I think there’s probably a more important component to it which is around culture. I know senior colleagues have spent an
awful lot of time meeting groups of colleagues, doing one-to-one sessions with individuals, talking to them about change, talking to them about what we’re doing, but I think what the survey is saying is we need to do even more of that and we need to
have different conversations. We need to recognise that that whilst people may broadly agree with what we’re trying to achieve here, there are some specific policies and practices which people don’t agree with and have become become real blocks. One of the things that the Tyson
wrote out to his team about yesterday, was giving operations managers more flexibility in the way that they deploy, assessors and inspectors, that had become a particularly difficult issue and I think what Tyson’s sensibly doing now is starting to give a bit more flexibility in
certain circumstances and over the course of the next few months we’ll see how that pans out and we may very well find ourselves bringing forward the piece of assessment work we’re doing around assessments about to split over the course of the summer. That feels
like a really important, tangible thing where we’ve listened to what people have said and we’ve recognised that we need to make some changes. I’m not going to go into the detail in these opening remarks by happy to answer questions about detail or general approach,
but I think the general approach really falls into those two streams
Mr Ian Dilks - 1:01:18
of work almost around technology, customs and practice, guidance, those sorts of things which again there’s a straightforward programme
Mr Ian Trenholm - 1:01:23
there, but then the second, I think, more important thing is around
Mr Ian Dilks - 1:01:26
how we build
and iterate our values, we’ve got activity in place to do exactly that, and then there’s some questions for us as an Exec team around our visibility, where we go, how we do it, and some of the decisions that were made and how that was
Mr Ian Trenholm - 1:01:42
Mr Ian Dilks - 1:01:44
perceived have been. Thanks Ian, Jacqui, do you want to add anything to that, or do we? I was just going to add, to reiterate what Ian was saying, the results, certainly aren’t where we need them to be. But in terms of next steps, the
demographic and characteristic data is being prepared and should be shared with colleague groups next week. Then I think it’s around actually triangulating all the data, stopping and not jumping in, but thinking about what the next steps are, so we should have all of the
Mr Ian Dilks - 1:02:25
data by the end of next week. Before we move to questions, Zee if I could impose on you, I know you’re not here to talk specifically about this, but as a member of staff, one of my colleagues round the table, would you be able to make any observations from
Mr David Croisdale-Appleby - 1:02:45
your perspective? I think I have raised those issues around the
Network Rep. - 1:02:49
recruitment and retention of ethnic minority colleagues and those with disabilities. In terms of working flexibly, Ian has mentioned a point where colleagues really appreciate the fact that if we are to move forward, there
has to be a flexibility where things are not working, we work together and this announcement that Tyson has agreed or proposed that inspectors work flexibly to lead end to end assessment to, increase capacity. I think it’s a welcome development and as a network we
are hoping to see more of that interaction where we are talking. You rightly highlight that we are tweaking our working on the issues of technology in the other side of the culture and the other the culture side of it, we want our leadership to
demonstrate those values that are so dear to so many. Such that we do move from a point now where we are now starting to get into a stabilisation mode, we have moved from the transformation. Now we want to see it work, but also having
that clear commitment and direction from the leadership in terms of
Mr Ian Dilks - 1:04:07
culture. Thanks Zee and sorry to prevail upon you, I know that’s not why you were invited here today. So to questions, Christine? Thanks. I
Ms. Christine Asbury - 1:04:17
mean first to acknowledge that I can see there are
a number of positives in this survey and that’s really important, but obviously as a board, I think we have to be concerned about the difficulties that have been expressed. There’s two that really concerned me the first one is the low number of colleagues who
feel that that their work is directly affecting the quality of care because that is our purpose and that’s a real challenge and a concern, and the other is that the one you mentioned already about the responsiveness of and behaviour at, executive level. So you’ve
talked a little bit about the action that’s planned, what we’ve got really is a demotivated staff group or at least pockets, significant pockets of demotivated staff and I think it’s about making sure that you will be doing things differently because clearly what we’re doing
at the moment isn’t having the impact that we would hope. And then the other one which relates to the culture and values and we may discuss it again there, but I just wanted to check how visible is the executive team in the culture and
values work? Because that seems to me absolutely fundamental. It’s about the hearts and minds that that we’ve been talking about, and it seems to me very important that the Executive team you and Kate and everybody else are very, very visible and actively engaged. Can
Mr Ian Trenholm - 1:05:44
I just answer that one specifically? Yes, we are. We go into all of
Mr Ian Dilks - 1:05:49
the sessions. How are you leading it? How are you showing that you’re
Ms. Christine Asbury - 1:05:52
leading it, rather than just go into the sessions? In a range of
Mr Ian Trenholm - 1:05:57
different ways but, Tyson. I was
Mr Tyson Hepple - 1:06:01
just going to say from that point of view, Christine, we are doing our values workshops at the four conferences operations conference that we got planned in April and in May. A large number of members of the board, I think, Ian, both Ians are going
to be at all four conferences, a number of you are coming to a number of them. You will actively take part in the workshops so you will be helping to shape the values but also in smaller groups be able to peer how people are
thinking and the way their thoughts are developing so you’ll all be very actively involved in that work and are hopefully at those four
Mr Ian Dilks - 1:06:36
conferences as well as in other parts of the organisation. Belinda. Thanks. Jacqui, so I’m just looking at the initial page about
Mrs Belinda Black - 1:06:41
the lowest agreement area, and it seems that lots of people think that no action will be taken as a result of the survey and that no action was taken as a result of the last survey. Sorry, I just wondered if you could do things
like you know you said we did? I just wonder why so many people think that, because you know some results are very disappointing, but there are some pockets of really, good results, where we’ve seen good numbers of improvement from the last survey, but still
we have a large number of people that are very unhappy, so I just wonder if you could top through the practicalities of what you know when we get the survey on what we actually do as a result of that. So like I say we
Mr Ian Dilks - 1:07:20
will have all the data by next week, and I do think we need to take a completely different approach to it. We have our equalities networks in the trade unions who are really keen to support us, and I think executive team need to lead
on this and we’ve already had those conversations. We need to keep the actions visible, there needs to be regular reporting and we need to keep it to a point where it’s not 101 priorities. What are the priorities? We need to socialise those, agree those,
and then review them because what’s inspected is respected, and I think we’ve probably missed that. And we’ve tried different things, we’ve tried different approaches and some of its reaped rewards, but I think in terms of the visibility and the accountability I think this is
the line in the sand with this particular survey. I think there’s
Mr Ian Dilks - 1:08:37
buy-in to recognise that. Mark. Sorry, we’ll take Mark’s in the opposite order, Mark, Mark and Stephen. Is that okay? I feel I’m
Mark Chakravarty - 1:08:48
jumping ahead here somehow. Just a couple of points, I mean
I think one as an organisation as a unitary board, we probably have to also acknowledge that we might have, in very good faith, followed the right process about transformation and ended up with an outcome that’s still not correct, not right. So you know if
we’ve got the wrong outcome, that intellectual honesty, but also that emotional honesty to say with some vulnerability, we’ve made choices that have ended up with an organisation where we really don’t want it to be and we have to take that ownership and that personal
commitment to change our behaviour so that that can be reflected to the organisation and change too. There’s one part there about that really owning that and being accountable for our own change to make a difference there. The second point was really around there’s so
much information in this, it’s sometimes hard to sort of say, how do you triangulate this? One of the most helpful areas is to sort of think about the majority of people, what motivates them and drives them in a professional perspective, is having purpose autonomy
and mastery. So the purpose piece, I think, without a doubt placed at the very heart of what we do at CQC and the greater objective is clear, but it probably is a symptom that we’ve disconnected people’s daily actions from that greater purpose. I don’t
see any more how what I do day to day contributes to that greater purpose, and I think that’s a real area of diagnostics. The autonomy is we’ve introduced a new framework, which is probably feels like the framework is driving the people and we need
to re-emphasise that what we want as an organisation is people that demonstrate their professional judgement and use that and use the framework to support that judgment, not the other way round. I was making the analogy I have a car that keeps correcting my lane
correction when I’m going across it, I really do want to cross the line, but it tells me I don’t right? And it probably feels a little bit like that and how do we return that? And the mastery piece is, do I feel like I
can grow in this organisation, and is there room for growth for me, and that might be role, descriptions and boundaries, but I think those three as orientation for actions might be a very helpful way forward.
Mr Ian Dilks - 1:11:07
Mr Mark Chambers - 1:11:15
Thanks Mark, Mark. Thank you, and it’s fantastic and
wonderful that our staff have contributed, our colleagues have contributed to this level of participation, 78% participation is strong and it allows us to look at the voice of the organisation. We mustn’t portray that by trying to sort of say that this is pockets of
feelings around the organisation no, these scores represent us and our organisation today. There’s lots to be disappointed about in here. The score that disappointed me most was just about our worst score, which was the one that Belinda referred to about, I think effective action
has been taken on the results of the last survey. Nearly half of our people disagreed with that. It was the least positive and it was almost half of people disagreed with that and the expectations for next year’s survey, what would happen next time is
over 50%, the people believe nothing will happen in relation to this, that in the next time, they do this, nothing will have changed. That’s really poor, because actually this is one of the very few scores in here that you really can control by taking
some action, telling people often and frequently what you’ve done and taking the time to understand what are the main drivers in relation to this survey and addressing them focusing on a few things and getting them delivered rather than lots of things and not delivering.
I know we had a discussion last time we looked at the survey, that we were going to do it differently and we did try and do it differently, but it hasn’t landed this tells us that that approach hasn’t landed. So we’ve got to do
something very different this time, it’s got to be owned around this table, it’s got to be delivered around this table and we’ve got to make sure it lands, and we’ve got to communicate it constantly and effectively through the year and it really needs to
be a very authentic response to what is a final warning in many respects that the culture is not where it needs to be. Stephen and
Mr Ian Dilks - 1:13:48
Mr Stephen Marston - 1:13:52
then Charmion. Thanks Ian, I think my starting point on this is a comment which I strongly agree with that
what we shouldn’t do is understand this staff survey as people not wanting change and therefore reacting badly to a big transformation programme, because there is a survey result in here that says the majority 61% of colleagues do understand why the organisation needs to change.
The lowest single survey response is the 15% just 15%, who believed that that change is being effectively implemented. So it’s not change per se that people are reacting to, it’s their experience of how that changed, the transformation programme and SAF have been carried through
in the organisation, and for me, I think, one of the big areas we should be looking at in how we respond to this survey is the communication with colleagues that gives them confidence that when they raise concerns about the way the change is being
handled, we’re hearing that we’re really actively listening to those concerns because they’re being brought forward by professional colleagues worried about their own ability to do their job well. And there’s a quick, clear, good, convincing feedback loop that explains how we are going to respond
