CQC Board Meeting - June 2025 - Wednesday 25 June 2025, 9:00am

CQC Board Meeting - June 2025
Wednesday, 25th June 2025 at 9:00am

Agenda

Slides

Transcript

Map

Resources

Twitter

Forums

Speakers

Feedback

Votes

Speaking:

Start of webcast

Share this agenda point

1.0 Opening matters

Share this agenda point

Sir Mike Richards

1.1 Chair's Opening Remarks

Share this agenda point

1.2 Welcome and Introductions

Share this agenda point

Sir Julian Hartley
Sir Mike Richards
Nimali Da Silva
Sir Mike Richards
Esther Provins
Sir Mike Richards
Arun Chopra
Mr David Croisdale-Appleby
Sir Mike Richards
Chris Usher
Sir Mike Richards
Melianie Williams
Chris Day
Sir Mike Richards
Aidan Fowler
Sir Mike Richards
Suzanne Kirwan
Sir Mike Richards
Alex Karetz
Sir Mike Richards
Chris Badger
Sir Mike Richards
Network Rep
Sir Mike Richards
Sarah Valloton
Sir Mike Richards
Stephanie Tarrant
Sir Mike Richards

1.3 Declarations of Conflict of Interest

Share this agenda point

1.4 Any urgent business

Share this agenda point

2.0 Board and Committee matters

Share this agenda point

2.1 Minutes of the previous Public Board meeting held on 26 March 2025

Share this agenda point

CM0625 2.1 Minutes of the Previous Public Board Meeting held on 26 March 2025

2.2 Review of the Matters Arising and Action Log

Share this agenda point

CM062522 Item 2.2 Action Log

Suzanne Kirwan
Sir Mike Richards

3.1 Priorities Programme Update

Share this agenda point

Sir Julian Hartley
Sir Julian Hartley
Sir Mike Richards
Sir Mike Richards
Sir Julian Hartley
Sir Mike Richards
Esther Provins
Sir Mike Richards
Alex Karetz
Sir Mike Richards
Esther Provins
Sir Mike Richards
Network Rep
Esther Provins
Sir Mike Richards
Sir Julian Hartley
Sir Mike Richards
Esther Provins
Sir Mike Richards
Mr David Croisdale-Appleby
Sir Mike Richards
Esther Provins
Sir Mike Richards

3.2 Draft Business Plan

Share this agenda point

Sir Julian Hartley
Sir Mike Richards
Melianie Williams
Sir Mike Richards
Esther Provins
Suzanne Kirwan
Sir Mike Richards
Chris Badger
Sir Mike Richards
Suzanne Kirwan
Sir Mike Richards
Alex Karetz
Suzanne Kirwan
Sir Mike Richards
Network Rep
Sir Mike Richards
Esther Provins
Suzanne Kirwan
Sir Mike Richards
Suzanne Kirwan
Sir Mike Richards
Suzanne Kirwan
Mr David Croisdale-Appleby
Sir Julian Hartley
Mr David Croisdale-Appleby
Sir Mike Richards
Chris Usher
Sir Mike Richards

3.3 Report from the Executive Team

Share this agenda point

CM062533 Item 3.3 Executive Team Report

Sir Julian Hartley
Chris Day
Sir Mike Richards
Arun Chopra
Sir Mike Richards
Chris Badger
Sir Mike Richards
Aidan Fowler
Sir Mike Richards
Melianie Williams
Sir Mike Richards

3.4 Dementia Strategy and Independent Voice

Share this agenda point

Sir Mike Richards
Presenter
Sir Mike Richards
Presenter
Sir Mike Richards
Presenter
Sir Mike Richards
Presenter
Sir Mike Richards
Mr David Croisdale-Appleby
Presenter
Mr David Croisdale-Appleby
Sir Mike Richards
Mr David Croisdale-Appleby
Sir Mike Richards
Sir Julian Hartley
Sir Mike Richards
Sir Julian Hartley
Presenter
Sir Mike Richards
Chris Badger
Presenter
Sir Mike Richards
Arun Chopra
Sir Mike Richards
Network Rep
Sir Mike Richards
Presenter
Sir Mike Richards
Alex Karetz
Sir Mike Richards
Chris Day
Sir Mike Richards
Presenter
Sir Mike Richards
Mr David Croisdale-Appleby
Presenter
Mr David Croisdale-Appleby
Sir Mike Richards
Melianie Williams
Sir Mike Richards
Presenter
Sir Mike Richards

3.4 Dementia Strategy and Independent Voice

Share this agenda point

Sir Mike Richards

3.5 Trade Union and Equality Networks Update

Share this agenda point

Network Rep
Sir Mike Richards
Network Rep
Sir Mike Richards
Esther Provins
Mr David Croisdale-Appleby
Network Rep
Sir Mike Richards
Chris Usher
Network Rep
Chris Usher
Sir Mike Richards
Sir Julian Hartley
Sir Mike Richards
Sir Mike Richards
Sir Mike Richards
Sir Mike Richards
Sir Julian Hartley
Sir Mike Richards

4.0 Any Other Business

Share this agenda point

Chris Day
Sir Mike Richards
Aidan Fowler
Sir Mike Richards
Arun Chopra
Sir Mike Richards
Webcast Finished

Select an agenda point

Scroll with video

Disclaimer: This transcript may contain errors. Please view the webcast to confirm whether the content is accurate.

1.0 Opening matters

Sir Mike Richards - 0:00:01

Good morning, everybody, and welcome to the Public Board meeting of the Care Quality Commission.

For those who are watching on catch-up, this is the meeting of the 25th of June, 2025.

And it's a great pleasure to be here chairing this board.

I'll come to that in a minute.

There are a number of new faces around the board table today, so we're going to do quite an

extensive round of introductions in just a minute.

1.1 Chair's Opening Remarks

I'll start with the apologies, three of our non-executive

directors were unable to be here today.

That's Kay Boycott, Michael Maier, and

Ruth Owen, and four from the executive director team, James

1.2 Welcome and Introductions

Bullion, Chris Dzikiti, Joyce Frederick Jackie Jackson. So those are the apologies. Then the welcomes - Can I welcome Diane Horsley who's

trade union, and I'm going to start with Mike Richards, who is

here with us in the room, with our gender equality network

representative, and then online we've got

Suze Cheska and D McAvoy who are also attending us as the

trade union leads.

And they're going to both be on teams today.

So I think without more ado, can we go into a round of introductions? I'll start with myself than we can go around the table. I'm Mike Richards,

Once upon a time I was here as Chief Inspector of Hospitals, that was between 2013 and 2017.

I then thought I was retiring but I clearly didn't get that right.

And back last autumn I was invited to come and do a review into what had gone wrong within

CQC and in particular why things had gone wrong.

And then after that I was asked if I would at least put my name forward to be Chair and

I'm delighted to have been awarded that post.

So I started on the 1st of April of this year.

That's enough from me.

Julian.

Thank you, Mike.

Good morning, everyone.

Sir Julian Hartley - 0:02:10

Julian Hartley, chief executive CQC for the last seven months.

Thank you.

Sir Mike Richards - 0:02:18

Good morning.

Nimali Da Silva - 0:02:20

I'm Nimali De Silva, director of legal services.

Thank you.

Good morning colleagues. Esther Provins, interim Chief Digital and Data Officer

Sir Mike Richards - 0:02:26

Esther Provins - 0:02:28

It's lovely to see you all here today.

Good morning. Arun Chopra, Chief Inspector of Mental Health. I started

Sir Mike Richards - 0:02:35

Arun Chopra - 0:02:37

last month in the organisation. I'm a consultant psychiatrist by background.

Been a consultant psychiatrist for 20 years.

The last five years I was the Medical Director of the Mental Welfare Commission for Scotland,

which is an assurance organisation of mental health services in the north.

Really looking forward to working with you all and with wider colleagues throughout the

organisation.

Thank you.

Mr David Croisdale-Appleby - 0:02:58

David Croisdale-Appleby, non-executive director for the last two years and chair of HealthWatch

England.

Sir Mike Richards - 0:03:04

Morning.

Chris Usher, Director of Finance.

Chris Usher - 0:03:07

Good morning.

Sir Mike Richards - 0:03:10

I'm Melanie Williams.

Melianie Williams - 0:03:12

I'm also director of adult social care in Nottinghamshire and immediate past president

of ADAS and I've worked in health and social care all my career and I'm really pleased

to be here on the board.

Good morning everybody.

Good morning, my name is Chris Day, director of engagement for CQC.

Chris Day - 0:03:26

Sir Mike Richards - 0:03:29

Aidan Fowler - 0:03:30

Good morning I'm Aidan Fowler, I'm interim Chief Inspector of healthcare at CQC.

Sir Mike Richards - 0:03:34

Suzanne Kirwan - 0:03:36

Suzanne Kirwan, director of performance and delivery.

Thank you.

Sir Mike Richards - 0:03:40

Morning, everybody.

Alex Karetz - 0:03:42

Alex Karetz, newly appointed non-executive director at CQC, background in the NHS and

the public and private sector in data and digital projects.

Sir Mike Richards - 0:03:53

Hi, I'm Chris Badger,

Chris Badger - 0:03:55

I'm going to be the chief inspector of adult social care starting in September and I'm

currently the executive director of adult care services at Hertfordshire County Council.

Really pleased to be here and looking forward to working with colleagues.

Sir Mike Richards - 0:04:05

Hi, I'm Diane Hollander.

Network Rep - 0:04:08

I'm the co-chair of the Gender Equality Network.

Sir Mike Richards - 0:04:13

Sarah Valloton - 0:04:15

Hi, I'm Sarah Valloton. I'm the Senior Corporate Secretary and the Team Leader of the Secretariat.

Sir Mike Richards - 0:04:20

Stephanie Tarrant - 0:04:22

Morning all, I'm Steph Tarrant, Chief of Staff.

Sir Mike Richards - 0:04:25

Thank you all for that and maybe just online to see if that's working.

Dee McAvoy, do you want to introduce yourself?

Yes, hello, good morning everybody, really happy to be here. My name is Dee McEvoy,

I'm the lead steward for the Royal College of Nursing at CQC and I co-lead with Suze

for the six recognised trade unions here, really happy to be here.

And next, Suze Ceska, can you introduce yourself?

Hi, Suze Ceska, no accents on it. I am the lead rep for Unison, one of your biggest unions

and alongside Dee McEvoy, as she said, we co-lead at the Joint Trade Union side at CQC.

Pleasure to be here.

Thank you both very much indeed.

1.3 Declarations of Conflict of Interest

The next item is about declarations of conflicts of interest.

I will give my own in full now, but all the rest will actually be recorded in the minutes,

I have been assured, and I've looked through.

None of them are relevant to today's meeting.

I'm not sure if it's a good thing or a bad thing, but just

so that people know, I chair the UK national screening committee

which recommends to the Government of all four UK

countries what screening programmes there should be.

I advise NHS England on diagnostic services.

I've recently been chairing a commission on palliative and end of life care, and I am a Senior Council at a small company called Incisive Health. So that I think - all the rest will be recorded in the minutes.

1.4 Any urgent business

So, I think any urgent business, I don't think we have any urgent business, but we can come

2.0 Board and Committee matters

2.1 Minutes of the previous Public Board meeting held on 26 March 2025

on now to the minutes of the previous public board meeting.

The minutes we have, obviously, I was not at the meeting, so I'm not in the position,

but just to remind people, there was extensive discussion of the IT review, and we will be

Coming back to that, Julian spoke about the organisational

priorities. That's on the agenda too.

Talked about anti-racism, the local

authority assessments, the performance

updates, the disability network, people

and culture, mandatory training and the public inquiries. They're all itemised in the minutes, just need to ask people if here where any points that they know where inaccurate in

2.2 Review of the Matters Arising and Action Log

the minutes or any other matters arising that won't otherwise be covered in the

agenda today. If not that's that's good but there is the action log and we just

go through those I think we can get through them quite speedily. There's the

first one was the response to the Ofsted inquest and that's going to come back to

in September.

Then on the item on WDES

which

all of that is going to be covered in

in line with the CQC way, and we're going to talk about that

in a minute.

The third item of the action log was about the national maternity

inspection at the end of programme report.

Now, I think everybody will be aware that maternity is an

extremely high priority, both in terms of how services are

delivered across the country and whether they are or not meeting

the needs of families.

But

importantly that also applies to CQC and how we do our

inspections and I'm going to be taking a

personal lead on that for CQC and that will also apply to the

item which was about MNSI, the maternity and neonatal investigations. And that clearly, we need to look at aswell to see if we are doing this as well as we can.

So there was also an item on FOI, but Chris, I think that's

coming back to the September meeting. He's nodding. That's

good.

The performance report update, again, all of that is in hand,

unless Suzanne, you had anything to say on that.

No.

Suzanne Kirwan - 0:08:58

Sir Mike Richards - 0:08:59

Okay, and then the people and culture

report, again, that's coming back into

the board in September, and then finally

the mandatory learning update, that's

to be included with quarterly reports in future.

So we can close that item and deal with it in that way.

Any points on any of those things on the action log that people wanted to question or make

comment on?

If not, that's very good.

3.1 Priorities Programme Update

So we now come to the priorities programme update and we're also

going to give some feedback from yesterday's private board

meeting there.