to those concerns. Not because we can always say yes to each concern that any colleague may raise, but overall and in aggregate I don’t think we’re yet convincing colleagues that we’re really listening carefully to their experience of how this change programme is being carried
through and responding where we can to make things better. Final point and I don’t think that discussion and that communication loop is just about tasks, procedures, processes, systems and transactions for me, there’s something quite fundamental going on here about colleagues’ professional values and their
professional identity and whether they feel that under these new arrangements they can carry out with integrity the professional purpose that they came in to CQC to undertake. So transactions, yes, we’ve got to make sure that the transactions, the systems, the IT platforms and everything
else work well, because that’s causing a lot of frustration, but I think there’s something deeper, which is about how we engage with colleagues to make sure that we adapt adjust our new ways of working so that they can still see, professional reward and satisfaction
from a job well done in supporting the health and care system to provide good, safe and effective care, which ultimately is why people work here. So it’s trying to get that line of sight through the way we respond to this survey back to people’s
Mr Ian Dilks - 1:17:41
professional purpose in being employed at CQC. Thanks Stephen. I actually had a number of comments, but I think my colleagues have made
Mr Stephen Marston - 1:17:53
them all. Charmion. Sorry, my turn? One further reflection, and that
Charmion Pears - 1:17:57
is, I think there was quite a strong sense in terms of
what our colleagues said around satisfaction within the team and potentially directly above them, but that sort of decreases. We talk about increasing levels of seniority in the organisation and I think one of the things I would like to hear back from the team more
on over time is the concept of the difference between leadership and management, and I think it’s incumbent on everyone in this room to really highlight and articulate what good leadership looks like and how everyone’s going to walk that talk and how it’s different from
management. And I think that was really stark in terms of the results and I think that links to the point Stephen made, which was my other, really big observation from the survey results, which is that our colleagues just don’t feel heard and I think
we need to challenge ourselves to say, are we saying what we want to say or are we thinking as good leaders about what they need to hear to be successful? What needs to be in place for them to be successful and responding accordingly, which
is what leadership is about? So I think it would be great to hear over time what we’re going to do to set out our stall as good leaders
Mr Ian Dilks - 1:19:11
around the table and come back with it at some point. I’m not sure, sorry Ali. Thanks.
Mr Ali Hasan - 1:19:19
I also agree with our colleagues and identification of areas that are positive in many areas that are challenging and disappointing. I think one thing that comes up every time we look at these results from our colleagues is the fact that the majority of our
staff are remote, and I think this is manifested in somewhere when we look at bullying, harassment and abuse or actually the two areas that have been highlighted as most common affecting and approximately one in five of our colleagues relate to e-mail tone and style
is the most commonly listed one in criticism. I think these are certainly areas that we should give some focus to specifically as we
Mr Ian Dilks - 1:19:52
Ms. Joyce Frederick - 1:19:59
continue. Thank you. I have looked at the survey several times and I have been troubled and upset by the results, I
think I’ve been here quite a long time in the organisation, so I helped to create the values of this organisation. So it’s quite impactful to hear that leaders in particular the executive team are not displaying the values many of our colleagues feel that that’s
not the case even though I sometimes feel, you can cut through me and they’re in there like a strip of rock. But it’s what we do as a leadership team, that’s going to be really important going forward. I’ve been quite shocked by the fact
that the purpose we have, the survey says it doesn’t relate to the care that people receive. The fact that people don’t think it’s safe to challenge. So, even if we actively went out to try and listen and hear, there is a barrier there that
we’ve got to get across so that people feel that they can raise issues with us and the fact that they feel that there is no change as a result of doing the survey so they might do it again and they might still be no
change. I think what they’re saying is that the journey has been difficult and a destination is still difficult and we need to change both of those things and do it really quite quickly. I know as a regulator that when I went out and did
inspections, if I saw survey scores like this they are so linked. Engagement is so linked to leadership and safety, crucially that those there’s a straight correlation between how safe as an organisation and what’s its leadership like with engagement, so I would say you know,
what would we say about us as an organisation seeing scores like this? So I do think this is a watershed moment we have to take it seriously, we need to stop. I don’t want to rush to any tick-box actions. I think this is about
listening and having those conversations and trying to work out what it is that matters to people most and acting on it and being brave enough to have the humility to say we have got some things wrong, but we need to change really quickly to
Mr Ian Dilks - 1:22:17
put them right. Thanks Joyce. Kate. Thanks for all of those comments,
Ms. Kate Terroni - 1:22:21
so I hosted a call yesterday with 200 managers and I asked them how they were feeling, as they were digesting the results for their area. Quite a lot of differing views, but some
strong kind of themes came through, which is don’t chalk this up to change, that dismisses how we feel. This is not about change in itself, and some of this is that we don’t agree with aspects of the destination where you are leading us to.
There was also a real plea to take your time, listen, reflect. And then there were some managers just reflecting on the hurt, which we all feel when you read a set of results like this, about a service that you are responsible for leading. I
think there is such a strong message about you’re not listening, so there was a load of activity that happened on the back of the last people survey, but as you read through the pages and pages and pages of comments that come back with these
surveys, there were a couple of really key themes that we can’t ignore and that they’re not all of people’s concerns, but messages around the inspector assessor role, messages around the relationship owner and messages around people’s ability to do their job to understand risk etc
are loud and clear for a large number of the biggest chunk of our people. I think, as Ian said and the announcement, Tyson made yesterday about the ability to do some flex with the inspector assessor role when it comes to exceptional circumstances, I think
is helpful. I think it’s really important that our organisation knows that we are not wedded to our model if the evidence tells us the model, isn’t right. So we had an idea, we listened to people, we’ve implemented it. We’ve now introduced the policy and
the framework and the technology to support the model come to life with how inspectors and assessors work, but it has to deliver, has to make us a more safer, effective regulator, and I suppose just my main message is, we are open to hearing how
this is going and we will continue to be open and we are ready to respond and do things differently if that’s what the evidence tells us. So I think that comment around you’re not listening will stay there for as long as people aren’t seeing
us being ready to respond to what the evidence is telling us on those two really key issues around the inspector assessor role and the role of relationship owner, where again there’s more work to be done. And just finally, as I said, at the top
of this, so it is personal and it is upsetting, so if you think there are seven of us on the Exec team and one of the poorest results are the percentage of our people who think the executes reflect the values of the organisation so
we need to sit with that this isn’t about, as he said, leaping to results but that is a real reflection of how our people feel and how sad is that? We’ve got the values work coming up and I just want to be really clear,
the values work isn’t how we want to see the behaviour of our people, change their values work is for all of us, so it’s about us setting out at every level of the organisation, what values we want to see and how that translates to
behaviour. So I suppose my only reflection back on the the information about how people perceive us as an Exec team in terms of displaying the values of the organisation. We are open and receptive as to how we might demonstrate that differently, but also we
are in the same group as you all when we think about what the values needs to be, as the organisation goes forward and what those behaviours need to look like. So I suppose I just wanted to share that this hits and you know we,
Mr Ian Dilks - 1:25:39
we want to do everything we can to get this back on track. Chris. I guess, building on what Joyce and what Kate said and I think the
Chris Day - 1:25:51
overriding emotion for me was sadness. I don’t want anybody to be unhappy at work and it’s clear
that the results of the survey show that people are, and I think there is to Kate’s point a falling trust with us as a team, which is unacceptable. We can’t have an organisation where the senior leadership isn’t trusted. From my perspective, as Joyce will
remember that only a few of us were here when we created the purpose of the organisation almost a decade ago now and that had with it a sense of what we were doing for people who use services and whatever we do next, the determination
from for me is that we respond to this in a way that allows people to do the thing that they want to do, which is to help call out poor care and drive improvements in services so we do need to respond to the challenges
that lie behind the survey. Like others, I don’t want to jump to simple solutions, but I think there are some issues we need to resolve around the practice of how people experience that they perceive it, it prevents them doing a good job, I think
there are issues to resolve around how we return to services, how we manage risk, how we maintain relationships with providers and with people who use services across an area and how we provide the right understanding of how services are changing over time. All of
this needs to happen but all of this starts with our ability to listen to colleagues and collectively act on what we’ve heard. I think there’s a willingness from us as a group to make sure that whatever we do next, we are able to go
back out and live the purpose that we created say a decade ago now, and I think we’re there’s hopefully what people are hearing as a
Mr Ian Dilks - 1:27:40
collective determination, that’s what we’ll do. Mark. Make this the last comment. Thank you, I do just want to echo
Mr Mark Sutton - 1:27:45
Kate’s comments there about the need for us to, I think, the way I would describe this was certainly thinking about this from a technology perspective, we need to evolve and it was always the intention that we would deliver a capability to be able to
support the organisation to be able to operate in a different way and in an enhanced way, but from a technology perspective, from a day-to-day emphasised perspective that needs to evolve. from out from a position that we get to around the initial operation and that
that’s actively happening at the moment. Tyson and I are spending lots of time listening to people getting feedback from inspectors and assessors and operations managers, and we are, we are making and we’ve got a body of changes that we’re building out from a technology
perspective and other ways of working perspective. We have, I spent two days at the end of last week up in Newcastle with, with colleagues from the contact centre working through a body of changes that we’re doing to enhance things, to make it more efficient
from a workload perspective, and to enhance the experience for colleagues. So I hope that gives a bit of reassurance that we are absolutely listening and are absolutely keen to move forward and
Mr Ian Dilks - 1:29:07
improve matters for colleagues. I said last comment, but I shall give Tyson
the last word. Thank you Ian and very briefly because I just want to
Mr Tyson Hepple - 1:29:17
align myself with what my executive team colleagues have said. The results were really sobering, particularly in my group and we’ve had a conversation about that, I really welcome the permission in
this room and on the call yesterday that we’ve got time to reflect about this. There’s an awful lot of material, an awful lot of comments and we’re still seeing some of the data at a more granular level. I think the two big issues for
me which have already been picked up is one about people’s perception of us as a leadership team and about how people like me, who have been listening. I want to reflect on that and also worrying is the extent to which people think the changes
we’ve made are getting in the way of them doing the job that they want to do. So again all I want to say that I align with all the comments my colleagues have said. I want to reflect on that, but I agree we do
Mr Ian Dilks - 1:30:07
need to do some changes. OK thanks, we ought to draw that to a close, I said my comments, I think, are being picked up by others, I’m not going to attempt to summarise that but forgive me a couple of observations. I spend more time
with the many members of the Exec than my Deputy colleagues and I can assure you and anyone else listening. This was taken seriously, people were shocked, they were personally hurt by it, but I would hope people didn’t make comments with the intention of hurting,