I'll just cover the items that we dealt with there and then I

want to come to Julian and Esther and maybe others to

comment on a bit more detail.

We had obviously quite a lengthy session

of introductions, the new board getting to know each other. We

then really did emphasise the CQC way. That was probably the

longest single item yesterday.

And that Julian will pick up in just a minute. The issue of the IT problems, Esther went into and she'll follow up on that in just a minute. Then there where other item on the

immediate actions and fundamental improvements we need

to make so that again those are on the agenda.

And then also just to say we had a discussion about a governance

review which we are now getting underway and there will be more

on that in the future. But, Julian, can I hand to you now to say something about the CQC way?

Sir Julian Hartley - 0:10:55

Thank you very much Mike and, perhaps just to start by saying really good to have new colleagues around the table.

We spent time yesterday at private board talking about and updating new board colleagues on

the process that we've been through around developing our shared purpose, our values,

behaviours, vision and how we, the commitments that we make to those that we regulate.

All of which I think are critical in the context of the sort of reset of CQC, the focus on

culture and improvement, and the way in which we engage and support all of our staff in

the organisation to do their very best and to realise their potential to make a real

difference to people that use services and support providers to improve.

So I think we had a good session there where we took colleagues through all the work that's

happened over the last several months, particularly all the engagement events, all of the feedback,

all of which will come together and be distilled into our clear shared purpose, values, behaviours

and so on.

We're aiming, Mike, you and I to launch that on the 10th of July?

which will be for our colleagues who we'll see then and have an opportunity to be part of that activation.

So more to come on that but I'm really pleased with the response we've had and I want to thank everyone in the organisation

and indeed many of our providers, experts by experience, all the range of groups that we've engaged with over the course of the last few months

to help support the work we do in order to help CQC improve and be the regulator that

we want to be. So thank you. Would you like me to move on to priorities and programme

update?

You can do that and then we'll go to Esther.

Sir Mike Richards - 0:13:10

Sir Julian Hartley - 0:13:10

So colleagues in the pack you can see an update on our priorities programme update. That gives

is an update on our four immediate actions and our five foundational improvements. For

ease of reference, there's a couple of infographics that give a sense of progress against those

immediate actions. And as you can see, in terms of those four immediate actions on blocking Stuck Assessments, we've cleared 480 of the 500. The remaining 20 - good reasons why those remain there for various technical issues and legal reasons. But that's, I think is good progress and work underway obviously to get those through as well. Enabling new assessments - we're working hard to deliver against a trajectory to deliver

more assessments and we've set ourselves that target of 9 ,000 over the next 18

months and making progress against that we're on trajectory for that and we're

looking at particularly with our new chief inspectors joining how we can do

even more to maximise our effectiveness in relation to assessments. On the

backlogs which was a particular concern when I appeared in front of the Health

select committee, we've been able to reduce that static cut that we reported to the committee

to zero, which is good news. And of course, we need to keep on top of this on an ongoing

basis to make sure that we don't allow any further backlogs to develop. And actually,

just to say, I was very - It was great to spend time with the National Customer Service

Centre last week in Newcastle and indeed to have the benefit of joining colleagues on

that, on the work that they do, to see first hand just the scale and scope of the activity

there so thank you to all colleagues in our National Customer Service Centre for working

hard to get on top of that. And on registration, more work to do here, I think we do want to

get that percentage of 35.2% down, and we are looking at some pilots to effect change

to reduce perhaps the time it takes to register new providers, which we know is such an important

issue for many of them. So good progress on those fronts, although obviously not complacent,

still plenty to do. On the foundational improvements, and I'll just cover these off and then hand

to Esther, particularly on the IT issue. On operations and regulatory leadership integration,

we were very pleased and I want to thank Dee and Suze and all Trade Union colleagues for

working effectively with us on this, but we have now been able to bring together the Inspector

and Assessor role, which I think is very important in the context of being able to maximise our

capacity for assessments, inspections and so on. Delighted to report that we have now

appointed all four chief inspectors and obviously Arun is with us, Chris is round the table

and both Bala and Toli were able to join part of our discussions yesterday so that's

good and I also want to pay tribute to Aidan who's been doing a fantastic job covering

the whole range during this period of work that we've been doing. So Aidan, thank you.

On the assessment framework, this is a very important topic because this is all about

how we make sure we are really clear about how we assess providers, how we make sure

that we offer a level of focus based on the type of provider, how we make sure we're clear

what good looks like, how we follow up essentially all of the recommendations, Mike, that you

made in your previous work, and that we take the recommendations from that report and indeed

feed in the recommendations from other external reports that we've had to make sure our assessment

framework is fit for purpose. And a lot of work's been going on there with provider roadshows

testing, engagement, and making sure that we do get that right. And then I've mentioned

CQC way and our values, behaviours, shared purpose underpinning all of that. And I think

I'm going to hand now, if I may, Mike to Esther to talk us through

Sir Mike Richards - 0:18:16

what is really key in terms

Sir Julian Hartley - 0:18:17

of all of that, which is the IT digital data, the regulatory platform, all of the issues

highlighted in the independent review that we considered at the last board meeting, which

we have put all of it in the public domain, is on the website for anyone who is interested

in that.

we felt it was important that we share an update on our plans to address those challenges in the

In the in the board in the public board. So thank you

Thank You Julian over to you Esther

Thanks Julian. Thanks chair. So just by way of context to add to Julian's comments

Sir Mike Richards - 0:19:00

For new colleagues sat around the table and those listening at our

Esther Provins - 0:19:02

March board meeting

we considered the independent review of RIT. There were 23 recommendations that were made.

It is a sobering read for those of you that have read it. And we considered that at length

at our last board meeting. And we committed to bring back to our next board meeting our

action plan or our response to those 23 recommendations. So the paper that we are looking at today,

that we have in the report today which will be uploaded into our

public board

paper pack by the end of the day covers off our response to the

23 recommendations that were made as part of our independent

review and also outlines a response and a plan to deliver

the two foundational improvements that Julian

mentioned, one in particular around our digital systems and

the second in respect of our data.

I'm not intending to outline the response to all 23

recommendations today, but those will be in the papers

that you'll see on our website.

But I would like to highlight some key points that are

really important for our colleagues that have

experienced such difficulty and challenges

with our IT platforms.

So that's colleagues both internally, who I know will be

listening, and also our provider colleagues and our

partners who use our systems and also access our data, who have also experienced challenges.

So the key points I'd like to outline are firstly we anticipate it will take us around

two years to really stabilise our digital platforms. So we are really starting again

from scratch in terms of the functionality that our digital platforms use to help us

do our duties and our regulatory duty. So although we think it will take us that period

of time, the roadmap that you will see in the papers is deliberately phased. It's a

deliberately iterative roadmap to deliver improvements throughout that time so colleagues

and partners will see improvements throughout the period ahead of us and it won't be all

at once at the end of that period of time. The roadmap sets out a sequencing which has

been carefully considered and also socialised throughout the organisation and with key partners.

The premise of the roadmap is that it tackles the most important and risky pieces first,

the ones that are causing us the most challenges. So you won't be surprised to see that our

assessment functionality is planned to be redesigned and rebuilt first. And this is

in recognition of the number of interim workarounds

that we are currently working with to help us still

complete our assessment process and publish our reports

to support improvement in our sector.

So that is a particular challenge that we are dealing with

and therefore it is the first thing

that we are intending to tackle.

And then the roadmap sequencing that you will see

goes on to our registration functionality and enforcement

and then our other functionality or core functions as an organisation.

So although the roadmap is staged, we are absolutely, well it's critical to understand

the interrelationship between those core functions. So that activity will not be siloed, there

is a really important piece of work that will be ongoing to make sure that we continue to align

and understand the relationships between our functions to get this right.

The next piece I just wanted to mention was the recommendations that were picked up or

cited in our review around a data-led culture. And again, our platforms, our IT platforms,

it's very clear that they were not designed with a data-first approach. So we are struggling

to report - and there is a lot of manual input

and validation required for our reporting at the moment.

And we are missing multiple opportunities to share

and collectively use our data to drive improvement

in health and care.

So there is a period of stabilisation needed

and that is reflected in our roadmap to ensure

that we have our internal processes and architecture set up

in a way that really supports that.

and we are not only starting to see the data, but we are also

starting conversation with our new board here today and also

with our providers and other external stakeholders and the

organisation around how we can better use our data to drive

that improvement. And that work will start from an engagement

perspective over the next couple of months with a view to

publishing our intentions towards the end of the year.

So as I said, the roadmap has been socialised throughout the organisation

and with key stakeholders, can I say thank you to all who

responded to that roadmap and provided us feedback.

The main points around feedback were around desire to see a more

granular and detailed plan.

So you will note it is very high level at the moment.

Colleagues in particular would like to understand where their

challenges they are facing in their day-to-day work

will be resolved.

The other key piece of feedback was around how can we make sure

that we align our activities both with other change programmes

or the other foundation improvements that we are working

on as well as the interrelationship between

the functions that we are looking at.

So again, we are responding to that feedback.

We will continue an ongoing conversation with our colleagues

around that because it is so important that the feedback that

we've received is responded to and listened to because we know

time, so last time that didn't happen.

One of the key responses to recommendations made by Peter

are going to be picked up in our co-design approach.

So you will note from the papers and from the independent IT

review that there were colleagues and stakeholders who

were missed or not listened to as part of that process. And that has resulted in systems that are not fit for purpose and our colleagues are finding it

incredibly challenging to use and there has been a significant impact on health and well well-being both from a physical

and mental well-being perspective in some of our colleagues and teams and so our co-design approach

Is being set up with making sure that we include all of our

Colleagues and stakeholders that need to be in there and a key response to one of the recommendations is us

Making sure that our staff reference group and - Diane you're here today and thank you

for your input into that so far.

But our staff reference group, who are made up of chairs of our

staff networks and our trade unions who are also on the call

today, thank you, are part of that reference group and can

help us and support us to make sure that we do not miss any

critical colleagues or functionality that we need to

embed and make sure that we get that right.

And so that will be a really key relationship going forward,

and that is currently being set up.

So, as I talked about earlier, our data strategy piece, we need to absolutely make sure that

this time around we adopt a data first approach, and that will be part of our co-design process.

In fact, one of the first pieces of our co-design process, so we make sure we understand the

interrelationship between our role and our functions in the CQC, and also get this right

from a data perspective.

So one of the other key points I'd like to make is it feels

there was a real disconnect last time

with what our digital programme outcomes were

and the needs and requirements

of our operational colleagues on the ground.

And so again, that co-design approach is fundamentally

going to be kind of carried out

with a principle around joint decision making.

So we need to make sure this is not a digitally led program.

It has to be done in conjunction with our colleagues

and our stakeholders to make sure we get that right.

And that will all be part of the co-design process

going forward.

And that ongoing dialogue is so important

and one that we will continue to have going forward.

And I hope the colleagues who are listening to this call

We have been watching with interest our

communication around this and that will absolutely continue.

So I would just like to highlight a couple of risks and

then very happy, chair, to take questions if there are any.

So there is a level of risk around our plan and I don't

I think that will come as a surprise.

One of the things that I think I'd like to draw out

is our ability as an organisation

to adopt this level of change.

And we are changing a lot at once.

And that is why our roadmap is deliberately staged.

And that is why our co-design process

is baked from a principle perspective

in joint decision making to make sure we can be nimble,

respond to the challenges we have,

continue to complete our assessment trajectory,

and continue to meet our performance

around our assessments, as well as our other core functions,

whilst we rebuild and redesign our IT platforms.

But the challenge ahead is large,

but we have, I believe, the right things in place

to make that happen.

But there is obviously some risk to that,

and I think we would do well to acknowledge that.

I think that's all I was going to say, Chair and Julian, very happy to take questions.

Sir Mike Richards - 0:29:05

Thank you very much indeed for that.

We'll open it up now to other members of the board.

Any questions or comments?

I think one thing that came through of our discussion yesterday was the magnitude of

the change that's needed and with that the level of risk that there is and the fact that

we can't immediately say,

we can switch it on now, it's all going to work immediately.

So we can get back to normal, this is going to be quite a big

mountain to climb.

Alex.

Thanks, Mike, thanks for that update.

Alex Karetz - 0:29:40

We discussed this yesterday but I wondered if you wanted to say a little bit about the work going for the information governance

Sir Mike Richards - 0:29:50

Esther Provins - 0:29:51

concerns and how we're going to fix that.

Thanks Alex. So we are - we have a level of risk we're carrying around our information

governance kind of activity.

And we have put in place some safeguards

from an immediate perspective to reduce our risk in that respect.

I think it's fair to say our programme of improvement

around information governance follows a similar trajectory

to our rebuild process to make sure

that we undertake our rebuild with privacy by design in place.

And so thank you, Alex.

that is absolutely worth acknowledging. There is a planned programme of work in place to

address that and obviously that's overseen by our Audit Committee internally.

Sir Mike Richards - 0:30:36

Network Rep - 0:30:39

Yes, Diane, you next. Thank you. Esther, I just wanted to thank

you for the engagement that you've had with all of the Equality Networks. We're really

appreciative of that. There's just a couple of questions that I've got based on feedback

from some of our members. You used the term iterative and that is a term that is quite

loaded within staff at the moment because that was what was promised before. And so

I think we would like to understand exactly what that means. Does it mean that we are

honestly going to pull back if things, if changes don't work? That was what was promised

before and they just went hell for leather in terms of we want to get rid of CRM so we're

going to do it anyway. So that's one thing. We also welcomed your talk of using much more

structured project management because that clearly wasn't used before. So yes, this is

a very long-term plan but what kind of push push-pull is there in that to be open to this actually

might take longer than two years.

So where is the push-pull in that?

And another question, sorry, I don't know at the moment,

is so this was the changes were all aligned around the strategy.

And so we sort of have some questions about that strategy

is coming to an end now.

So are we, is that going to continue?

And are our aims going to be the same?

So, for example, there were things like, as you've said, inspections were going to be

data led, reports were going to be much shorter and more concise.

Are those things that we are still aiming for?

Is the strategy still standing in that regard?

And just finally, I wanted to thank you and Anthony State for responding where people

are saying that they're having concerns with the technology.

assistive tech system to make sure that they are not

effectively, however, we have got members of DEN who have said

that they effectively still cannot do their jobs and

potentially have to be redeployed which they are finding

very, very stressful because the current system doesn't work with

the assistive tech that they have got.

Esther Provins - 0:33:00

Thank you.

Thanks, Diane, really helpful comments and questions.

I'll try and cover them all but please keep me straight if I

forget something.

So the word iterative, thank you for that.

That's really helpful. So obviously, I wasn't here last time so the loaded-ness of that word, I haven't understood. So thank you, that's really helpful feedback - maybe I can explain what I mean by that, I think that might help.

And I outlined yesterday my priority is delivering safe and -

a safe and stable IT platform of which we can build on.

And that is key.

So my understanding last time,

and again I think where we've ended up is

there was a lot of complexity built into the systems

and the scope changed and crept throughout the design

and rebuild process.

And so we have a set of systems that are in some ways

really complex and have really complex business rules that are kind of hardwired into them

that actually are not what we need. And so when I talk about iterative, it's around delivering

a safe platform that we can then build on to make sure that we can cope with the change.

So there will always be change, there will always be continuous improvement, we will

always tweak how we do things and that's I guess part of life. So my priority is to give

is to give us a stable foundation on

which to build on and make sure we can cope with the changes

like the ones you mentioned about what the size of our

reports or how we do things might tweak and change. And

that's part of improvement. But my priority is to give us a

foundation that can manage that and we can do those things in a

really planned way.

So in line with the principle of keep it simple, which was recommended in our independent IT

review, what we're likely to see is simple functionality that we can then build on and

we can then tweak in a very planned and structured way.

And that's what I mean by iterative.

So what we will not end up with, or very much doubt it, is for example an assessment functionality

that does everything that we think we need it to do for the next five years, that's just

not realistic. What we will start with is a simple application, simple system that works

and then we can use that on which to build changes and improvement in. So I hope that

answers kind of that piece of the question and if there's a better word I can use I'm

very happy to use that, Diane. You asked about rolling back and a really good question.

In essence, we have rolled back, haven't we,

to some of our legacy systems,

and that's causing us some risk that we're carrying,

but we have rolled back.

So, and again, just to wrap this up

with your governance question as well,

where we need to get to, and this is being planned,

is around some really strong, secure gateways,

an agreement as to whether what we build

is fit for purpose and used,

and then there will be a joint decision

around that going live.

So that I feel really strongly, and this goes back to my comment around joint decision making,

I feel really strongly that that decision making has to happen with all those colleagues

and partners that are using that piece of functionality.

And so what we will not do is end up in a situation where our digital colleagues say

that something is ready to go but our operational colleagues or rather stakeholders are not

happy with that.

So if we get to that point we will stop and that's really important.

We will pause because otherwise the negative impact is just too

great.

So that will be wrapped up in joint decision making.

From a contingency perspective, we absolutely - in line with best

practice.

You enable the functionality to roll back and we can plan that

as part of the co-design process, Diane.

and that's part of that planning and that joint decision making.

I think I've covered your questions,

but do let me know if I haven't.

Julian, you want to come in?

Sir Mike Richards - 0:37:08

I just wanted to answer Diane's question about strategy.

Sir Julian Hartley - 0:37:12

And I mean, really good question, Diane.

I think I'm sure you'd agree it was

the execution of the previous strategy

got us into the deep trouble that we're in.

So what we, as you know, what we are focusing on based on both the external reviews and

reports but also importantly the feedback from all of our staff following the question

I posed to you all on joining the organisation about priorities, hence the kind of four immediate

priorities and the five foundational improvements.

In terms of a broader long-term strategy, I think given we've got a new board, we have

got some time together to think about that, we'd want to engage with all of you as well.

So I think right now we're clear about the focus on the action we need to take rather

than elaborate strategies and the focus on the things that Esther's described.

So, I think that there'll be an opportunity to think and shape, but I'm sure as again

you probably acknowledged, the culture of any organisation has greater impact, influence

than a strategy.

So we're really focused on getting that right, and then in time, this board will have an

opportunity with the whole organisation because we are part of one team to shape that looking

ahead.

Sir Mike Richards - 0:38:50

Back to you Esther. Diane, I forgot to answer your question around DEN, our colleagues from the Disability and Enabling Network

Esther Provins - 0:38:51

I do know that we have challenges in this area and we

know that our current systems don't always work with the

assistive technology that some of our colleagues are using.

I'm very happy to look at this on a case by case basis.

The real challenge we have is the

question of how much time and energy do we invest in resolving

our current systems versus rebuilding and redesigning new

systems that will support all of our colleagues.

And so there is a real balance to be had there.

So, and previously I think it was at the last board meeting,

you know, I'm absolutely committed to making any

improvements that we can make now that are sensible to make.

But I do absolutely acknowledge that we can't do everything now

and that will mean that some colleagues are continuing to work within a really challenging environment.

So, you know, there is a real acknowledgement there, but you know, my commitment is I will do what I can now,

but there may be some things I just won't be able to do because we do need to attend to fixing everything

rather than trying to kind of plough our energies into the here and now.

But absolute empathy and kind of an understanding of our colleagues in that situation,

And I know how difficult it is on the ground,

having seen how some of our systems work.

It is very challenging.

So absolute acknowledgment around that.

David, can I bring you in?

Sir Mike Richards - 0:40:24

Thanks very much.

Mr David Croisdale-Appleby - 0:40:27

I intend to try and keep this with the narrative that's

developing on this.

Esther, your paper is very comprehensive.

It's straightforward, but it covers an awful lot.

It does raise with me a couple of points which I hope are helpful.

The first thing is about pinch points.

As you go through with several work streams,

there are always points at which there are interactions between those, et cetera.

And I wondered, I'll go through my several questions, if I may first,

whether there are any points that we ought to be aware of now from the work that you've done

that you think are going to be critical and tight,

that we need to be aware of as a board.

My second point really was when I looked at it

and I looked at the resources that you've got,

I was concerned about whether you had sufficient resources.

And the resources I'm talking about

are obviously financial resources,

but also about the support structure that you need for this very clearly laid out programme

of work that you're doing. And if you could just update us on where you might be on that,

because it's important, I think, that you feel that you've got the support structure

and the capability that you need to support you achieve these things.

And finally, and you would expect me to say this, of course, as one is developing something

as different as the programme that you're developing.

What about things that we're doing now

that we perhaps no longer will need to do in the future?

And I would like you to consider that

because that would be something

that would not only streamline our operations,

but it would focus the resources that we've got on that.

So, those are the points I wanted to raise with you, if I may.

Back to you.

Sir Mike Richards - 0:42:35

Thank you.

Thanks, David.

Again, really helpful questions.

Esther Provins - 0:42:39

So, from a pinch point perspective, there's a number that come immediately to mind.

The first I call out in my narrative of the paper, and I think this again is a cause of

concern or anxiety across the organisation, and that is how can we build a new assessment

functionality application whilst we are

intending to go out to formal consultation.

And I think that is one particular anxiety for the

organisation and there is a concern that we will start

rolling out new functions in November and then get to early

next year and realise that we need to completely change or

radically change the way that we do that and therefore go

through a second rebuild and redesign process.

So my response to that is, again, just referring back

to my previous comments around keeping things simple,

but also creating a stable foundation on which to build.

At the moment, we do not have a stable foundation

on which to build in any changes to our assessment

functionality.

We are using complex interim workarounds

that our colleagues are using a number of different systems

to complete assessments. And so if we were to try and introduce changes to that process

now, we would find that very, very difficult. So we need to introduce a stable foundation

for our assessments. And as much as possible what we will do is future proof the build

of that to take into account what might happen as part of the outcome of the consultation.

And that is entirely possible and doable. There may well be some tweaks needed post consultation

to make those as minimal as possible.

I think there's some good planning that is already under

way we can make that happen. That's one pinch point, David.

The second one, and they're kind of related, again refers to one

of the recommendations made in the independent IT review, which

is around a better understanding of our business processes. And so what we have ended up with, at this time is, a system which we call our regulatory platform.

which doesn't service the needs of all of our core business areas as a CQC.

So a lot of areas were descoped and there are a number of business functions that we have

that are not part of our regulatory platform and are still using legacy systems.

So for example our oral health team and other kind of smaller core kind of central functions

that are not necessarily

part of our standard approach to assessment and regulation and enforcement.

And they are not part of our regulatory platform.

And we don't well understand or we don't well have it

documented how all of our functions interrelate.

So, there is a real need to do some

preparatory work around that and that is starting as we speak.

But that piece around how we build a system or a number of

systems that interrelate to effectively enable us to do our - run our services and discharge our regulatory duties is quite challenging. There's a piece of preparatory work there needed, David.

So that's probably my second pinch point I would just call

out. From a resource perspective, you're

absolutely right. We have a really great set of

colleagues I work with in our kind of digital technology and

data and insight functions. But we don't have all the

capability or capacity that we need to do our redesign and

rebuild. There is a piece of the

of set up work that we need some support with and there is a mechanism already in place

that we have discussed as an executive team to help us get the immediate resourcing that

we need to help us do our enablement kind of preparatory work phase that we are in.

And then our any additional support of which there will be a need for, David, will be part

of a business case that this board will review and approve over the coming couple of months

which is again, is an important step to release the resources that we need to make this important work happen.

And then finally you asked me what will stop. I can think of a number of things off the top of my head.

So again, as I mentioned earlier, we have challenges with our reporting and our data.

We have a lot of manual validation work that we do at the moment.

We have a lot of QA and kind of data governance in place that we have had to put in place to keep us safe.

those are activities that I would anticipate will stop or taper off over the period of time that we do our rebuild and as

our systems more get more mature and

again, this is an opportunity and and again, that's why the co co-design process is so important

This is an opportunity to streamline our processes

And so I would really value in that co-design approach that we will be talking to colleagues about over the coming weeks -

conversations about how things should be done from an efficient

and effective process perspective,

and not just rebuild processes that we currently do because

we've already done it in that way.

So I think there's a real opportunity as part of this to

be - to make sure that we're more efficient and more effective in

the way that we work.

And then just finally, I think we acknowledged yesterday that

we can't do everything at once as an organisation.

We've got a lot of work on, and so there will no doubt be things

we will decide to

pause as part of prioritising our work and our focus and our

resources over the coming year or so.

(David) Thanks very much, Esther.

Sir Mike Richards - 0:48:15

Thank you, Esther, for all of those answers.

the priorities programme. I can't see any, so I think that means we can go into the draught

3.2 Draft Business Plan

Sir Julian Hartley - 0:48:43

business plan. Thank you very much, Mike. So what you have

before you is essentially the metrics or the how we measure our progress against the key

priorities that we've just discussed. We also have a suite of other metrics that cover other

areas of activity that CQC undergoes. Now, this is important in the sense that we need

to, I think, visibly publicly demonstrate how we are improving, how we are progressing,

and be able to measure that and demonstrate that.

I've already gone through the progress we're making on those four priorities, but I think

there's a level of detail that sits below those about the specific areas that we are

measuring.

And both Suzanne, Esther, and indeed the whole exec team has worked hard to make sure that

we can be confident in how we can make sure we're measuring this effectively.

We've got the right data flows and all this comes into a balanced scorecard that we can use both for

the board moving forwards

to give an update on performance and also in discussion with our sponsor team at the Department of Health and Social Care

because of course they're very interested in seeing

demonstrable progress against these areas. The other thing I'd say is that we have done a lot of work with wider teams in the

organisation to make sure that we've got the ability to gather the data, report on the

data.

I would also emphasise the fact that in conversation with trade union colleagues, networks, and

indeed all staff, the importance of making sure that we see these in the sense of empowering

teams, team -based approaches, a sense of how we do this with the right culture and support

around that. We are not about a kind of blunt performance management approach. This is very

much being done with the focus on empowering teams to build confidence, to deliver, and

to then see the visible progress that we are able to make.

So, what I would appreciate actually, it does say on the paper the board are asked to discuss

and note, at this point I would appreciate approval of these metrics with the proviso

that of course we may need to tweak, change, add as we move forward, particularly in ongoing

discussion with colleagues at the department where there are particular issues that they

might be interested in, but having already discussed these metrics and built them into

a balanced scorecard, I think we're in a better position in terms of being absolutely clear

what we're aiming to achieve.