3.2 Culture Plan progress update

that people were personally hurt when they read it. And I think there is a real desire to do something different, the challenge is what? The perception is reality here, so people think we didn’t respond, we didn’t respond, but at the same time you know,
I know first-hand an awful lot of people have done an awful lot of things. So there’s this clear disconnect between an awful lot of activity because there was, and perception that that things were done, so I think one of the biggest challenges you’ve got
we’ve got is to square that circle of, why is it that senior leadership thinks it’s listening and is doing things and the people on the ground don’t? I don’t have the answer to that, but it seems to me that that’s at the heart of
what’s been here, but I do thank you very much indeed for demonstrating the seriousness with which we hope it’s taken, certainly whether we’re still getting the data this is a hot work in progress. but thank you for being so straight on our position and
we all just have to consider how best to bring it back to the Board. But I think, one clear message everyone’s taken is we need some process stuff, but by and large this is not about process, this is about behaviours and ways of working
so and as the whole board I mean the executive are in the firing line, but you know it’s a unitary board, so we all have some skin in the game in that. OK, thank you very much indeed, we’ve run considerably over the allotted time,
but entirely right that we should, very serious point. If we dealt with nothing else today it should have been this session. Can we move on to, there are a couple of other things I want to go through before the break, and the next one
actually is directly related. You’ve already talked about the cultural plan progress. I mean, this is really just an update, I think, for the benefit of the colleagues, but Kate do you want to pick us up? So this
Ms. Kate Terroni - 1:32:26
can be really brief and I’ll hand
over to Jacqui. So part of our plan, linked to all the things that we’ve been talking about, but we were hoping to do anyway at this point in time is check back in with colleagues about the values that were established 10 years ago to
say that they still resonate with you. Do they still describe the organisation we want to be with a purpose that we’ve got and Jacqui and her colleague Darren have been busily arranging many opportunities for lots of our colleagues voices to have a say on
that, so Jacqui do you just want to give a quick update? So a lot of this conversation has already been had, but just to summarise, between now and the end of May, we will have had the opportunity to speak to circa 2,600 colleagues. The
values work has been baked into ops conferences and any pre-arranged meetings where possible, and we’re also looking at some stand-alone meetings in addition to some virtual conversations for colleagues who can’t travel. In addition to that Darren is having conversations externally to get an external
view and an external contribution to the existing values and looking forward to our values, which obviously will be thread through the final report, and the conferences are all being supported by Board colleagues and Executive colleagues. We are also going to have several sessions for
Equality Networks, trade union colleagues, who may be attending conferences in their substantive role but also will provide additional opportunity with the lens through equality groups and trade union relationships, so I think that is in terms of all the planning and we’re there or thereabouts
with that. To support managers because Joyce and Chris talked about the values 10 years ago and one thing that resonated with me was this was an ongoing and live conversation and it went on for several months. We’re in a different position because we had
officers where we could do visual displays and really have that buzz around it. We’re going to be a bit more challenged because of the working demographics, but we’ll have to think creatively about how we can really encourage the conversation to be fluid and to
be kept alive, so to start that conversation off managers have had briefing packs to support the conversation in preparation for conferences in the team meetings. We’ll have people available if anybody wants to have a conversation in terms of understanding, the bigger picture and obviously
some of the areas have talked about the survey once we get the full suite of data that will form part of the bigger review of our culture and values and I think that’s it is far is the current activity. It has felt a lot
more alive than it has done for a number of months, so I’m hoping the colleagues will really embrace the opportunity to be part of this big
Mr Ian Dilks - 1:36:07
conversation. Thanks Jacqui. I mean, as we will get a bit more engaged when you get bit further, so
that will come later, but this is just explaining where we are.
Mr Stephen Marston - 1:36:22
Stephen Jacqui, thank you very helpful. The one reflection I would offer you is that I understand why we’re using the shorthand of just to keep talking about this as a values exercise, but
there is one precious reference in the paper that this is about future values and behaviour. Given the staff survey I think it would actually go down like a lead balloon if this is only about values that just remain words on the page. I suspect
what colleagues really want to talk about is not just the values but and then what? How are we going to make sure that, whatever values we alight upon, they are then lived? The behaviours follow, please do keep that as a single conversation this shouldn’t
just be about a set of words that we put on a page. It is in there, it’s the behaviours and the link in relationship. Totally agree.
Mr Ian Dilks - 1:37:19
Ian did you want to comment? I’m 100% Stephen this is absolutely about
Mr Ian Trenholm - 1:37:22
values and behaviours. You know, I completely make
room for the possibility we could end up with the same four headline words, but a fundamentally different set of behaviours that sit underneath it. That could very well be an outcome or we could end up with an outcome with different words and different behaviours
I don’t know. But for me the behaviours are absolutely there as well, and I hope I will also get into a little bit around how we describe our purpose, which is an important subset of this as well. Thank you. Thanks Ian, Charmion and then
Mr Ian Dilks - 1:37:51
Mr Stephen Marston - 1:37:53
David. Just a brief one, I think it’s really important, as you go
Charmion Pears - 1:37:58
through the exercise, not to lose sight of having congruence between internal brand values and external brand values, and what we expect of providers and others we work with, we hold ourselves to
the same duties, have the same kind of value set, so please don’t lose sight of ensuring that marries up. Not least because most of those we
Mr Ian Dilks - 1:38:17
regulate their contact with the organisation, that people will fill
Mr David Croisdale-Appleby - 1:38:26
the surveys. David. It’s a comment to Jacqui. Recently,
Healthwatch, which, as you know, is a committee of the CQC carried out exactly this exercise and although of course it’s a much smaller organisation it still is a distributed organisation with 153, individual committees. I would just offer to share all of that with you
because it was a very, very full consultation and very much was driving towards the reality of the behaviours that we expected everyone in the organisation, but particularly those that led the organisation to demonstrate in their everyday behaviours and there may be something that you
would find of value. That that would be great and actually I’d extend that to anybody who has worked with values behaviours, culture work, that you have recognised as being positive outcomes have worked well, all ears, in terms of you know, what is what has
been successful. Because that really is the ultimate end to this, we want to have a good experience for all those involved with a purpose at the end, so you know any discussions, any material, we would really welcome that opportunity. Could I suggest, if I
Mr David Croisdale-Appleby - 1:39:54
may, as a follow up Jacqui if you contact Louise Ansari and asked her
Mr Ian Dilks - 1:40:01
for that information? I will thank you. Joyce. So this gives me the
Ms. Joyce Frederick - 1:40:07
opportunity first to thank one of our colleagues, Amanda Hutchinson, who worked in a regulator for more than 22
years, actually set up Healthwatch. She retired just a couple of days ago and she’s going to be a trustee of many things in her retirement but a trustee of the National Trust and she highlighted their values, so I think there’s two things for me.
One looking outwards not just about what we do internally, but what do others do that works, that’s good practice and secondly, the more active the values are the better that they become integral to people. So I don’t think this exercise certainly it’s about values
and behaviours, but I don’t think this exercise is about trade in words. We’re not going to swap one set of words from another. If you look at the National Trust and I’m not, I am a National Trust member, but I’m not advocating that everyone
be so, but if you look at it there’s really, they’ve got four active statements about make it happen, Love people in places, welcome everybody, and in a series of things which, then it doesn’t point to you’re not living at our values as an individual
is a kind of collective active work. This is what we do, and this is how we behave. So if we could look to learn from external outside sources, but also bring the best things in, I think that would be really helpful Chris last comment?
I think I agree with that, I think there’s a there’s a really
Chris Day - 1:41:24
interesting point as well about how we use insight in a more real-time way to understand any deviation from values and behaviours. So or at both a local level, but also potentially at
a macro level as well, and how we quickly respond to areas of concern that emerge in a more real-time way. Where I think it was a conversation we had earlier on today, but now we’re able to gather more insights from different sources in more
real-time way, both internally and externally. I think the challenge of this is how we use it to respond to some of the, as we set out new cultural norms for what we want to do in in terms of values and behaviours, how we not
only communicate those, but how we respond to challenges to those that
Mr Ian Dilks - 1:42:07
we hear through our own insight. Okay thanks. If there’s no other comments, Jacqui thank you for that, we don’t progress and look forward to hearing the outcomes in our report, thank you. Right,
for the benefit of anyone who may be listening and dialled in late, just to say that we haven’t got the RDS update now, I’m not going to repeat why not, but we haven’t, but we have moved in looking at the progress on our equality
objectives and delivery priorities, and if people dialling in want to look at the papers for that they are now sitting under AOB on our website for this meeting. But Joyce I think you’re picking this one up is that right? Yes it is thank you.
I also have a colleague Helen Ketcham on the line, should we have any
Ms. Joyce Frederick - 1:42:54
specific, detailed questions. This paper was actually led by Lucy Wilkinson, but she is at a dentist today and she did not want to give up her dental appointment. As you know,
it is an NHS dentist and I am going to stay as rare as hen’s teeth, but no pun intended. If I set the scene a little bit under the equalities act, we have a legal duty as a public sector organisation to have equality objectives
every four years. and this assist us in meeting the general public sector duty and that duty says that we should have due regard to eliminate discrimination, harassment and victimisation, promote equality of opportunity and foster good relations between those who share, protected characteristics and those
who don’t. Equality objectives don’t cover all the areas by which we meet that duty, but they really do help us to focus in on how we can actually make our attempts, or our ways of working to meet that duty transparent and to provide assurance
for the board and others who may want to look at our work. So the paper presents what we did last year at 23/24 and then the priorities that we want to look at in 24/25. We have four areas that recover externally, and that’s how
we amplified voices of people, how we use data to help us respond to equality risk, how we work with others our partners and stakeholders. So can we improve access or experience and outcomes in health and care services, and how we use our independent voice
to reduce inequalities. The fifth one is about our workforce, and we’ve discussed that earlier because it comes in our quarterly people report. I just wanted to say that, though it feels like an annual cycle and it’s a four year programme assessing inequalities and doing
this type of work is really a long-term activity, it takes quite a while to change the agenda and move things on in a different way. So the paper highlights the progress we made last year and you can see we made a great deal of