A lot of the feedback we had from external colleagues in terms of organisations that

represent providers that we regulate have said consistently we would like to see how

you are holding yourselves to account against deliverables.

We would like to see measurable progress,

particularly on things like inspections, registration,

some of the important work on IT and digital,

the ease of submitting documents and so on,

the speed at which we're able to respond

to information of concern.

And actually we've raised the bar

on some of our ambition in these metrics.

We've set tougher targets for ourselves to achieve.

So this is by no means an easy ride.

This is going to be, require a lot of focus

and a lot of work, but I do believe it's the right approach

in terms of speaking to the key priorities,

foundational improvements, as well as some of the other

key areas that we, where we have activity.

So that's the context for these.

I do appreciate there's quite a lot of them,

but this is an attempt to create a balanced scorecard

across the range of activities of CQC. And certainly I think that as a board we want

to make sure that we are, you as a board, are holding us as the exec team to account

for delivery of this. And also that we're supporting our valued colleagues to see progress

and improvement and use that to further build momentum and positive progress over the coming

months. Thank you.

Sir Mike Richards - 0:53:27

Thank you Julian and people will have observed that these cover a wide range of different

areas so people may wish to comment, you know it's not just the total volume of assessments

but it's the assessments in each area and then the registration issues etc and the information

concerns etc etc. So I'm going to open this up for discussion. Melanie.

that we have.

So it is really important to see this and I'm really pleased to

Melianie Williams - 0:53:52

see that the core business is represented.

I know there are many measures but I think that is necessary

given the breadth of the core duties that we have.

I want to relate this back to the previous conversation.

Sir Mike Richards - 0:54:13

So what is our level of confidence that we have got the

Esther Provins - 0:54:17

I think it's probably a joint response between Suzanne and I.

So the metrics in here are the ones that we can measure.

We've done that work.

There are other metrics that we cannot, but we have done that validation work between

my team and Suzanne's performance team.

But I'll hand to Suzanne if that's okay, to see if Suzanne wants to add anything.

Suzanne Kirwan - 0:54:39

Yes, it was just to say that when we developed the measures and targets that were reviewed

and developed, we look to the context of existing resource priorities and the system limitations,

data quality and missing data points.

So this is actually what we can measure.

So this is doable.

Sir Mike Richards - 0:55:03

Somebody else?

Yes, Chris.

Chris Badger - 0:55:09

Yeah, thanks for the sight of these.

I think my comments would be really around some of these have got target dates in September

26.

I think the comment, just to reaffirm what others had said, is being clear on the kind

of milestones we want to get to ahead of them to show enough momentum and progress, but

without rushing to do something where we haven't got the foundations right.

I think there's an interplay clearly with the work Esther's talked about, but also for

these to be delivered, we need to create the conditions with which colleagues can succeed,

and it's clear that there's still some foundational elements where that's not the case.

So we'll need to review those and understand where they happen and I guess be really open

and transparent about where we come across roadblocks and be clear to the teams that

are here but also partners, providers, et cetera, about why that's happened and what

the alternative plan is.

Because I think it's important that we do that rather than simply chase a target.

It's important to show progress but we need to be doing, you know, that number of assessments

but they need to be quality assessments.

So we need to look at the numbers and the quality of what we're doing, otherwise that

will impact on credibility.

So something that just talks about as we go along where we expect to be and if we haven't,

why, what we're doing about it and being really clear about what the alternative plan

is.

Thanks, Chris.

Sir Mike Richards - 0:56:26

Suzanne Kirwan - 0:56:27

Yes, just to say on the number of assessments, we've actually got a glide path and a trajectory

month by month of incremental increases to take into account previous productivity and

also take on board new starters, new capacity, et cetera. So we can do that incremental growth

as we go along. So you will see that in the more detailed reports. You will be able to

see that. Alex and then Diane.

Sir Mike Richards - 0:56:55

Alex Karetz - 0:56:58

Yeah, thank you for these. They look really good, very comprehensive, a lot to measure

as you say, and very happy to approve if others are.

It would be quite helpful if this isn't a lot of work for us as board members to see

where we are on the baseline, just to see how you set it.

So, you know, just to pick one at random, percent of providers who have a positive sentiment

about the new portal at 68 percent.

I'm sure it's not higher than 68 percent now, but for us to know, you know, why we've set

this and whether they stretch goals or not, which I'm sure they are very stretching, if

it's not a lot of work, if you could just circulate out of session where we are now,

I think it helps us assess whether we've set our ambitions too high, too low or right.

Thank you.

Suzanne Kirwan - 0:57:46

Sir Mike Richards - 0:57:46

Nothing about that. Yes, Diane.

Network Rep - 0:57:51

So yeah, I just wanted to say that the Equality Networks are really grateful that you've mentioned

culture when you spoke about this. Some concerns that have been raised to us around this are

the issue of recruitment, the fact that it is still not where it should be, it is still

far too slow and so there is the potential risk that while we know that we've got to

recruit people, are we actually going to be able to do that effectively and at the rate

that we need and at the speed that we need. Also in terms of recruitment there's the induction

and whether that is going to get people up to speed quickly enough and whether that has

been taken into consideration because even though you do induction and it takes a certain

amount of weeks in order to be a skilled inspector, it's more than a few weeks to do that. And

The other thing about culture that you mentioned, I think the concern that was expressed and

what came to mind this morning was this idea of it's not the tools that are the problem,

it's the intention behind them and so we've got the tool off the target at the moment,

but sometimes there is an intention behind it of competitiveness where certain individuals

might want to use that target or exceed that target to almost prove themselves and that

can be detrimental to staff in some ways. I'm not pointing the finger at anybody, I'm

just saying that that is a potential element that we need to think about.

Sir Mike Richards - 0:59:37

Esther, if you want to come back. Thanks, Chair, and just responding

Esther Provins - 0:59:39

to the

point around the metric around the portal. So apologies because I think I missed this,

are two metrics that we agreed. One was around our portal and one was around our website

use and they are importantly different. And our expectation is that we wouldn't necessarily

see an improvement on the portal one over this coming year because of our rebuild work.

So if I may, chair, there is just one adjustment to make to this paper and I apologise because

I didn't see that it hadn't been made prior to publication.

Suzanne Kirwan - 1:00:15

Sir Mike Richards - 1:00:17

Thank you. Any other points on this? Suzanne, did you want to come in?

Suzanne Kirwan - 1:00:21

Yes, it was just to say when we did the targets, particularly on the number of assessments,

we've taken on board the current headcount and who we've got, and we've not kind of based

this on – we've based it on the current headcount, and so we're taking that into

account through the numbers.

David.

Sir Mike Richards - 1:00:45

Thank you very much.

Suzanne Kirwan - 1:00:48

Mr David Croisdale-Appleby - 1:00:51

I think, Chair, you're going to be asking, certainly as Julian did, for approval of the

draught business plan, which I, for one, would be very happy to approve.

But next week, we expect, who knows, to see the NHS tenure plan and the DASH review come

out.

And it's, if we do approve this, Julian,

I think it might be very helpful for, certainly for me,

perhaps for other board members,

if when you've had time to digest those two things,

if there are any significant changes

to what we've approved today, just as a headline,

you know, to know that we would be apprised of that,

I think that would be very helpful if I could suggest it.

Sir Julian Hartley - 1:01:36

Yes, David, very happy to do that. And I think just as a general point, I think there's a

lot of change and moving parts at the moment. As you say, we need to be agile in the way

we can respond to that. And I think the point you made, Alex, about just understanding where

we start from is a good one. So I think what will be helpful is approval for what we've

not, but with the acknowledgement that we may need to adjust change and also add some

follow -up information to make sure that we keep this fit for purpose in terms of what

we're measuring and reporting on based on the environment that we're regulating. I'm

sure, David, that there will be some many things for us to consider as CQC in the context

of ten year plan. We do have some time Mike don't we as a board to come together in July

to have a good session to think through some of that. So I think David it's a well made

point but I think we've identified the need for us to come together and think about how

we make sure we're building in the important ambitions of that plan into our work looking

Mr David Croisdale-Appleby - 1:03:00

forward. And if I may say, and the guidance, the streams of guidance that are likely to

follow that subsequent, which will be the department, the government's view about where

the priorities lie in that and time sets again.

Sir Mike Richards - 1:03:17

Chris, I think you want to come in. Yeah, I was just going to come back to acknowledge

Chris Usher - 1:03:20

Diane's points about recruitment and induction. Just Jackie's not able to be with us, but

different

we do our workforce planning because I think this challenges in terms of how and where

we recruit the right people, which the recruitment team were talking to me about.

Induction as well is something that we're looking at just to look at how we make that

process more efficient and effective.

So I know Jackie was on with that.

So it's just that knowledge we're fully aware of both of those and on with them.

I think that's a good point.

Sir Mike Richards - 1:04:22

Any other questions at this stage?

If not, I think we've got to is that we're now being asked to

approve the draught business plan subject to any adjustments that

may be necessary, particularly in the light of the 10 -year plan.

and also to add in that we'll get some baseline figures so that people can see

how far off those targets we like we are. Is that acceptable to people? I see a lot

of nods around the table so I shall take that as acceptance. Thank you very much

that's an important step.

3.3 Report from the Executive Team

In which case Julian it's back to you to report from the executive team but you

can bring in others as you wish.

Thank you very much, Mike.

Sir Julian Hartley - 1:05:11

So you've got the report on the work

that we've been doing as an executive team

in terms of a lot of engagement, actually.

And I wonder, Chris, you might want

to say a little bit about that.

Because we've had, over the last several weeks,

a lot of interaction with providers,

with different sectors and key stakeholders.

Most recently I think we had an important part to play

in the NHS Confederation Conference.

And thank you to colleagues who ran the stand

at the Confed and they reported a lot of positive interest in the work that we are doing and

a lot of actually people in sectors in providers keen to help and support us in our work.

I think the range and scope of that engagement demonstrates I think the importance of us

getting out there and demonstrating how we're changing and what we're doing to

make sure we take seriously the feedback that we've had and then I think maybe

Aaron you might want to say a little bit about the mental health bill because

obviously a lot of work on that that's a very important part of our current work

and since you've joined us I know that's been an important part of your focus

And then I think the rest of the report really just highlights what we've already discussed

around the progress we're making on our key priorities, our foundational improvements,

and also how we're better gathering insight from people that use services to get good

qualitative and quantitative feedback and hopefully particularly with new

colleagues around the board table we can do even more of that in terms of

gathering that insight and then feeding that back. Our state of care report

relies on that quality of feedback that we gather which is going to be so

important. So maybe starting with you Chris then maybe Aaron and indeed any

other colleagues that want to sort of comment on the work that we've been

doing over the last few weeks.

Thanks, Julian.

Chris Day - 1:07:55

I wonder if I could just acknowledge the thanks I have for providers, people who use services

and colleagues who have been involved in the co -production events that have taken place

so far.

We have many more planned.

In fact, we have one going on today in Leicester and I'm joining a second event in Leicester

tomorrow.

Six key strands to work at the moment.

As Esther said, the importance of co -design, co -development is

crucial if we are to be successful.

It literally plays to the point we talked about earlier about

making sure that we're bringing people with us who will have to

operate the systems, use the systems,

and get the benefit of the systems.

And I do think in this co -design and co -development work,

bringing colleagues, providers, and people who serve us together

in the same place is actually very useful,

culturally useful I think to make sure that we're all in the same place doing

the right thing. Alongside that alongside that co -design co -development piece the

importance and it mentions in the report about regular communication to

colleagues, to providers using both internal and external channels, to people

use services so that everybody understands where we are and I think we

would try to a little bit more thinking about informational content as well that

tries to show the links between different areas of work so you get to see not just things

in strands, not just conversation about the assessment framework, but what's the relationship

between the assessment framework and the work we'll do on the redesign of our system. So

we'll try to show how that works sort of end to end. There has been a number, and importantly,

good conversations with strategic partners in this space as well so we can think about

not only the day -to -day interactions but also how we link strategically to other organisations

involved in our work.

An important part of this will be about making visible

the people that are doing the work.

I think one of the things, learning from the last

transformation, is making visible that people who are

actually doing the work are actually involved in that

engagement, making sure that they're visible to colleagues,

visible to providers, visible to people who use services so

that we can be really clear and provide the right feedback

to people so we can make the right informed decisions.

And all of this, of course, is then to help us do the things that you talked about, Julie,

in terms of stated care.

So all of this contributes to our ability to have an informed view of the health and

care system.

So a lot of the work that we do isn't just about individual inspections or individual

areas.

It's about what we know as an organisation in the systems that we regulate.

And I think as we come through that coproduction work, making sure we're able to not just deliver

on individual inspections but deliver content that's meaningful for our future views on

how sectors are performing will be critical.

Sir Mike Richards - 1:10:45

Thank you. Chris, should we move straight to you, Aaron?

Arun Chopra - 1:10:51

Thanks Chair. It may be helpful for me to outline a couple of key priorities from my

perspective for the mental health sector. We obviously talked about the four immediate

priorities and the five foundational improvements, which are cross -organization.

But since I've started over the last six weeks, through speaking to patients, through speaking

to providers, and from speaking to other stakeholders, two key areas which they've really emphasised

to me that they were very keen that we prioritise and that I'm keen to take forward.

One is around driving improvements around the pathways that people take when they are

entering and leaving mental health services.

What providers and patients are both saying to me is that

actually that's one of the areas that they think worries them the

most and actually where they think that there's

the most opportunity.

So in that space between when someone's been referred from

general practise to mental health services,

negotiating the pathways within mental health services,

and once they're being discharged,

how can they get back?

How can carers identify concerns?

So one of the things that I've been working on with the team

is around our assessment framework and how do we make

sure that it has the right questions in it so that we're

identifying those gaps and working as a regulator to help

close them.

So that's one key priority area.

The second key priority area is around the mental health bill.

The work that our Mental Health Act reviewers do and our Mental

Health Act operations generally in the CQC is really vital work

to safeguard people's rights and promote human rights of those

people and also to address inequalities.

With the mental health bill that's just completed its

committee stage in parliament, there are some brilliant safe

safeguards there and some great innovations that could really address some inequalities

aspects and improve the rights of patients. But it's going to be vitally important that

they are properly implemented and we have a key role in monitoring that implementation.

So I'm very keen to strengthen the work that our Mental Health Act operations team do,

working alongside our inspectors to actually make sure that those ideas as they come through

from the bill are properly implemented and that we're asking providers how they are delivering

the expectations from the new act and identifying areas of

best practise and looking at compliance with the mental

health act generally.

So that's a kind of key focus area for me.

Sir Mike Richards - 1:13:06

Thank you very much, Aaron.

I think eloquently demonstrating why we have needed a chief

inspector of mental health.

So that's great that you're with us.

But, Chris, you've got a question.

Just to echo that priority from Aaron,

I think it's important.

Chris Badger - 1:13:19

It's a good example, isn't it, of one of those areas which will

need cross working across chief inspectors, particularly mental health, I'm thinking around

I think new commissioning that will need to take place, local authorities around learning

disability and autism, which will be an impact of that, which I think will be welcome but

will need thoughtfulness from both NHS and local authority commissioners, impact then

on the provider market and what needs to be delivered, and of course associated impacts

for AMPs and so forth.

So I think illustrative of the need to think through how sectors work together, particularly

on big issues like this which have an impact across the system.

Anyone want to come in?

Aidan?

Sir Mike Richards - 1:14:01

Yes, happy to comment.

Thank you, Mike.

Aidan Fowler - 1:14:06

So I'm now almost exactly four months into a six -month period, and Julian, you'll remember

we discussed where we might support.

So supporting the incoming and appointment of Chief Inspectors, tick.

So, I will overlap with the new chief inspector of primary care briefly and seamlessly transition

with the secondary care chief inspector, and you'll not be surprised that we're already

having conversations about transitioning that, which is really important.

Just to echo what Julian was saying, the stuck assessments for a starter have been a real

concern.

Some of these have been quite aged, so there's been a lot of engagement with chief executives

of organisations around that, so I'm really pleased that we've made such good progress

with that. I think that's really important for providers. Publishing reports that are

quite aged has been problematic, and our ability to re -inspect those organisations and creating

the capacity for that has been really important. I think the work on information of concern

has been critical in getting those processes right and being more timely with that and

knowing what the risk out there is really important,

as it is with notifications.

So I'm pleased to see we've made good progress on that.

Lots more to do on the assessment framework,

but we've started that process, and we

had another important session on that yesterday.

And you won't be surprised that I've

taken a very big interest in the safe domain,

particularly in trying to feed into that, supporting MNSI.

And you rightly point out the ongoing concerns

about the maternity system and making

sure our investigations around that are timely important. I would say I think in

sport and maternity that one of the most satisfying things I've done here is

publishing the report on maternity in East Kent and seeing the progress they've

made following concerns there. I'd just like to say how pleased I am to see

progress in that area. I think that's an important reflection and just making

sure that our reports are going out in a much clearer way saying why are we there,

what are we seeing and making clear why we're rating as we're rating.

So I think we've seen some really good progress

and I'm pleased that we've been able to achieve that.

Sir Mike Richards - 1:16:16

Thank you very much indeed, Aidan,

and thank you for what you have done over the last few months

and are going to do until you go.

Any other points from the executive team that people want to say?

If not, we can move on to the dementia strategy. Sorry, there

is one. Sorry.

Melianie Williams - 1:16:44

≫ Just a quick reflection. I think at the moment the

evidence of impact has to be on delivering the core functions

now. But it's really good to see there's some suggestions of

where we may move to in the future, think about broader

and in the coming years, it's about the impact on people's lives and their outcomes actually.

So it's just to say I welcome that sort of sprinkling of suggestions about where we're

headed as well, but recognising there's a job about safety now.

3.4 Dementia Strategy and Independent Voice

Sir Mike Richards - 1:17:17

Thanks Melanie. Any other points round the table? If not we'll bring in our presenters

for the next session, Stephen Kelly and Joe Wallace,

and they can then introduce themselves.

I think we'll have about a one -minute break while they come in.

Sir Mike Richards - 1:17:52

So welcome to you both.

Maybe you would like to just introduce yourselves and what

your roles are, but this is a really important item we're

coming on to, which is dementia.

Interestingly, just in the last session, we were also discussing

how important it is

going to be to work across the areas that the four chief inspectors cover.

I think that's probably shown by dementia as much as it is by any area.

So Stephen, do you want to go first and then hand over?

Thank you.

Good morning colleagues.

I'm Stephen Kelly.

Presenter - 1:18:36

I'm deputy director of adult social care.

Good morning colleagues.

Sir Mike Richards - 1:18:42

I am Jo Wallace and I'm also Deputy Director of Adult Social Care.

Presenter - 1:18:46

Sir Mike Richards - 1:18:48

Okay, over to the two of you and when you finish talking it's best to turn your red

light back off again.

That helps the camera I'm told.

Presenter - 1:19:04

Okay, so good morning colleagues.

Thank you so much for having us here.

So we are here to talk to you about the work we've been doing on the dementia strategy

to give you an update.

And this item really is about improving the experience of people living with dementia

in all settings, and our regulation of those settings as well.

As part of that work on the 20th of May, we published our first independent voice piece

as part of the dementia strategy.

and that was about the experience of people living

with dementia, their family and carers across sectors.

That report really highlights the continuous inequalities,

continued inequalities, barriers, and the variation in care

that people continue to face across the sectors.

So it's a really important topic, isn't it, for all of us,

but who we have voiced in the report,

the experiences of our people who have used services in GP practises in the

context of access in hospitals and in adult social care. And the voice of

people do really highlight where things have gone well but they also highlight

where there's been real issues. So for example someone saying about access that

they have felt really left alone, that they hadn't seen a doctor or nurse in

over a year, and then someone else saying

that their GP had been an absolutely fantastic advocate

for them to get their diagnosis of early onset dementia.

A member of the family saying that their mother in hospital

had been under 24 -hour observation

with no human interaction, and then saying

that when they visited mom in the care home following that,

mom was sitting in the lounge singing Christmas carols

while the carer was giving her a head massage

and saying, who wouldn't thrive in an environment like this?

There are so many different experiences in that report.

And I think one that really summarises

what good can look like when there is good collaboration

is someone saying, the team worked together so well so

that his wife could be his wife again,

and his daughters could be his daughters again,

and not just his carers.

There are many more voices.

But I think this topic is so important for all of us,

isn't it?

I mean, it's now more likely than not

that people will either be living with dementia

or be a carer.

The number of people living with dementia

is set to increase to 1 .2 million by 2040.

And the cost of dementia care is set

to increase from 42 billion last year to 90 billion in 2040.

And that's just the financial cost.

What of the human cost?

to the fact that dementia continues

to be the leading cause of death in England.

So I am really proud of that report.

And I'm really proud and pleased with the support it has had

and the support this work has been

given by external partners.

And that included when we attended a parliamentary event

last autumn, which was joined by around 150 MPs.

But the Independent Voice piece itself

had great support from our external partners,

including from Care England.

The report is a call to action for others,

but importantly to ourselves at CQC.

So we must press on.

So the question is what's next for this work?

And that's developing statutory guidance.

That's really the centrepiece of the dementia strategy.

It will be a co -designed, widely accepted definition

of what good looks like, that we will co -produce

with people with lived experience with partners.

It sets a really clear expectation

of what we expect from providers across sectors,

a clear expectation for people drawing on and choosing

services, those commission services,

and for us to regulate against as well.

And it follows in the footsteps of right support by culture,

which is statute guidance for the delivery of services

for people with a learning disability and autistic people.

And of course, we recognise all the efforts

that have gone into raising the profile and research

of dementia by different organizations.

But as the regulator, we have a unique view

of health and social care and a unique role in it

to bring those efforts together and to make

that definition of good a reality

and to drive those collaborative improvements.

For us, this work fits perfectly with the immediate priorities

and the foundational improvements

and actually enables our journey to become

that effective regulator we want to be.

And that is without impacting our ability to carry out more assessments.

In fact, it will help us to increase the quality of our assessments.

And as a real cross -sector piece, as you were saying, Mike, this has really got the opportunity

to bring together the chief inspectors and directorates on a really important topic to

work together to keep our focus on people's experience.

from GP practises to outpatient departments,

to long term decisions about care.

And then finally, it really speaks to CQC values

and what we're trying to achieve through the CQC way.

Listening to people and partners,

building those trusting relationships,

increasing the confidence and capabilities of our own teams,

improving the effectiveness of our assessments

and our regulations is at the very heart of it.

So we really welcome your questions,

but also your support for us to formally enforce this work and to really get going with it.

Sir Mike Richards - 1:24:54

Thank you very much indeed for that. Jo, did you want to?

Presenter - 1:25:01

Just open for questions, Mooly. We're really keen to be able to answer any questions that

Sir Mike Richards - 1:25:08

you have. So while people are thinking up their questions,

I just comment from me, one of the things that I heard loud and clear during my review

in the autumn was across the sectors, the need to redefine what good looks like.

And I think this is going to be a major priority for the organization, the chief inspectors,

but throughout the organization.

And you've also eloquently said that's not just us.

That's co -design, co -production of that, but it was a major request, I think, from all

the sectors I talked to at the time.

So who would like to have a go first?

Yes, David.

Thanks very much, Mike.

Mr David Croisdale-Appleby - 1:25:53

In my standard declarations of interest, one of them is that I'm the Executive Chair of

Dementia UK, so I'll just mention that in case colleagues have already forgotten that.

And it's on that that I wanted to ask you, obviously,

welcome what you've done.

We have some 500 admiral nurses who are specialist mental health

nurses experienced and trained in dementia care.

And the model that they adopt, which is different to Alzheimer's

society, et cetera, is that all the advice that they give has to

be clinically based.

In other words, it has to be demonstrated that there is a clinical underpinning for any

recommendations they give in the nature of what good care, as Mike has turned it, actually

looks like, as opposed to what I might think good care looks like.

So what is the clinical underpinning?

So it's really an offer to you to engage with our nurses, because they are on the front

line of dealing with the families as well as the

individual has dementia, but the families who are affected

by the care.

And that affecting goes straight to the heart of one of the

government's priorities, which is getting people into work,

keeping people in work.

And, you know, as you found, a lot of carers either limit their

career aspirations, and that's discriminatory because a lot of

those are women rather than men.

And that puts an artificial kind of self -imposed last ceiling on

their capability of delivering to the economy and delivering

the self -actualization of occupying senior roles.

So this is really critical in all sorts of different important

agendas that the government has as well as we, society.

So just finishing, the offer is there.

Come through me, engage.

we will give you every assistance necessary.

But I think there's a lot of rich,

frontline learning that might be helpful.

Thank you.

Yeah, thank you, David.

And I'm pleased to say we have already got

some really good connexions with some of those

Presenter - 1:28:17

abnormal nurses and we have been speaking with them,

which has been really valuable.

And important to say that the statutory guidance

that we're looking to produce will be very much

based on research and we have a literature review that is starting to make sure that

we're reflecting all of the best practise and all of that kind of clinical guidance

as well as social research based guidance as well. So we'll be looking to engage with

lots of people and get that included.

Mr David Croisdale-Appleby - 1:28:51

One of my trustees is Alistair Burns who was the previous dementia czar as you know and

I'm quite sure that I carry from Alastair,

a very willingness to contribute.

That's helpful to me.

Sir Mike Richards - 1:29:07

And I worked alongside Alastair for many, many a long year.

As Alastair has said, you work closely with Alastair Burns.

Mr David Croisdale-Appleby - 1:29:14

But you have there somebody who's

been at the forefront of the policy area,

as well as bringing his own medical and clinical knowledge

to this.

and now his practical experience of how care operates

in the community and in all the settings that we cover.

Sir Mike Richards - 1:29:37

Quite like to bring Julian in on this as well.

And the question is in my mind, which for all of you is,

do we have some idea of time scale

for developing this guide?

But Julian, do you want to say a word first?

Thank you, Mike.

Sir Julian Hartley - 1:29:53

And I too wanted to touch on that point about timeline.