progress really in incorporating equality assessments in our single assessment framework, using it in our independent voice, like the statements we made on inequalities in our State of Care report, the work we did to listen at communities and we’ve piloted local outreach where we’re talking
to people.in vulnerable areas of communities, trying to get what what they their experience of health and care services, like the campaigns we’ve done, and also the research projects that we’ve done on inequalities as well. We do realise her that we need to do more
as an organisation on equality monitoring until we have that we cannot point to how we protect people from discrimination and bullying, or how we make sure as equal opportunities or how we look at characteristics, protected characteristics and the risk and the safety of services
for there. So as an organisation we have to make sure that equality monitoring is something that we can do as part of the data we collect and the data we use. We also need to apply the work that we do in terms of our
research and make it part of our normal practice, and we do need to publish more on safety where there are equality related issues. The paper also covers our measures of success and overall, they’re the same as last year. That doesn’t mean nothing has happened
in the intervening year. It is actually quite a good thing to be the same, because it’s such hard work. I told you at the beginning that this is a long-term slog in terms of cultural change and behavioural change and quite a lot of infrastructure
change, not just within our organisations, but external as well, to be the same as last year, and progressing new priorities is a good thing, and actually there are some areas where we’ve also made slightly more improvements. This year we had a session with the
board in November to look at what impact we might make and the board were really clear, and it was a really good session as in focus on fewer things, so we can be far more impactful and integrate that into lots of pieces of work.
So we’ve got our list of what we want to do in 24/25 based on that focus, and they are agreed with the people who will lead in those areas, and they are thought of as being achievable outcomes and activities that we can measure and
actually talk about our success in the future. We also this year have said that the things that have been outstanding for perhaps the last three years we really have to nail down and complete in this the fourth year. We don’t want to carry them
over into the next set of equality objectives that we do, because those duties that I outlined are serious. We all know about making sure that we protect people and carrying over things year after year means that we’re actually not fulfilling our duties as an
organisation, so the Board are asked to approve the equality objectives, the measures for last year, as well as agree the objective that we’ve set for 24/25 and, like I said I’ve got Helen Ketchum on the line, should you ask me with a detailed questions
about this work, because Lucy Wilkinson is not here. So Helen do you
Mr Ian Dilks - 1:48:09
wish to add anything? Good afternoon everyone, no nothing to add unless I possibly can help. So you want us to note the progress we’ve made and specifically then want us to approve
the objectives for the current year, so there’s a there’s an approve at the end of this sitting in the papers. So questions or comments?
Mr David Croisdale-Appleby - 1:48:36
David. Thank you very much indeed. Joyce just a quick question. Do you really think we’re going as fast as we
Mr Ian Dilks - 1:48:50
appropriately can with this? It’s a very quick question, with possibly
Ms. Joyce Frederick - 1:48:54
quite a deep answer. I would like to go faster, is my answer, there are some areas that we should improve on, particularly about using the voices of people and the data we collect so
that we can have more action on safety. Equity related safety issues. I am very encouraged by that that answer Joyce. We have round the
Mr David Croisdale-Appleby - 1:49:13
table quite a lot of colleagues who have been involved in this sort of thing in other organisations and I’m sure
would all be delighted to help you with unblocking things that are in the way or suggesting ways in which it could be speeded up Thank you,
Mr Ian Dilks - 1:49:32
Ms. Joyce Frederick - 1:49:34
Mr Ian Dilks - 1:49:35
Ms. Christine Asbury - 1:49:37
that would be really helpful. I’m interested in what you were saying about collecting data from providers, and I
just wondered about their capability to provide it where we’re at with
Mr Ian Dilks - 1:49:47
Ms. Joyce Frederick - 1:49:50
that? So I might come to Helen on specific providers, but it’s not just providers, it’s about people who contact us, so it’s feedback of care knowing the protected characteristic, if there is a
protected characteristic of people tell us about issues of which they could be very vulnerable, issues would be really helpful so that we could direct our efforts and resources. We did do a study in general practice on partners who came from a black and ethnic
minority background. and the study showed that we need more information to acknowledge if, there is any regulatory bias but equally their ratings, there was there was a correlation between perhaps lower ratings, but that was more to do with the fact that they are in
areas that perhaps are more underfunded and are in a city and have communities that need more help, and so there they had more challenging and difficult circumstances, but it would be really helpful because as a regulator, we want to know that we don’t incorporate
our own bias. Our workforce is diversifying, as you’ve seen in the people report, but we need to make sure that we are doing the appropriate thing so collecting it both from the people who contact us and providers is going to be very important. OK,
Mr Ian Dilks - 1:51:04
Mr Mark Chambers - 1:51:06
thank you, Mark? It’s related to both your comments and in our efforts to move fast on this, which we really should absolutely, we should be able to make sure that we are capturing the right data where we are capturing the data ourselves, but I
think there’s a bit of a danger that we get sucked into solving somebody else’s data problem where we’re trying to draw on data that has not been captured in an optimal way, and I think that the sort of support from round the table to
making sure that we’re using this to encourage the right data to be captured at source by the right people, I think it will be really
Mr Ian Dilks - 1:51:51
important. Linked a little bit to one of my points such as pick it up now, was the, if you
look at the delivery priorities for the year, one of them is your second objective, but if you look at where we stand at the moment you’ve rated it red so our starting point was going to be, is it realistic to have a priority for
the year that we’d be trawling in its red but then you seem to have limited it because of the problems of collecting data from providers? Question is, is it even doable or is a good use of key resources? It is doable, there is a
Ms. Joyce Frederick - 1:52:30
plan to say, how do we do it as an organisation, it might not be done all at once, but though there’s a delivery route by which we want to get this done, I do think it’s right to limit it because if the core of
our ability to identify and then mitigate risk based on protected characteristics, having that data that pinpoints that this is where these issues are is vitally important. The delay in that means we have less impact so that that’s why it’s red and in terms of
how we do it as an organisation we have a delivery plan. James is not here, but we want to take it through his strategic oversight committee, identified as one of the priorities for that committee and then they’re going to be weighing up how we
can get this done. So there is a route by which we can try and get it
Mr Ian Dilks - 1:53:28
done, and we’ll see what happens as a result of that. Three things to
Chris Day - 1:53:30
build on that. On a practical the giphy buckle care element of this, there’s an
improvement we need to make to allow us to capture some of the data that will help us to make that that assessment. And that’s the part that Joyce talked about in terms of the investment that we need to make to make that possible. But
two of the things that are happening nonetheless, one we’ve worked with a number of partners who represent different groups, that we really want to try and target for as part of the care campaign, and they are helping us to reach into those communities that
we may not normally reach. The second which speaks to the original question about how providers can do this, we’re working with national voices and a number of other partners to try to get a link between what ICS’ and local authorities ask for and what
we ask for. So in essence there’s a there’s a pincer movement. If you like, on us, on organisations to make sure that they are providing the right information and some practical help and support for those smaller organisations that will find that more challenging, and
I think that will help because I think you’re right, I think there was a there was, it is, it is naturally easy for some organisations and naturally harder for others, so the work we’re trying to do this, working across the country, to sort of
help. Give ICS’ a sense of how they can do it, how we can support it, so there’s a there’s a coming together, if you like, of minds about why this matters, because it matters to an ICS to understand the local population so they can
Mr Ian Dilks - 1:55:09
provide the right services as well, so we’re trying to do it through those routes as well as ourselves to try and make it make a difference. Thanks Chris. Ali? Thank you, and it’s great to see a continued focus on this area and a great amount
Mr Ali Hasan - 1:55:21
of work being done over the past year. I agree with the sentiment made earlier about the need to do things faster and I’d encourage that pace of focus go specifically on the outcomes that people get as well as access and experience. I’d be interested
to hear more on objective 3 and how we see that evolving over the next two years that this set of objectives going to run and in particular whether we’re going to be able to demonstrate that all work has had a direct effect on measurably
improving equality of access, experience and outcomes on the sectors
Mr Ian Dilks - 1:55:55
we regulate. Thank you Ali. That certainly is linked to our single
Ms. Joyce Frederick - 1:55:59
assessment framework. So and all those three questions are under the key question of responsive. So one we will be doing that for our
assessments, but secondly we will be doing it for our research and also our campaigns, but I will hand over to Helen who might have a bit more information, but just on that single assessment framework and the ability now to pull out that data should
give us some results quite quickly and also that the variation in different areas you’ll get, you’re going to be able to get what’s happening in different parts of the country that we can point to but Helen did you want to add to that in
terms of the plan around access, experience and outcomes? Thanks
Mr Ian Dilks - 1:56:39
Joyce. The Single Assessment Framework, a new quality statement on equity in access, equity and experience and outcomes and workforce equality, diversity and inclusion, give us a unique opportunity to eat to create a baseline it
would be able to measure those across a number of different providers and in future once we’ve got that we can then target our action in order to show how providers and different sectors perhaps even regions have improved over time as a result of some
of the work that we’re undertaking. So it’s a great opportunity there. May I comment on the point around other people’s data completeness, or
Mr Ian Dilks - 1:57:20
Ms. Joyce Frederick - 1:57:24
did that answer the question? Please do Helen. Thanks Joyce. I was
Mr Ian Dilks - 1:57:25
just thinking absolutely Chris’s point that we have taken a
number of actions, including the targeted campaigns, to make sure that we’re amplifying the people’s voices who are potentially unheard or historically have been, however, without the equality monitoring piece in feedback on care and at any other point at which people contact us is hard
for us to say how successful we’re being in that space. The point about other people’s data completeness your right, some providers or many providers struggle with collecting ethnicity data and other types of equality data, so there may not have be able to give a
full picture themselves, but we can begin to, we do have an action in here about beginning to comment or where on data completeness itself. So if people are persistently not collecting data which will help them show whether they’re being fair equal, not discriminating, then
Mr Ian Dilks - 1:58:24
that’s something we can consider to comment on too. Ok thanks. If there’s no other questions Joyce and Helen, thank you very much indeed for that. So we’re being asked to approve the proposed objectives for the current year, are we happy to do that? Yep,
okay thank you. Helen, thank you for joining us. Right, we are running considerably behind time, I’ll try and make up some of it a bit later on, but unless it’s going to mess up others later I suggest we do take a comfort break now.

COMFORT BREAK

COMFORT BREAK

If we could keep it to absolutely no more than 10 minutes but stretch our legs and then we will rejoin, let’s try to do it for ten past four, then we’ll go to the SAF update. OK thanks very much. Right thank you very much

4.0 Policy matters and external environment

for coming back so promptly, we’ve got a number of relatively short items and certainly quite useful if we can try to get through in a little under time so that I know one or two people need to get away for trains a lot of
people travelling a long way. Next thing is, we have an oral update from Ian on the single assessment framework, and there isn’t a paper of this. We’ve actually, for the purposes of the board, covered quite a lot of the issues and another for about
a couple of things. We don’t want to make sure we cover today, so I’ll ask him to pick it up on that, but I think you want Members of your exec to expand. Ian, thank you, I think we’ve covered quite a lot of what
Mr Ian Trenholm - 2:00:06
I was going to say in other items in different ways, but I think there are some important points to make. We went live with the final major release of our registration and enforcement service on the 13th of March and that’s added to the roll-out
of the assessment service, which has gone live over a series of go lives from the end of last year into the early part of this year. As of about half an hour ago, we have got 1325 assessments that are either completed or in progress,
and there are about 10 quality statements per assessment on average and that number rises to 11 quality statements on average per assessment in adult social care. So I think you can see that the colleagues are opening up new, newest quality statements when they need
to, and next day they’re opening up enough quality statements to drive re ratings in some in some cases which I know is an important issue for a number of providers. A lot of work is continuing and Tyson, and Mark in particular I’m sure will
talk about this in a second. Addressing concerns both internally and externally. We’ve had some really important feedback from our colleagues internally a very, very granular feedback and a number of things are changing as a result of that. Some of that is about fixing specific
things in the system, although that’s relatively modest in terms of the overall numbers, most of the things are about working practices, guidance, customs and practice. Those sorts of things, I know Tyson and Mark will want to say a few words about that in a
second, but also we’ve had some really important feedback from providers, both big and small, who’ve talked to us about their experiences of using a single assessment framework. Some people report having a good experience, having had a good positive relationship with the inspectors. Some people
have asked questions of us wondered about whether the experience they’ve had represents a policy change or whether it was just what they experienced with a particular inspector, and we’ve been working through some of those things I think if we were to distil down a
lot of the provider feedback, I think I think there’s a couple of things that the that stand out in terms of what the what’s important to them. I think the first one is providers who are asking the question of how do I get from
being a requires improvement provider to a good provider, and how do I have my ratings effectively revalidated and again Tyson could just talk a little bit about that in terms of our organisational priorities, because I think we can address that particular concern very clearly,
and that really arises from the fact that we have we have since COVID been operating in a very much a risk informed way. We’ve been doing more and more sort of more routine work in in recent months, but certainly for an awfully long time
we were, we really focused on providers that were struggling and we’re now in a position where we can start to talk more openly about our priorities and then start to give us a providers a real sense of when they should expect their service to
be to be to be looked at again and how exactly will do that and the second thing that providers were asking it was with was how are we going to manage relationships going forward, we had a programme before where individual inspectors would have a
portfolio of relationships that they managed, some providers really liked that some providers did not like that, they felt they wanted to be able to have a have a broader conversation. that placed an awful lot of pressure on individual inspectors. Many inspectors had very, very
high workloads, and particularly where there was a lot of risk in their portfolio and they had multiple providers that were struggling. They were having to spend an awful lot of time on enforcement work following up warning notices and so forth, and they felt that
was quite difficult. The model we’ve got now means that risk is now held at a team level, but we do need to make sure that, on a very practical level, an individual manager in a care home or in a hospital or wherever in a
hospital service, has got a point of contact and we’re going to be doing some work over April on exactly that point and Tyson can talk a little bit about that in a minute. We are looking, we are recognising that I think there’s a need
for our own teams to be much more confident in the way they work with the system, that’s not in any way criticism even in any individual, that’s just simply a reflection of where we are. What we what we’ve been doing is moving from the
old system to the new system. So there are some colleagues who haven’t actually seen an assessment all the way through from planning through to publication and that inevitably means people are a little bit uncomfortable at the moment with where they are. Lots of work
is going on in the background, in detail, with operations managers and super uses and other people to give people the support and make them feel more comfortable, and I think for me it’s about with a methodology they were familiar with. They were very comfortable
using discretion and knew their way round, to navigate around the system and how to get to an answer. I think people are inevitably much less comfortable with a new methodology. A couple of months in there’s a need for people to become more comfortable, so
Tyson and colleagues are focused on, helping people get to that point and you can talk about that in a minute. A number of technical fixes have been completed and rolled out alongside changes to regulatory practice. Things like the regulatory practice Handbook has been updated
with a number of issues and of course will continue to do that. The teams have identified, in teams people identify changes to screens, changes to reports, operations managers have seen summary reports and so forth produced and that that the activity continues, the fact that
we’re using a platform means that our data is now in a very structured way, it is relatively easy to make changes to the way that information is rendered or the way information is reported on and that means that as new requirements emerge we can
be much more responsive to that than we’ve ever been able to do. There have been some particular issues that have arisen as a consequence of being in a transition period. We made a conscious decision to go live with the assessment service in a series
of steps, starting in the south of England and working our way our way north. I think that was the right thing to do in terms of making sure we can train people and we can address early issues with the system. However, in doing that,
it’s meant we’ve had to run two systems at the same time. That’s created inevitably some confusion with some of our inspectors, but it’s also created confusion in some of our providers where, if you’re a large provider group that operates nationally, you will have some
of your care homes on one method and some will be on a different method and, of course, that that inevitably creates some level of confusion and concern. I think one of the key messages that I’ve been given to provide us when I’ve been speaking
to them is the single assessment framework is not designed to fundamentally raise the bar or fundamentally change practice if you are delivering a decent service for the people that you’re looking after and you were doing that yesterday and you’re doing it tomorrow, you should