So, I mean, really good to see this, and I think a very important set of activities for

us to do, and I was pleased to see how you framed it in the context of the work we're

doing to rebuild the immediate priorities, foundational improvements.

That's really clear.

I think it's good to see that, and indeed, Mike, with the board's agreement, the next

steps around sharing a work plan for approval by the exec team, which then enables us to

have that statutory guidance ready for Dementia Action Week at the end of May 26.

So there's a good, I think that feels like a good timeline to really build this in terms

of not consuming disproportionate resources in the short term because we've got a lot

of work to do, but equally giving it the right level of priority at the same time as we develop

and rebuild. And I think getting that right is going to be a conversation we'll have together.

But I'm sure we can do that in the context of the level of sort of instinctive support

and encouragement around this.

So I think the proposal on timeline in the paper

might look sensible from our perspective,

and obviously we can come back and report back to the board

once we've done more work with colleagues

on the detail of the work plan looking ahead.

But thank you.

Sir Mike Richards - 1:31:37

Yeah, could I just, sorry, could I just add to that,

Sir Julian Hartley - 1:31:39

that we've spoken with a lot of ops colleagues as well,

Presenter - 1:31:44

and obviously very mindful of pressures with other work.

That timeline, we can have some conversations about

sort of the practicalities of that.

But operations colleagues are telling us

that they're really, really keen to get involved in this,

and we have masses of expertise in the organisation

around good dementia care.

And we see very much this piece of work

and we can be very flexible to work around how we bring that in.

Chris, I think you had a question.

Sir Mike Richards - 1:32:32

I really welcome this and just for me to be able to speak to it.

Chris Badger - 1:32:36

from the organisation and the local authorities I currently work at. When this landed it had

real leverage really within our organisation which I think is a good reflection of what

we had and actually something around best practise that comes from the regulator has

an inbuilt sort of cachet with it because of the kind of sense of the authority behind

it. So really to be welcomed. I think there's a really significant bit of work around the

quality of commissioning, of quality dementia services and pathways and that's quite variable.

So looking at that, that links to local authority assessments.

But most importantly, I was really pleased to talk about the training and skills that

need to be given to people working in care providers.

That's probably the most important thing.

But there's some excellent practise out there that you've highlighted and if the more that

we can sort of bring that out, showcase it, the better.

But I think the answers are out there on some of that, but it's just being really clear

that both commissioners and providers understand that and can look to sort of deliver that

at scale. So I really welcome that. I think it's a good example of the role of a regulator

to promote good practice, set clear standards and guidelines and that will drive practise

up across the patient.

Presenter - 1:33:51

Thank you Chris for that encouragement and that feedback as well. I think that is what

we've heard. It's setting those guidelines but I think the other side of it is this element

of co -designing this together.

So it's not going to be something

that we as the UCC think this is the right thing.

It's going to draw on the rich evidence and experience that's

already out there, the research, bringing it together.

But bringing it together with the voice of people

and our partners to really set up that rich evidence

base that we support while we are saying,

this is what good needs to look like,

and those clear expectations for commissioners of service

as well as providers, of course.

And you're absolutely right.

And the report does highlight where there is good practise rightly.

What it highlights is it's not consistent enough and that's why we need this work, isn't

it?

But yes, it's absolutely right that we shine a light on where there is good practise and

then say let's do more of that across the sectors as well.

I talked about the hospital experience in one of the examples, but of course the report

also highlights where that has gone well, where there is potentially use of quieter

parts of wards to really provide that person -centered support as well.

Thank you.

Thanks.

Aaron.

Sir Mike Richards - 1:35:01

Thank you both.

Arun Chopra - 1:35:04

Just to echo comments around the room, very supportive of the work, and I think it's really

important.

I think you were making the point about pathways, and Chris and I were earlier reflecting about

the importance of cross -sectoral working on particular areas like dementia.

So that's a really good example of an area where we can work across the inspectorate

to make sure that people are getting good care and that we're promoting good examples

where we see that.

I suppose as well as the work towards the guidance, I think we could start to think

about how this informs the assessment framework and the work we're doing around quality statements

already, because there's so many good examples that you've already drawn out that we can

start to think about how we embed that within our approach to the assessment framework and

the quality statements.

It's just an offer and we can chat about that further, but certainly James, Chris and I

I can have a think with you as well about how we embed that.

Sir Mike Richards - 1:35:54

Go to Diane first and then Alex.

Hi, Stefan.

Network Rep - 1:35:59

The quality network's really welcome the work that you're doing

and as you probably know the carers network are a fundamental resource

because among us there are many, as what we call, careants.

We're also part of the sandwich generation.

I really welcome what David said about the financial penalty that so many women pay when

we become carers.

For many of us who are part of the sandwich generation, it's a really difficult balance.

A few things that have come up for me is that dementia is very much an umbrella term for

several different conditions.

And again, as David has already mentioned, Alzheimer's is just one of those.

So I was wondering if that is going to be brought out because the different dementias

present very differently.

And in terms of GP access, one of the things that we know is that, you know, oh, you get

a memory assessment if you're lucky.

Well, that's not necessarily relevant for different types of dementia.

So we need better GP care in that regard.

But also in terms of getting the information that you need,

I know you've gone out to consultation.

The LGBT group did a really good session on trans,

and an excellent question was asked,

and a really good answer was given within that about caring

for trans people who have dementia.

so I'd recommend that you make contact with the person who gave that really, really detailed

answer in that regard. But in terms of getting feedback more generally, this is just a point

about my own experience of give feedback on care. Give feedback on care, while a good

tool on our website does not enable us to give feedback on pathways of care. I have

to go in and I have to pick a service.

And so that means that I would have to do multiple

entries to give an experience of a pathway.

It's laborious and it makes people give up.

Is there any way that we can do give feedback on

care where we can actually say, these are the

pathways, these are the people that were involved

in the pathway of care and this is what happened

because it is extremely difficult to do that.

and I know that I've given up because it's how do I do it and it's boys.

Sir Mike Richards - 1:38:36

Thanks very much Diane I think you've just added to this workload

which is but but she's taking it on the chin I can see that but there's also the point

back to you Stephanie Jo about different types of dementia for example.

Presenter - 1:38:53

Yeah thank you Diane that's really helpful and absolutely dementia is an umbrella term and it

So we've been talking about dementia and it covers a

different range of dementias and I'm always keen to talk about

people with a dementia rather than that other label of

dementia. We've included already as our stakeholders and people

we've been having conversations with various different

organisations that champion the care of people with specific

types of dementia, such as Parkinson's UK, the Lewy Body

Dementia Society.

So there are various different organisations

that we are already speaking with.

One of the things that we have been doing already so far

and have continued to do is look at how

we improve our dementia training for our own staff

in the organization.

And that training is really, really valuable

in supporting our inspection teams

to understand the different types of dementia

and the different types of specific needs that people might have as they go through

that journey through the pathway of care and support.

So yeah, really, really important that we capture all of those different experiences.

And just to pick up on a couple of other things that you mentioned, you were talking about

intersectionality there, and that's a very big part of our work in the statutory guidance,

is to make sure that we're thinking about what it's like to experience living with a

community of people living with dementia and perhaps being from

the LGBTQ

communities, perhaps being somebody who is a black, older

man living with dementia in a deprived area with really poor

access to primary health care support. Really, really

important that we include all of those voices when we're

gathering our evidence for building that

So, we've been working really hard to promote the use of our SOFI observation tool over

the last 18 months, and for those of you that may not be aware of this, this is a research -based

framework that we've been working on for the last 18 months.

that allows us to understand what people's experiences are when they can't tell us,

when we're going out and doing assessments.

Really, really valuable tool that's really, really person -focused.

We've been working hard to increase the use of that,

so therefore improve the quality of our assessments

in adult social care services but also in hospitals as well.

Sir Mike Richards - 1:41:38

Thank you. Can we go to Alex next and then Chris?

Thank you and echo what everyone else says.

It's a really great piece of work

Alex Karetz - 1:41:43

And thank you, Stefan, for some of those comments from reflecting the comments that people gave

you at the beginning.

So it really kind of brings it to life.

And I mean, I agree with Mike's point that this is something that touches on all four

of our new chief inspectors.

And, you know, there's been a lot of commentary recently that the role of CQC in the future

is about assessing those gaps in care and the quality of the intersections rather than

the providers.

I think it was the first question you got asked at the conference, Julian, at your session

about how we're going to do that.

and it just strikes me this might be a piece of work as we take it forward that is one

of the pathfinder pieces to challenge ourselves that rather than, and to your point as well

Dan, rather than going by unit of provider, provider, provider, are we assessing those

gaps and helping those gaps kind of, excuse this phrase, quality of care within those

gaps as well as just within general practise or wherever else it is.

Sir Mike Richards - 1:42:40

Chris Day - 1:42:42

Chris. Again, really supportive of this work, really, really important to the organisation.

Just a couple of things. I agree with Aaron's point about it, I think it should and could

inform our thinking around quality statements for providers. I also wonder, and this links

to a wider point, whether sometimes examining what creates the right environment, not just

for an individual organisation but for a system to work well.

And I think there's something really important for us

in trying to understand not just what individual organisations

do well, which is really important,

but also what lies behind that in terms

of the way in which organisations work together,

the way funding flows.

And I think uncovering some of that

would probably help us to be better partners for trying

to drive change and improvement.

So individual organisations and what they're doing

is absolutely vital.

But I do think being inquisitive about what's

the wider environment in that area that encourages that to be the case.

And just to link that point to the point that was made about following people's experience

of care, I absolutely agree with that.

In some of our other work recently, we've deliberately chosen to follow people's experience

of care over a period of time, and I wonder whether this might lend itself to that type

of work where we're looking at domicile care at the moment about people's experience of

care over a period of time.

And I do wonder whether we could think about using

something like that to sort of attract over time

people's experience of the local systems of care

that they'll use.

Thank you, Stefan.

Sir Mike Richards - 1:44:14

Can I come back?

Thank you, Alex, thank you, Chris.

Presenter - 1:44:17

I think for me, this is a really important piece of work

to actually activate all those levers for improvement

we have as a regulator.

We are talking about statutory guidance as the centrepiece

because it is, well, at its heart, it's directive,

it's anticipatory, but it's also going to be

a co -produced piece of work, of course.

But it's, for me, the centrepiece

and the start to much more.

If we can define really clearly what good looks like

and have that widely agreed,

that's just setting a line in the sand

for everything, isn't it?

What then flows on is actually how, like you said, Chris,

how does that link across local authorities,

across systems?

What else can we say in this space

where we might have to use other influential levers

or stakeholder engagement, et cetera.

So for me, it's the centerpiece.

But there is so much more we can do with this to see

how things link up from there.

But currently, we really need to take that role.

We've got that unique role to actually bring

all those efforts together to get to a point of saying,

this is what good looks like, setting that up clearly,

and then really thinking, what other regulatory levers

or improvement can we engage?

And I think this is the perfect piece to do that.

David.

Sir Mike Richards - 1:45:32

Thank you.

Mr David Croisdale-Appleby - 1:45:35

Sorry to come back again on a point that you raised.

I think you mentioned at the beginning that you were going to carry out a sort of or produce a compendium of relevant research.

Was that right? Did I understand that?

Yes, we're doing a literature review.

Good. Then I can ask my question, if that's all right.

When we produce national guidelines at NICE,

we typically look at something between 5 ,000 and 8 ,000

research papers from around the world.

And one of the reasons that we look at so many is because

there's quite a lot of stuff produced that is not produced

in this country, is not produced in America,

where you might naturally look, but is produced in other

countries that have different cultures.

And one of the things we do at NICE is to say, okay,

that's what this piece of research from Japan,

let's say, shows.

Is that relevant to the way in which our systems operate

and which our culture operates, et cetera?

And we will narrow down that enormous number of papers

to the ones that seem themselves to be good research,

really excellent research, reproducible research.

but also those that bring in ideas from cultures that may not be the same as ours,

but we can sense irrelevance, or we can sense irrelevance to subgroups of our society and our populations, etc.

So in doing that, if we are to produce something that will be seen as this is the almost, you know,

the kind of approved research, the acknowledged research.

Are you able to go through that kind of process

that we go through at NICE?

Or is that just too much to ask?

So we have research partners commissioned externally

to do that, David.

And I'm happy to pick up a further conversation in more

detail.

Presenter - 1:47:41

So we're working with IFF and Leeds Beckett on this.

And they have produced an initial catalogue of research

they want to look at.

Mr David Croisdale-Appleby - 1:47:59

Discussing it with some of us at NICE might be helpful.

It might shortcut some of the stuff that you do.

Thank you.

Melanie.

Sir Mike Richards - 1:48:12

Hi, Stefan and Joe.

Hi, nice to see you.

Yes, really welcome this.

Melianie Williams - 1:48:16

it's absolutely crucial, so I'm hoping the board will approve it because it sounds

like there's that mood in the room. So what I'd really like to see in the work plan

is just pushing that bit about inequality because we know dementia, there's a protected

characteristic of age and a long -term condition of mental health, so I'm really keen that

we get into that space about just driving what will the statutory guidance deliver for

individual outcomes as well as some of the wider stuff we talked about, about pathways

and systems, so I'm really keen to see that we get to that stage in the work plan because

I think that for me there's just a little bit that missing from the strategy on a page

was just about impact. But yeah, I really welcome the work, I'm really pleased to see

it, so thank you.