3.4 Single Assessment Framework update:

end up in the same place from a ratings point of view. This is not some deliberate attempt on our part to fundamentally change people’s business or business model by regulation. So although some of our language has changed and our approach has changed, you know
there’s a really important message to providers I think around, keep doing what you’re doing if you’re doing a good job, the new system will recognise it in the same way the old system did. We had some specific issues, though around notifications on our portal
as we were using this transition piece, we were using old notification forms into the new system. There was an inevitability of having to do that, but in doing that that correct has created some challenges. It has exposed the fact that we were doing a
lot of manual re work on information that providers were giving us in the past by using the system. We’re taking a lot of that out in the long term that will have enormous benefits for both for providers and for us, but in the short
term, and has thus created some problems. I do want to just take the opportunity, just to say a big thank you to our NCSC colleagues, who’ve been doing some sterling work over the last few months they’ve taken backlogs, they’ve gone through gone through notifications,
they’ve looked for where there were challenges and so forth. We don’t think that there are many major issues within that backlog, but a lot of people have worked long hours to catch up and I think it’s an enormous tribute to that team in the
way they’ve stepped up and supported the transition space. There are some challenges with the new portal, particularly around e-mail usage. We know that it’s really important to providers that they can delegate access to people within their service in order to create notifications. That’s something,
they were always able to do before. We had some particular problems with the portal in doing that recently, so we had to roll back that functionality and had to apologise to provide us when that first went live. We’ve now got a fixed for that
which is currently in test, and I’m expecting that to be to be rolled out to providers in the next week or so, but we are being incredibly cautious about that and retesting with a small group of providers just to make sure that actually works.
We are still having about 300 providers a day enrolling so that that drumbeat of enrolment is important and making the obvious point that not every provider needs to put a notification in every day, so you know this, should sensibly be a slow-burn process over
the next month or so, and I think we’re on track to do that. So I think that’s all I wanted to say just by way of some of the headlines in terms of overall approach but I know, Tyson and Mark want to pick up
on some of the specifics that they are working on. Thank you Ian. Just very briefly to pick up on three of the things Ian’s talked about, and I think we’ve covered some of them earlier today, The first is the change that we’ve made to
Mr Tyson Hepple - 2:10:11
our assessment framework, to say that in exceptional circumstances, inspectors can now create and lead in assessments, which includes writing the report. We’re going to do that until the end of June to see how it goes in terms of helping the team to get through
their word, and then obviously we will review it after that. The second thing I was going to say is that I communicated with my teams yesterday what our priorities for the next business year will be and in the planned assessment category, which will account
for 70% of our work in this area, the first priority will remain high and very high risk, as services for us to do assessments with but the second one will be to do with services rated inadequate and or requires improvement, where we will score
all quality statements, and the key questions rated requires improvement or inadequate. That is in direct response to the feedback that we’ve been given from our own people, and from providers that actually, where we do assessments for requires improvement and inadequate services, we should open
up enough quality statements to re-rate if that is the right thing to do, and the final thing I was going to say was on relationship ownership which Ian also covered we are going to start rolling out a integrated team e-mail address, we’re going to
start doing that in early April, but we’re going to do that internally so that we can work out amongst ourselves how we will make that work so that we note that we’re going to pick up all of the information given to us and we’ll
deal within the proper way and I think shortly after that probably going into May we will then roll that out externally and we’re looking to put the finishing touches to a new, I think, more sophisticated approach to managing relationships which will be based on
risk. And the risk that you may pose for the service will then dictate the seniority and also the frequency of the contacts you will have with us and who you’ll have that contact with, so there will be much more about this over the coming
weeks. Happy to give an update at the next board, but I think as a direct result of the feedback we’ve been given, these are some of the adjustments we’d been making. Thanks Tyson, Mark. Thank you so just to
Mr Ian Dilks - 2:12:16
reiterate some of the engagement that
Mr Mark Sutton - 2:12:18
we’re doing working with colleagues across the organisation, so Tyson, Ian and other colleagues from the programme, from technology from data and insight I’ve been spending a lot of time with colleagues from various different areas, from inspectors for assessors and operations managers, and we have,
we’ve had some really helpful feedback from colleagues about how the systems landing, how the regulatory processes are landing, the way of working is working, and we’ve taken some of those really constructive ideas and we are working on putting those into a programme of work
that enables us to plan for continuous improvement. Just a particular example of those who came from a meeting that Tyson and I had earlier this week, colleagues have talked about how it is challenging currently to upload evidence, and then that takes quite a while
to then allocate that to quality statements. And we’ve got a change that we’re working on right now, that will make that really slick and really significantly improve that piece of work make it a lot more easy for colleagues to enter a piece of evidence
and then tag that in multiple locations and do that very quickly. So and some of the changes that we’re doing, are almost a media, we can make configuration changes to change things like work buckets to enable people to triage work or we can implement
standard operating procedures relatively quickly, others require a change programme and work that we will put in those backlogs of work, and that takes a little while though we will have a regular drumbeat of those changes over the course of the next few weeks colleagues
can expect to see that, and hopefully that will give some assurance about that change and, as I mentioned, a number of colleagues were up in Newcastle last couple of days of last week and again we had a really constructive conversation about improvements that can
improve the way of working for colleagues, improve the efficiency and help them manage their backlogs of work. Those changes are all identified and we’ll be implementing those over the course of the next few weeks we’ll have those backlogs of continuous improvement for all the
other services for assessment, registration, for enforcement, so that’s hopefully something that colleagues can start to see benefit from those over the course of the next few weeks, one of the other things I wanted to mention is that this is not all about just enhancements
and fixes. The investment that we made in the platform, the structured data, the ecosystem that we have, is going to enable us to start to do some really exciting stuff that is going to I think people will really start to see the benefit of
that in coming months. One of the things that we started work on now in partnership with Microsoft is a what we’re calling a regulatory co-pilot. So so co-pilot is a suite of AI tools that Microsoft have that supports with increasing the ability for colleagues
to be able to do work, drawing on the data and the guidance that you have in your organisation, so I think really excited to see what comes out of that in the course of the next few weeks or months. Using our guidance and data
to be able to support colleagues with access to ready information summarised of our regulatory information helping boost their quality and improved productivity. Thanks Mark. I mean a lot of the comments
Mr Ian Dilks - 2:15:55
from people, I guess, link to the much longer discussion we had earlier, coming
out of the people survey. I mean it was a fast and furious update of a rapidly moving process. I am conscious of time has anybody any questions for Ian, Tyson, or Mark. Prem. Prem, Zee and then Stephen. Just a quick, actually the clinical context
Charmion Pears - 2:16:21
of this methodology, ultimately, what we want is whether it’ll improve
Prem Premachandran - 2:16:27
the quality of care and also identify poor care. So the three things you look at it actually to see whether are improvements in clinical outcomes, patients’ experience and staff morale. My experience so far
talking to external partners and providers and the these quality statements definitely will make that happen and also other things. a lot of providers I spoke to were saying that they could do their own self-assessment from this, they couldn’t do that before, so they could
do the self assessment, even though they’re own scoring, so it’ll actually improve the people providers engagement by doing this new methodology. As we touched on earlier on, so self-assessment is the
Mr Ian Dilks - 2:17:11
way forward, is it Prem? Zee. I wanted to address Mark about the changes
Mr David Croisdale-Appleby - 2:17:21
Network Rep. - 2:17:24
that you are doing to the IT system. I think linking it to our members with protected characteristics, those with a disability and those that time has shown that they are from time to discriminated against, there is a big issue that I think is taking
quite a long time to resolve for the issue of evidence uploading. There has been an outcry from colleagues that it takes a long time to upload evidence why I am bringing it, although it may appear a minor issue, for those people, colleagues with caring
responsibilities they want to knock off , go home for day at three o’clock. But if it’s taking like a couple of hours, three hours to do that people are not able to do their work and when you think of our strategy of going into
smarter regulation. If you’ve got systems that frustrates your colleagues, let frustration wake us. We are not able to deliver in what are the effective and safe care for people. Stress levels rise, sickness rises and those who stay behind to do the work are more
frustrated, so I think we need a push in how you communicate with colleagues and are still some of them are not quick fixes, but uploading evidence needs a quick fix. I think that’s a really good
Mr Ian Dilks - 2:18:50
Mr David Croisdale-Appleby - 2:18:51
point and being the interim executive responsible for the carer’s quality
Mr Mark Sutton - 2:18:55
network is something I’ve been working with colleagues around this so I completely understand what you’re saying. I think specifically on that if I could answer quickly. There are two points around evidence upload. We did have a performance issue around that which has now been
resolved. The issue, I think that currently exists is around that the ability to tack quickly evidence against quality statements which we’re working on right now. But I do think a couple of words on accessibility for colleagues. I do think the ability for colleagues, to
manage their work in packages of work does create greater flexibility for particularly for carers, and I’ve had that explicitly discussed with the carers quality network that they see the new way of working as a great opportunity for them to increase the flexibility of the
work, the way that they can work. I think the other thing is we are working really carefully and the accessibility hub which has just opened has got colleagues, there are working really hard to make sure that we’ve got an awful lot of software and
hardware solutions that support colleagues with their accessibility needs around the new platforms, and I think there’s evidence that is a significant improvement on ways of working that we’ve had before.
Mr Ian Dilks - 2:20:15
Thanks Mark. Stephen. Thanks Ian. I think you’re right that some of this, for me,
Mr Stephen Marston - 2:20:20
links importantly to the discussion we were having in relation to the staff survey, because what I think I’ve been hearing from colleagues is two clusters of issues about their experience of the roll-out of the SAF, one is very operational. It’s about glitches with the
technology, it’s about systems that don’t quite join up sufficiently, and it’s a lot to do with just needing training, support, help, coaching, hyper care just to get used to a whole bundle of new systems, ways of working and technologies. I do absolutely believe all
of that is fixable with a bit of time and lots of help from Mark and his colleagues. We can fix these sort of operational glitches to get to something that feels for colleagues, smooth slick easy to use, they understand it, it just becomes a
new way of working. I do think there is the second set of issues though, which is more about does this new way of working allow us still fully to use our professional expertise and insight to generate activity that has professional integrity? And again, I’m
sure the answer to that is yes, it can do all of that for you. I just think they’re probably quite a few colleagues out there who are not yet seeing that. It goes particularly to the point Kate made earlier, that a lot of this
debate and discussion is around the distinction of role between inspector and assessor. But I think there’s quite a lot that we need to keep working on in discussion with colleagues about how they can use these new systems and ways of working so that this
is still a professionally rewarding place to work with high job satisfaction, because they know that they’re doing something that has real value for the public. And it’s trying to get a line of sight as we keep improving revising adapting all of the systems, just
keep that in mind. Where we really need to get colleagues, there’s a sense that this is still a really rewarding place to work because my professional understanding can be fully deployed and I can achieve professional integrity and value in what I’m doing. I think
Mr Ian Dilks - 2:23:00
that’s a great point Stephen, I think as you say, there’s a bucket of things that just need fixing, but your professional integrity point is
Mr Ian Trenholm - 2:23:04
absolutely spot on. I mean, I think in my mind when we started out on this journey, we had it in
mind that we, we could, collect the information that we were collecting in a way that would give us insights which we had never had before and so that, although we are effectively collecting and codifying every aspect of each report, our inspectors are still walking
through the door and seeing the same things but they are now capturing them in a more codified way. The opportunity that potentially gives us in terms of insight is massive, I think, but as ever there’s this unfortunate point that we are right at the
beginning of the process. We haven’t primed the pump yet and I think we do need probably a few hundred more assessments published before we can start to create that insight that we would never have had before. And it is one of the conversations that
Mark and I are having around, when can we get something that does start to demonstrate the real value, and I think it does then reconnect people with that reputational integrity point, but it’s absolutely spot on. OK thanks well, thanks very much for the update

4.3 Martha’s rule

Mr Ian Dilks - 2:24:12
Ian. I’m just very conscious we’re running way behind now and I’m worried about people getting trains. Some things we will deal with, Joyce morphos rule I mean I in particular was very keen for that agenda to discuss. There’s quite a helpful background paper, but
we’re not going to, I suspect, do justice and proper discussion today. So would you rather subjective, we took the update note as red gives us something and then we’ll put it on the agenda for the next meeting to have a slightly longer discussion? Is

4.1 Rapid review update: Nottinghamshire Healthcare Foundation Trust (incl Rampton Hospital)

that OK? The rapid review update is Chris going to join us? Hi Chris, sorry to keep you waiting, you will have seen we’re running horribly behind schedule now. We did circulate a copy of the report, but I don’t think many people have had a
chance to look at that, so it’s very long, I’m not suggesting talk everyone through it. but Ian, I don’t know if you want to introduce this and then how do you want to play it. Given the time I’m going to hand straight over to
Chris, if you just want to use the microphone Chris thank you. I’m
Mr Ian Trenholm - 2:25:30
Mr Ian Dilks - 2:25:30
guessing it’s on yeah brilliant thanks, thanks Ian. Thanks you for having me this afternoon, I’m just going to give you a quick summary on the rapid review into Nottingham healthcare NHS Foundation
Trust. So a bit of a context. Following the conviction of Valdo Calocane, the secretary of state for health and social care commissioned us to do a rapid review into Nottingham NHS Foundation Trust. There were three main areas. She asked us to focus on a
rapid review of the available evidence into care and treatment for Valdo. Second part was to look at patient safety and quality of care provided by the trust. And finally, it was for us to look at an assessment of progress made by Rampton since our
last CQC inspection, which was in July 2023. In the report we published yesterday, we are focusing on the first two parts, part 2 and 3, and then later in the summer we will publish separate report which focuses on part 1, which will be talking
about the care and treatment for Valdo. So there’d be sometime in June 2024 in terms of findings, I’m just going to run through some of the headlines. There were two parts for community mental health services and inpatient services, there was a demand for services
and access to care. There were some issues around people struggling to access services when they needed those services, the quality of care and treatment across the trust varied. There were some inconsistencies in terms of care planning. Sometimes people were not involved in their care
and they were never actually included in planning that care. In terms of staffing levels did not always meet the demand of the caseload sizes that staff were working towards to, and sometimes they were not even able to respond to the referrals which were coming
to them as part of the services they were providing. Risk assessment and risk management was inconsistent, which increased the risk to people coming to harm. In terms of leadership, leaders were aware of the risks and issues which were within the trust, but action to
address those safety concerns was often reactive, and they did not appear to have clear oversight of those risks. There was an issue around culture. Feedback from staff showed evidence of bullying and harassment by senior managers towards employees, there were issues around low staffing levels,
low staffing morale, increased burnout and high sickness levels. In Rampton we saw some signs of improvement since our last inspection in July 2023. There were some improvements in terms of deaf patients who were having great access to staff who were trained in British sign
language. The availability and provision of therapeutic activities, had also improved since our last inspection and also saw an increased number of nursing staff on the wards. However, we continue to have concerns across a number of areas within Rampton. Communication between staff and patients was
still poor, particularly for those patients who were in long-term segregation. Patient or dispersed therapeutic activities were being cancelled at times and obviously there were issues around fiscal health problems and then finally, we also then took an opportunity, as part of this review, to do
some recommendations. We made recommendations to national bodies, there were 10 for community mental health services and inpatient services for the trust, seven for Rampton high secure hospital, and we also made five recommendations to NHS England as part of those recommendations two were specific to
NHS England one was for NHS England to work with DFC and another one for NHS England to work with the HSE and the Royal College of Psychiatrists and want to work with us to CQC and we also made two recommendations which were specific to
CQC, and one of those recommendations is for us to take a greater look into community mental health services within the country, because we think from this review there are signs that actually there are some concerns across the board within mental health services that we
thought actually it would be a good position for us to have a look across the country around community mental health services. So that was part of the review, and I just given you really a rundown of that, but finally I just wanted to say
I’ve been really impressed with the staff we’ve worked on this review, I think we were given six weeks to deliver this review and the staff we’ve worked on, this have been absolutely amazing and I was just saying to them today they’ve defined what is
teamwork and if anyone wanted a definition of teamwork the staff who have worked on this review have been absolutely amazing. So I’m grateful I’m talking here myself but actually there are so many people who have worked on this review and I’m so grateful, so
I’m grateful to the staff and also to the ET for their support in getting us to this position. Thank you very much. Certainly I on
Mr Ian Dilks - 2:30:30
behalf of the Board second your comment on the people. It was interesting to be asked, but it was essential
to the secretary of state and others that we delivered a good report on time and they did so thanks very much indeed for that from all of us. Questions or comments? Belinda. I’ve got a couple of comments. Community mental health teams could be anywhere.
It’s very common themes out there across the country and I would
Mrs Belinda Black - 2:30:56
support a review of all the community mental health services, but specifically Rampton that hospital has consistently for years had concerns about staffing levels, overuse of restrictive practices. We’ve been going for five-year CQC
rating it requires improvement, inadequate, alternative, I don’t know which one it is at the moment. Obviously something different has got to happen hasn’t it? Because this has gone on for decades at Rampton hospital, and I just wondered what you think will is needed to
make those key differences at the hospital. Part of our recommendation to the secretary of state is around the re-licence they get it is supposed to be five years. So every five years they get to be re-licensed to run those services. Our recommendation is for
them to be given 12 months with conditions, so the improvements we have seen currently they have to maintain and sustain those improvements. In terms of example, staffing levels are up to 85% and they need to maintain that they need to maintain activities for patients.
They need to make sure British sign language staff are working with deaf patients, so those are the improvements we expected to see so that 12 months gives us an opportunity to go back in and we can still make recommendations as part of the update
to the secretary of state before she makes a final decision. And we’ve never been in this position before. The second bid is with we have asked for another high secure service to be partnered with Rampton to provide them with some support in terms of
leadership. In looking at some of the issues we’ve also asked for someone to look at culture, we’ve also asked for someone to look at the staffing levels. We have never been in this position before, where we’ve got actually, 12 months to measure the improvements
Mr Ian Dilks - 2:32:44
are taking place. Thanks Chris, any other? Prem. Just a quick question, I think you know I am totally support I think it’s not unique to Nottingham, it’s everywhere, so like maternity. I might even
Prem Premachandran - 2:32:55
say might be dead and I think you should, so I
totally support you do that. Other things I want to ask is there is a big question about mental health in black and minority communities, this one. Do you think there is any option to expand this one to understand that aspect of it from this
review? I mean we before the Section 48, we’ve got a priority for regulator leadership already, which is looking at the experience of black men in mental health services and that’s a priority and commitment we have made at CQC. We have started doing that work
with rethink mental illness to really understand what is the experience of black men in mental health services we know they are overrepresented, we know they are most likely detained on the mental Health Act 3.5 times as compared to other minority groups, so there’s something
about actually the work we are doing on that experience of Black men and mental health, it’ll obviously give us some intelligence in terms of some of the work that we have seen within the section 48 review. Thanks Chris again. I just want to add
Mr Ian Dilks - 2:34:07
my voice to Chris’ in terms of his thanks to all the colleagues who have been working on this piece of work and also to thank Chris
Mr Ian Trenholm - 2:34:13
personally for the leadership that he’s shown here, I mean really fantastic piece of work. And I think what’s
been really interesting about this, I think is it has shown regulatory leadership working very closely with Tyson’s group in terms of people on the ground whilst also, coincidentally, rolling out a single assessment framework, it has to be said, Lorraine Tedeschini in the Midlands, and
her team were doing fantastic work as well as Chris’ team, in terms of communications and talking to the Department and so forth. So this feels like the right sort of model we should be doing this again and again as part of pieces of work.
Just picking up Prem’s last point. You know my mind, a single assessment framework, the quality statements around inequalities are exactly the sorts of things we would assemble as part of an ongoing programme of work that would use the single assessment framework in the way
that we used our work on maternity and I see a similar sort of concept of a programme of work with a package of quality statements that are particularly focused on the issues that we see, and I think it’s a really good start, but I
think there’s a lot more work for us to do in the way that Belinda was describing. Thank you, We track recommendations of things CQC should
Mr Ian Dilks - 2:35:24
do so obviously we will put these to others well, although that will come back, OK, well, Chris thanks very
much indeed. I’m sorry we shoehorned you in and it was a bit rushed, but since the report was published yesterday it seemed it would be a huge missed opportunity not to give you an opportunity, just to say what you’ve been doing so well done
you very much. The ICETR update was last thing for significant discussion anyway, I think Rebecca is joining us, yes hello Rebecca, I was looking the other way. Tyson I’m told in James’ absence, you’re going to make a quick introduction. Rebecca, I do apologise, keeping
you waiting, but you will have worked out from that. We’re running badly behind schedule, so it would be nice to keep this to not more than the allotted 10 minutes, if we could. Allow Tyson to introduce it, we’ve read the papers, so don’t need