Sir Mike Richards - 1:48:58

Any other questions, comments people want to make? If not, I think what I would say

is I think you've heard the very broad support coming from the board, this really matters,

the importance of the work that David has done in the past.

So we are encouraging you, I think, to get on and start

developing this guidance, but working with all the people

around the table that you've already heard from and, of

course, others, and taking account of whatever is best

practise in other parts of the world, as David has said.

So we'll be back in a few minutes.

Presenter - 1:49:39

We are running ahead of schedule.

Sir Mike Richards - 1:49:46

So I think we could just take a ten -minute break if people would

like that.

So those watching online in ten minutes and we'll be back to

keep going.

I'm going to start with the trade union.

3.4 Dementia Strategy and Independent Voice

Sir Mike Richards - 1:50:05

Yep, we're on.

So welcome back after this break.

And then we've got an important item now which is on the trade

union equality networks update.

And Diane is here in the room with us.

3.5 Trade Union and Equality Networks Update

Network Rep - 1:50:35

Yes, can do. Right, so as I've already said before, I am the Equality Network Chair for

the Gender Equality Network, but when I come I represent all the networks. So an update

from the Gender Equality Network is that we now have two new co -chairs of our network

because our workload has increased because one of the things that was a priority for

us was to review the maternity policy within CQC.

That has broadened quite massively now to become a parenting policy review because we

realised after working with the QI team that there are some fundamental changes that we

would like to make and we would like board support with that.

We had a day where we brought together some members and some of those people were quite

senior leaders in the organisation who had experience of various different policies and

we found out that apart from the things that I'd identified within the paternity policy

being missing, as in nothing mentioning baby loss in terms of miscarriage.

There not really being anything about neonatal care which will be added

shortly because that's a new statutory requirement. Though there were various

other things about that but what came clear through this away day is that our

paternity leave policy.

Although fits within the standards,

the UK is one of the worst in Europe and in the world

in terms of how much we give for paternity pay.

And one senior leader did outline why two weeks simply

was not enough, especially when you experience

a traumatic birth.

And there are complications because not every birth

is standard and straightforward.

We had parents who had experience of the adoption policy,

and they went through it really thoroughly

because we mapped it all out.

And we realised that that is now quite out of date

because it's fine if everything goes swimmingly.

But these days, baby adoption is very, very rare.

It doesn't mention foster to adopt.

And most adoptions now are older children adoptions, which are much more complex.

Children are often very, very traumatised when they're coming to adoptive parents.

And there are certain things within that policy which we could very easily change, but we

need to also ask for some fundamental changes because one of the things that is missing

is failed adoption.

failed adoption it was highlighted to us is as serious as baby loss because of

all the steps that lead up to it and unfortunately we do have evidence that

within the organisation somebody did actually unfortunately end their own

life when a adoption failed and the man their manager did everything in their

power to support them, but unfortunately our policies do not always allow managers to know

what they can do and can offer. And so hands can be tied with regard to things

like that. And we keep hearing over and over again, generally

across the networks, that we call it the manager lottery, but sometimes it's a case of the

will say take all the time you need and then actually that's not the case. The person can't

take all the time they need or the manager isn't fully aware of the policy and so somebody

going through a different situation has to review the policies themselves and go to the

manager and it re -traumatises them and things like that. So we are working with the academy

me to prevent such situations from happening,

but we also need to make sure that our policies are

as clear as possible so that managers

can get the correct and consistent advice

and give good support to people.

So we also learned that in terms of shared parental leave,

it is so complicated to do it.

Some people have actually looked at it and just gone,

And do you know what, I'm not even going to bother.

So that means dad's missing out, or the non -birthing partner in same -sex relationships is missing

out, although the person who's not regarded as the primary parent in same -sex relationships

is missing out, because it is so complicated, especially when two people do not work in

the same organization.

So there are some ways in which we are going to push forward with that.

So obviously it's quite a big comprehensive suite of things and we are going to be asking

for some changes that may require board approval because they are changes in terms of how much

leave people can get, in terms of what pay people can get and things like that.

Other things that the networks have been hearing is, again, about recruitment.

I know I've already touched on this before, but it goes beyond inspector recruitment.

We've been looking at it quite generally.

As a joint network group, we have been pushing for change for two and a half years now.

Change has unfortunately been very, very slow on some areas where we feel that there can

be some quick wins. Yes, we know that there have been two external

reports done, but we are yet to see the change materialised from them, and those reports

were given to us late last year, and we're now in June, and we think that, you know,

potentially there are changes that can be made there.

We're also hearing that in terms of progression, I know that Simon mentioned this before, progression

routes within CQC to a certain extent don't exist. People do feel that they have been

held back and I know that recruitment is always competitive but we are hearing that there

are still a lot of interim appointments and they are lasting for a long time before people

get made permanent or are pushed back. So there are issues with that. The final thing

that I would like to raise is that recent staff forum meeting where a lot of the quality

network chairs go and we have representatives for staff forum from all over the organisation

joining. There were concerns raised around from policy around the review of the assessment

framework and the fact that, yes, there's a lot of internal and external engagement

going on and that's absolutely brilliant, but there are concerns around what's happening

internally and how staff are being able to import into that. So those are the things.

Sorry if I took up a lot of time.

Can I just add to what my ask of you, which is because we've got a lot of people who are

Sir Mike Richards - 1:58:34

the organisation, can you say a little bit about how the quality networks actually work?

Because I suspect some of our colleagues don't know.

Network Rep - 1:58:45

Okay so we have a disability equality network, a carers network, the race equality network,

LGBT and the gender equality network. Basically we try to be independent of the organisation

and invite members to join.

Members don't have to be of that particular grouping.

We encourage people to join as allies.

So what we do is we have members meetings

where we try and discuss issues within the organisation that

are of importance to our members.

But we also try to run learning events

so that we can promote information

across the organisation to help how we carry out our work.

So one of the things, apart from the maternity work,

that the Gender Equality Network is trying to do

is to promote an understanding of the fundamental misogyny

that lies at the bottom of a lot of health care,

and particularly historical misogyny

within mental health care.

So we're trying to raise the voice of things like that.

And so we'll get carers trying to raise the voice of the difficulties of being a carer at work,

being a carer within CQC and how we can improve things.

So and then we come together as a joint network voice to discuss,

are there things that we can push for together as a whole group because they're affecting everybody,

or do we need to work on them individually?

So, we each have our own aims for the year or over two years, and we try and work towards

those.

So, as I've mentioned before, our core aims within the gender equality network at the

moment are for improving the maternity and paternity parenting offer within CQC, but

also to raise people's confidence levels within CQC because there are areas where women's

confidence is often knocked back and the evidence shows that anyone who's been out of the organisation

for a year or more, so if you've taken maternity leave that's lasted a year, your confidence

is knocked and it takes a long time to get your confidence back to and that can affect

your progression. We work with the carers as I've mentioned before because of how there

is a penalty usually on women because we're forced to go part time. We work with LGBT

because of trans issues so we do work with all of them and again we work with Den because

a lot of disability issues, again, disproportionately may affect women, but we also, although we

work a lot on women's issues, we do look at issues to do with men as well, so the increased

suicide rates around men, because we try to work with that, so we work with LGBT because

that is an additional concern within there. So, yeah, we basically work quite well together

and have those things.

Diane, thank you very much indeed. Before we move on to the trade

Sir Mike Richards - 2:02:15

unions, are there

any questions or comments to Diane and then we'll come on to the trade unions.

Yeah, yes, Diane.

Thanks, Diane. And just, you know, really helpful to hear about the work of our staff

Esther Provins - 2:02:34

networks. We spoke about this earlier, but the important work they do to support our

colleagues in this space. And I know at our last board meeting we acknowledged that our

new executive team would mean a revision in the sponsorship arrangements for the staff

network, so I know that's still work in progress and it would be really great to get that in

place. Just a comment on your work around paternity,

maternity policy. As you know, I have lived experience in this area having gone through

shared parental leave, which I agree is a real minefield, it's really challenging, and

an adoption process which is never certain until it actually happens.

And so, you know, the support that we can give around that feels really important.

And also links, I think Julian and I and other colleagues from the exec team led some calls

around Carers Week where we reflected on how important the role of an employer is in supporting

our colleagues with work -life balance and important life events.

and so that feels like a really important step forward and really supportive of that work, so thank you.

Thank you, Chair.

Mr David Croisdale-Appleby - 2:03:39

Thanks for that, Diane. I just wanted to mention that in my experience in this area, some of the most

enlightened policies that I've seen in large

organisations are in the legal profession and in the accountancy profession who seem to have got over that problem of

that you've referred to as misogyny particularly,

but also because they put so much resource

into the training of people,

and they just don't want to lose them.

Therefore, you could say, well, it's a defensive move,

but that doesn't matter.

The fact is that some of the practises that they've got

to protect the individual, to produce something,

even though it's a large firm,

that is tailored to that individual is quite impressive.

So if you haven't already looked, I would recommend a look at some of those.

Thank you.

If you could pass those on.

Network Rep - 2:04:34

When we developed the maternity policy, sorry, menopause policy, one of the things we did,

we did an external look at what policies were out there.

And we looked at the civil service.

Yeah.

Gloss over that.

And what we actually did was we found that the University of Glasgow had a really good

policy and we looked at that.

I would also be remiss, because I did promise I'd mention this, that as part of the parenting

suite we want to review the fertility policy as well, because at present people who are

going through facility treatment, don't get paid leave for their appointments, and that

can be an additional stress, and we feel that it is not parity with appointments for when

you're having antenatal appointments, so that's a piece of work.

But thank you, David.

Chris.

Thanks.

There's two points I was going to make.

Sir Mike Richards - 2:05:39

Chris Usher - 2:05:40

Diane, did you say a colleague had taken their own life?

I just want to acknowledge that, and that's really sad to hear if I've heard that correctly.

That's historical, but it was around a failed adoption, yes,

Network Rep - 2:05:55

unfortunately.

That's not good.

Chris Usher - 2:06:01

The bit I was just going to talk about recruitment, again, obviously talking about before, but

the wider recruitment, I should have said more on this before, but it's probably something

And then we need to do and I can pass on to Jackie and team to

get back into the networks and update on a lot of work

happening. And it's probably just more need

to shout about that.

There's been a lot of work with external

providers and looking at how good best practise approaches,

looking at values -based assessments, looking at how we

can do better forms to include, get feedback and generally how we can get better diversity

and inclusion on recruitment.

There's a lot of activity happening but I think we just need to look at how we connect

up and celebrate and shout that and get feedback on it.

Julia.

Thanks, Diane.

Sir Mike Richards - 2:06:51

It's really good to hear from you.

Sir Julian Hartley - 2:06:53

And just to say, Mike, your question about, and Diane's response around the role of the

equality networks in the organization, I've been really impressed with the work that all

of them are doing and in fact have the opportunity to spend time with each of them.

We are looking at how we, you know, maximise and use the expertise and energy from the

networks in the work that we do as an organization.

I'm sure Chris will have noted the key points around policies

and so on, Diane.

And just to say that we're looking increasingly as a team

at how we make sure that equality networks and indeed

trade union colleagues can be part of some of the work that

we're doing that we've talked about today in terms of

the

feedback and also the coproduction around where we're

going and useful to hear your point about the assessment

framework as well, which of course is a very live and

immediate issue that we want to get right. So appreciate that.

Thank you.

Sir Mike Richards - 2:08:10

Okay. I think at this point we can move on to trade unions and

welcome again to

Sue Sesker and Dean McAvoy.

first is it you,

Suze? Me. Good,

over to you. Thanks very much for inviting us

along today, it is a genuine pleasure to

be here. We thought we'd start out with a

little bit of an introduction about who

your unions are, as it's often

talked about the union or the unions,

but we want to make it very clear that

we are here and represented in the six

recognised unions at CQC, and I'd like to

name them. So they are Unison, the Royal

College of Nursing, ASEAN,

Public Commercial Services, PCS, Unite Prospect, and then we have the Royal College of

Arthium, Maternity? Midwives, sorry, I almost got one wrong. So that covers our MNSI colleagues,

and so they're an umbrella organisation, so we don't work as closely with them, but we just want

to make sure that we name them, as myself and Dee both have members in MNSI as well. So we wanted to

just explain that we work collaboratively with our Across the Unions, which I've only ever been a

unique across local government and the health sector and I think CQC really benefits from

that collegiate approach. We're a diverse range of colleagues in membership and we have a lot

of benefits to bring. We want to really ensure that we're not viewed as just one union and that

as much as we very well organise for the benefit of CQC there's a lot of things that have to go

down to an individual union level. D? You're on mute D. Often a thing I have to tell you about.