4.2 ICETR update

to go through the detail, high spots, and then we’ll take questions thanks. Thank you Ian, welcome Rebecca I’ll be very brief. It’s clear
Mr Tyson Hepple - 2:36:26
from the paper, this is a really important piece of work. It was recommended by Baroness Hollins that we took it on
from the Department of Health and from the NHS and NHS England, we secured some money for this work in December last year, I think it was, and I think Rebecca wants to give the board an update on our progress towards implementation. Yes, thank you,
Mr Ian Dilks - 2:36:47
Tyson just wanted to check the speaker was working. Yes, so you’ve given a bit of background, thanks Tyson, I know you would have read the paper. So just to give a little bit of context from of where this programme of work has come from
and why we’re leading with NHS England for the next two years CQC have been commissioned by Minister Coldfield through department of health and social care, to deliver the independent care and treatment programme for the two year period, and this was following Baroness Hollin’s report
and recommendations about the previous running of the ICTR programme with Department of Health and NHS England for the last four years. The ICTR programme was actually set up as a result of our out of sight publication published in 2019. So ET and Board agreed
the CQC could take on responsibility if funded by grant in aid, and we have that agreed and, as Tyson has said, we’ve actually received the funds to commence this work as of December 2023, so last year. Just to provide some clarity, as well we’ve
provided some definitions of what an independent care and treatment programme is, and also a current treatment programme is separately, and since December we’ve engaged in monthly regional meetings with the ICBs and have a national view of how many people are still waiting in long
term segregation for an independent care and treatment review and also what support they’ve had in place to support more appropriate placements. And we’ve seen some good practice in the north-west, where we’ve seen some significant reduction actually in long-term segregation. Moving onto governance, which is
really important, we’ve got agreements in place with Department to meet requirements set out under the memorandum of understanding, and we will be reporting quarterly on finance and progress with the programme in any learning from that and our first assurance meeting was held in March
with Department, this year. In terms of other reporting, we’ve agreed that Department of Health or CQC and NHS England that we will be able to continue to report on ICTRs annually and last year we did this in our mental health annual review report and
we will continue to do this going forward. Our report this year will reflects Baroness Hollins, report and recommendations for CQC and NHS England to jointly run the ICTRs for this 2 year programme, which has just been published. But I’m really pleased to share that
I’ve had some helpful discussions with Baroness Hollins to shape our thinking of an independent external oversight panel that will be co-chaired by someone with lived experience and that would be from September 2024, and that will really then enable us to shape our independent voice
piece, and I’m really looking at the position of that is very much about positive stories, what works, what really supports people to get out of long-term segregation, which is obviously the most important thing and why we’re doing this. We also have a plan of
the trajectory over the next two years, but where we are so far is that we’ve successfully recruited to our dedicated post. That’s the Chair posts, mental health act chair posts, we secured our expert chairs to deliver training and to coach new chairs, and we
have been able to continue working closely in collaboration with NHS England and will do that through year 1, so we then get that will then handover and carry on working on this independently and lead that model for year 2. We’ve been working with our
business architect to agree a short term solution to store data and reporting and this will be on our current systems on sharepoint and, last but not least, our priority is very much to support people to move out of long-term segregation into services that support
them well in the community, with the right staff and the right support and the right relationships. So we’re on target to do that and just to say in terms of those people waiting for an independent care and treatment review all of them will have
at least one in the next 12 months, if not more. That’s it for me, I’m
Mr Ian Dilks - 2:41:02
open to any questions. Questions anyone? Christine. Thank you just to say I do have an interest and I think it’s conflict, but my husband was part of Sheila Hollin’s
Ms. Christine Asbury - 2:41:13
panel, so that has been declared already. But I just really wanted to stress the human aspect of this that these are people who are probably having the worst experience of care you could have and it’s really really important that we do this piece of
work so thoroughly endorse it, and I really hope that we can have some impact on improvement because we need to see a reduction. I’m glad you said Rebecca that there is already a reduction but we really need to see that happening. Absolutely thank you
for your support. I thought you were going to say something, if not it
Mr Ian Dilks - 2:41:47
is an interesting and rewarding to do a piece of work with a clear
Mr Ian Dilks - 2:41:53
purpose. I mean we’ve spent a lot of time debating sometimes where we do work, how can we
see the benefits for people. This one you we can see more clearly. Can I just ask one quick question, are there any risks to our ability to do this, I mean not hopefully none, but are we set up to be able to complete everything
in time or are there any risks that you haven’t articulated that might make it difficult for us? I think we are set up to deliver because we’re working alongside NHS England in the first year and the methodology that’s been used, we are adjusting and
adapting to make it, to improve that through the learning that’s happened through the last phases. So yes, we are set up we’ve got a trajectory over the next 12 months in terms of the number of panels that we will stand up and, as I
said, we will be looking to complete those within the year for at least one per person. Some people might want more than one independent care and treatment review, and so we will be able to do that as well and then if there are more
people in year two, obviously we will be able to continue that. So
Mr Ian Dilks - 2:42:57
yes, we are absolutely set up for that Would it be your intention, this is a loaded question isn’t it, would it be your intention that when you’ve done this, not only we
know what happened to a number of people, but we have some thoughts that we’ve learned from looking at it that bring about some changes that would stop this volume happening again. Absolutely, I think the point is the independent voice piece there in terms of
our independent oversight panel that we’re going to have external panel, I’m really looking for that panel to be able to really pull out the themes and trends from the work and the programme. But also, like I say, to look at the good practice and
really see what good looks like, and I think alongside that, in terms of our powers to assess our local authorities, ICBs we will be able to we want to shape the market to really think about what does the right support at the right time
look like for individuals that need it. so yes, absolutely 100%. Right, thank you. So it doesn’t look like there are any questions for
Mr Ian Dilks - 2:44:00
Rebecca, thank you very much indeed for joining us. Twice standing in for James we appreciate it, we look forward to the

6.0 Board and Committee matters

work continuing. Right a few last items Charmion we had an update from your last, well, the last your first committee meeting. Thanks Ian, so
Mr Stephen Marston - 2:44:25
the update has been put into a new format where we will bring to the board matters that have been reviewed
Charmion Pears - 2:44:29
by the Committee, will be looking for approval, matters approved or endorsed by the Committee and matters we’ve discussed that may be of interest. Two items we bought today to the board that were reviewed by the Committee that have been brought to the board for
approval, one was the annual report and accounts for the 22/23 year that approval was subject to successful completion of the audit, which relies on the final provision of the LGPS information. The board have granted that approval and then, obviously as accounting officer, Ian will
finalise the last remaining matters, We also today discussed the counter-fraud policy and strategy, which was approved by the board, the Eric also looked at the the plan in place, for this year, as how this sits in relation to the strategy and looked at the
cases of fraud, breaches and irregularities. There are a number of measures that we approved or endorsed at the committee. Just to pull a couple out in the interests of time we are moving from PwC to GIA is our internal auditor. We approved the proposed
internal audit plan, which has 16 audits on it next year, and that work was done with GIA looking at our strategic risks, the major controls in place, the Government’s new risk control framework and consulting stakeholders. So the plan is very comprehensive. We also looked
at, we also approved the internal audit charter in the memorandum of understanding in terms of management assurance. Clearly, in 2021 the government functional standards came into place. The team have done a lot of work on those functional standards in terms of looking at the
assurances but also continuous improvement, and it was proposed by the Executive, and endorsed by the Committee, that the previous system of Ian gaining management assurance in his capacity as accounting officer, that we move away from that in favour of focusing heavily on the functional
standards and the new assurance framework. So the EREC endorsed that proposal in terms of other matters discussed or considered by the Committee, I would probably just pull out, in the interests of time, the work that the team is doing on the Corporate Risk Register
and the progress that’s being made in that area, with a new Risk Manager in place. We are seeing significant progress. A number of the risks that were outside tolerance have moved into tolerance. A lot of work is going on in terms of looking at
the adequacy of controls and what controls can be put in place in the mitigating actions there. We were very pleased to see the work that had gone on by the team in terms of a new risk they’ve identified in terms of transitioning effectively and
safely to new ways of working. considerable focus on the key themes, the drivers of risks and in the controls that are being put in place, so the Committee were very encouraged by that work, I think that in the interests of time I’ll just take

6.2 Minutes of the previous Public Board meeting held on 7 February 2024

any remaining questions from around the table. A pretty comprehensive
Mr Ian Dilks - 2:47:46
summary Charmion, thank you. Any questions? No OK. Then a few last things, we’ve got the minutes of the last meeting, they were circulated before any comments, so we take them as approved? Thank you. There’s the

6.3 Review of the matters arising and the action log

matter arising, there are only two on the log both are due to come to the board in the future so they’re both on track. So I have no comments there. Ian, can I just comment on a point to about the Ofsted report, it is
Mr Stephen Marston - 2:48:22
about providers experience and the changes in our operational group,
Ms. Joyce Frederick - 2:48:25
Mr Ian Dilks - 2:48:35
so the action will be with Chris Day and Tyson Hepple. OK. I don’t want to over engineer it, but I think it was just that we had a long discussion about the implications of Ofsted
so I think what’s come out or we discussed then to be fair we’ve seen examples is that the that the sheer existence of the awful Ruth Perry case of bought people made people focus on the consequences of the stress you get on to be
regulated. And I mean we talk specifically about adult social care providers, but I mean that’s been raised by an NHS as well, so this was just to say, we’re doing we agreed a lot internally, including training development, more people just we should check in,
though to say are we actually seeing any change in experience or behaviour and it obviously quite separately, but will need to pick it up, is the consultation, Ofsted is doing and what comes out of that, a separate matter but it will come back to

6.4 Board Committee membership: New member to RGC

the agenda. There are a couple of about three items on board committee membership, just for the record we should ensure are approved. So I’ll just take them collectively, I’ve mentioned them before, so hopefully people are aware. Charmion joined us and now chairs the ARAC,
but it’s all seemed very sensible that the ARAC Chair should also be on the LGC, so my first proposal is that we appoint her as an LGC member, the second is Mark Chakravarty, joined us last June he hasn’t been able to make some of
the earlier ARAC meetings, but as a result of transition from other roles, but we are proposing that, given his background and experience, he should join the ARAC, and thirdly, it’s all so much a new approval but a year or so ago we found ourselves
in the position after the previous Audit Committee chair left and obviously we have a gap of about 14 months before one departing and Charmion’s appointment that previously the freedom to speak up, responsibility has been with the ARAC chair and we looked at that and
Stephen kindly offered to take it up, which he’s done over the last year. So the question we had to ask ourselves was now that we’ve got an ARAC chair on the board should you switch it back and I’ve talked to Stephen and Charmion and
the proposal is we don’t change and Stephen is going to continue people do talk to him. I think it would be unnecessary, apart from the fact Stephen, do a good job unnecessarily disruptive at a time when this is important to stop changing faces again,
so it is really a reaffirmation that we’d like him to give you that role, although obviously as necessary will need to liaise closely with or Charmion. When double-checking, how this has said, I have to say we found that the documentation on Stephen’s role on
the intranet, was perhaps not what it should be, which I have asked secretariat to look at as a separate issue. So recommendations around those two appointments, the new ones, and reaffirmation can I have everyone’s agreement with that? Thank you very much indeed. So any

7.0 Any Other Business

other business from people. No, it does not like it, well that closes the meeting. We usually or often have questions from members of the public at this stage, but in fact we’ve had none submitted this time. So there are no further questions so that
for those listening in thank you very much for joining us we’ll see you in a couple of months’ time.