Sorry, so sticky. Hello. So as Sue says, I'm Dee, I'm the lead for the Royal College of

Nursing and I wanted to extend a thanks to Julian and Mike for giving us the opportunity

to be here. It feels really good, really inclusive. I think we have a really important role here,

the Joint Trade Unions at CQC. We're often described as a critical friend, a canary in

coal mine. I think we like to think of ourselves as a trusted partner. We're very active here

at CQC. We have quite close relationship with our membership. We have regular engagement,

so we hear unfiltered feedback, really valuable. We're a very experienced group of trade union

reps, and we have fantastic full -time officers and extensive resources from our individual

trade unions that we can call upon and do call upon. And our basic aim really here is

to work with our senior leaders, with Julian and Mike, Esther and others, to address the

issues that are arising and to find some solutions. And we feel we've really moved into a much

more positive space in terms of that. I think Susan, I'm just going to give you a brief

summary of a couple of things that are important issues and issues that are maybe impacting on our

members currently. So I think first and foremost to say that our members are absolutely committed

to delivering our purpose and rebuilding the trust in our regulatory approach. That's why we're here,

we have amazing people who work in this organisation. They want to deliver our

regulatory responsibility, they want to do a good job for people using services. And

that's been very difficult because of the tech and the workforce issues which are now

being addressed in an inclusive and safe way, considered way, and we're very grateful for

that. I think the second point I'll make is around the work that we're doing to improve

equality, diversity, inclusion and accessibility within CQC. And just as Diane said, we also

have a policy subgroup trying to influence and shape those policies, benchmarking with

others. And what we're really interested in is looking at how we...

Oh dear, thank you.

They're frozen.

Yes.

Sir Mike Richards - 2:12:31

area, but we're not quite there yet. And so that's a focus for us.

Leadership. Dee, we're losing you intermittently. Shall

we go back to Sue's? We're clear about our responsibility.

I'll let Dee know our connections. Sorry? You keep cutting out Dee. Oh have I gone?

We'll get you back but let's go to Sue's now to say a bit more and then we can bring you

back hopefully the line will be better. Sorry Mike. So yeah the points that I wanted to

share, I think it shows a very collegiate approach to things, is that the CQC way is

eagerly anticipated by all of our members and I think that they all provide a lot of

that some people need after quite a turbulent two or three years, but mostly it'll help us to move

to a more positive working environment and I think we think that the board will be pinnacle in this.

I think what we'd like to share with you as a board is that how we get this, how we do this

and how we get this right will matter. There's a lot of weight being put on the CQC way to fix a

lot of things and so it's often the detail where we need to look and get things right. It's the

things that often has more of an impact on people's general day -to -day feelings at work and how it feels

to be a CQC employee. And the third thing, obviously we've de -started on our first,

was just that there's a lot of change afoot and it provides not just external scrutiny but

there's a lot of internal focus on again how we're doing things and I just wanted to sort of

echo that whilst our members are have been through a lot they are very much solution focused and

trying to support all the change and improvement activity and we need to be mindful that it's our

members who go out and engage with the public and providers on that sort of soft local level.

So all the strategic and the great stuff that we do with public engagement centrally

can only be strengthened by empowering our staff when they are out in public and engaging with

providers to be able to talk about our organisation positively and the things that we're trying to do.

It does feel like we're in a very different place and as personally as an CQC employee that feels

refreshing and so we just need to continue that momentum. And the last thing I was going to say

is that me and Dee are very approachable so if anybody would like to get in touch with us talk

about how we can work together, how we can support things, how we can liaise with members to support

some of the initiatives underway and the improvement and recovery activity that we're

already linked into, please don't be shy. We're friendly and we're always willing to sort of

discuss how we can serve our members who are also CQC employees. We're on the same side, we're all

trying to do the same things. So work with us, we're here to help, that's all. Thanks.

Thank you very much for that. I don't detect shyness as being one of

Sir Mike Richards - 2:15:23

the problems around

this table. So you're all right on that. We'll go back to Dee. I'm afraid you froze, but

let's see how it goes. And if it does go off, you might want to turn your camera off. But

let's see how it goes.

You were just talking about the policy stuff, Dee, by the way, if that helps to pick up

where you left off.

Oh, okay. I was going to say, I don't know where I got to. So that was around the improvement

work around our equality, diversity, inclusion and accessibility and putting those policies

into action, really. I think that's where I got to and delivering those outcomes for

our people. So the bits that maybe weren't clear were that our leadership, that we've

clear responsibility throughout the organisation for the delivery of those policies. And that

then we've got very clear arrangements and escalation points where we need them in those

policies. And as Diane was saying, the trade unions, we have our policy subgroup also trying

to mould, influence those policies and ensure that they're person -centred. We use person -centred

a lot in our work and we'd like to see that in terms of when we're talking about our people

as well. So I think that was it for me. I don't know if there are any questions. I hope you heard

that. Mike, do you? We heard that very clearly, so thank you very much

Sir Mike Richards - 2:17:00

indeed, but I'll now look

around the room here to see if people want to ask any questions or make any points. I

think it was all very clear. And the most important bit is we want to work together.

And the CQC way will be fundamental to that. And as you will have heard earlier in the

meeting, it is not very long now before the formal launch of the CQC way. And I think

what I can also say is that we discussed it at yesterday's private board and there was

strong support for this around the board table. So the board is engaged in this as well as

others. Any other specific points? Julian, anything you wanted to add?

Sir Julian Hartley - 2:17:48

Well just to thank both Dee and Suze and also the wider group that you represent and having

had good sessions with the JCNC and indeed I think the maturing relationship

in terms of frank and open conversations about our shared challenges and I think

that that feels important it feels like a very clear respectful and open

discussion and I think the point that was made, I think you said it, Sue's about partnership

is one that I think we want to role model in our work together and it feels good having

you as part of this conversation around the board table, so thank you both and look forward

to working together on the many challenges that we all know we face but hopefully can

and make good progress. Thank you.

Sir Mike Richards - 2:18:58

Thanks Julian and my thanks to the two of you and also to Diane for your part in this.

4.0 Any Other Business

So that's I think a really useful discussion. That I think takes us into any other business.

First of all, is there any other business around the table that people wanted to raise?

If not, we do have three questions that were posed by I don't know who, but people outside.

And I'll read out the questions, but fortunately I've got other

people lined up to give the answers.

So, question one.

When members of the public report concerns to CQC via the

Newcastle Centre, how are they informed of a follow -up?

Chris.

Well, first of all, thank whoever the questioner is,

thank you very much for the question.

I just want to say that the value of people's feedback

Chris Day - 2:19:47

can't be overstated.

We had 130 ,000 pieces of feedback on care that informed inspections last year and it's a key part of our success now and in the future.

And I regularly speak to people who provide that feedback and I know how, first of all how hard it is to provide that feedback and how important it is that we support people.

So at the moment you can sign up to receive alerts on organisations where you've offered feedback to

CQC so you can see when we've taken action against an organisation but we know there's much more

that we want to do and it sort of it placed the conversation we had earlier about

data and technology. We do want to do more. We want to be able to provide systems where

where first of all people can directly know

when their data is being used as an automatic feedback loop

for people to receive that information.

We've piloted such approaches in the past,

but it does rely upon,

relies upon a couple of things.

It relies upon colleagues,

Inspector colleagues making sure that they understand

how and when they've used that information.

And as you can imagine,

it relies upon their technology

to make that feedback possible.

I do think how we record that information on the system and how we use it to then inform

people of youth services is really, really important, but it comes alongside another

group of things around our assessment process that's also important.

So I think it is part of what we want to do.

It also, for me, links to our work with teams locally, so how we work with operational teams,

organisations working with people who have given feedback

and also organisations that offer it on their behalf, people

like Health Watch, so I'm really keen that we rebuild those

relationships locally as people go back into their sector

specialties, and that we make sure as part of our

redevelopment of the technology that we consider that important

element of feedback.

Sir Mike Richards - 2:21:54

What is the frequency of dental practise inspections currently?

Thanks very much Mike.

Aidan Fowler - 2:22:07

So we're responsible for inspecting and assessing just under 12 ,000 locations in the world of dentistry

and the historical aim has been to try and inspect about 10 % of those a year.

Our average age of inspections at the moment, which has been increasing, is just over five years.

So clearly we want to do better on that.

The observant amongst you will have seen in the business plan that there is a target of

1 ,500 inspections by September 26.

Currently, if you look at this year -to -date financial year, that is, we've inspected about

2 .1 percent of the estate, that's 241 inspections, which puts us on target to meet that.

And if you then have an annual rate of 1 ,500 inspections a year, that would equate to inspecting

about once every eight years.

It is important to point out we don't rate,

we give a compliance outcome for dental practices,

and importantly we respond to concerns and risks.

So we will inspect on the basis of risk and concerns

raised in addition.

All of this is subject to review as we look at scheduling

and so on in the future.

Thank you very much indeed, Aidan.

Very clear on that one.

Sir Mike Richards - 2:23:18

So question number three, which is coming to you, Aaron,

what arrangements are there for inspecting arrangements

for accommodating patients with mental health conditions?

Thanks, Mike.

And I think the first thing to say

is just to acknowledge the importance of that question.

Arun Chopra - 2:23:36

In my experience, patients, people

with lived experience, carers, will often

see things that those of us who've worked in services

might not notice.

So I think it's a really important question.

And in answering the question, we involve,

we use an organisation called Choice Support

to access our people with experience,

so the experts by experience.

We aim to involve them in our inspection activity.

And if I can broaden the question,

as well as the inspection activity,

both onsite and offsite, we also involve them

in the work of the mental health act reviewers.

So they also join the mental health act reviewers.

There are difficulties, there are issues around

logistics, making sure we've got the right person with the right experience for the service

that we're visiting, and there are some logistical difficulties as well.

In acknowledging that, the teams have informed me that we've actually got a working group

set up for next month, which is actually going to look at just going beyond the inspection

and the review activity to how we involve experts by experience, patients, people with

lived experience, carers, in setting the strategy and the priorities for the mental health sector

and team.

So that's the work that we're doing at the moment.

Thanks.

Thank you very much indeed, Aaron.

Sir Mike Richards - 2:24:49

So this is clearly very much on the agenda already,

but will continue to be so.

So those were the three questions we had from the public.

Finally, any other business that anybody wants to raise?

If not, I will just say great thanks to everybody

around the table for both the presentations they've given, for the papers behind it, for

making my first public board meeting relatively straightforward.

So thank you all very much indeed.

Chris Badger

View profile

Arun Chopra

View profile

Mr David Croisdale-Appleby

View profile

Nimali Da Silva

View profile

Chris Day

View profile

Aidan Fowler

View profile

Sir Julian Hartley

View profile

Alex Karetz

View profile

Suzanne Kirwan

View profile

Esther Provins

View profile

Network Rep

View profile

Sir Mike Richards

Chief Inspector of Hospitals

View profile

Stephanie Tarrant

View profile

Chris Usher

View profile

Sarah Valloton

View profile

Melianie Williams

View profile

We welcome your comments

Required field

Name

Comments

Need an accessible hCaptcha?
Check available options.
Sign up to hCaptcha or Log in to hChaptcha.

By clicking Send feedback, you agree that Care Quality Commission and Public-i can use the information above to review your feedback and contact you about it. See our Privacy Policy for more details.

CQC Board Meeting - June 2025 - Wednesday 25 June 2025, 9:00am - Care Quality Commission

CQC Board Meeting - June 2025Wednesday, 25th June 2025 at 9:00am

Agenda

Slides

Transcript

Map

Resources

Twitter

Forums

Speakers

Feedback

Votes

1.0 Opening matters

Sir Mike Richards - 0:00:01

1.1 Chair's Opening Remarks

1.2 Welcome and Introductions

Sir Julian Hartley - 0:02:10

Sir Mike Richards - 0:02:18

Nimali Da Silva - 0:02:20

Sir Mike Richards - 0:02:26

Esther Provins - 0:02:28

Sir Mike Richards - 0:02:35

Arun Chopra - 0:02:37

Mr David Croisdale-Appleby - 0:02:58

Sir Mike Richards - 0:03:04

Chris Usher - 0:03:07

Sir Mike Richards - 0:03:10

Melianie Williams - 0:03:12

Chris Day - 0:03:26

Sir Mike Richards - 0:03:29

Aidan Fowler - 0:03:30

Sir Mike Richards - 0:03:34

Suzanne Kirwan - 0:03:36

Sir Mike Richards - 0:03:40

Alex Karetz - 0:03:42

Sir Mike Richards - 0:03:53

Chris Badger - 0:03:55

Sir Mike Richards - 0:04:05

Network Rep - 0:04:08

Sir Mike Richards - 0:04:13

Sarah Valloton - 0:04:15

Sir Mike Richards - 0:04:20

Stephanie Tarrant - 0:04:22

Sir Mike Richards - 0:04:25

1.3 Declarations of Conflict of Interest

1.4 Any urgent business

2.0 Board and Committee matters

2.1 Minutes of the previous Public Board meeting held on 26 March 2025

2.2 Review of the Matters Arising and Action Log

Suzanne Kirwan - 0:08:58

Sir Mike Richards - 0:08:59

3.1 Priorities Programme Update

Sir Julian Hartley - 0:10:55

Sir Mike Richards - 0:13:10

Sir Julian Hartley - 0:13:10

Sir Mike Richards - 0:18:16

Sir Julian Hartley - 0:18:17

Sir Mike Richards - 0:19:00

Esther Provins - 0:19:02

Sir Mike Richards - 0:29:05

Alex Karetz - 0:29:40

Sir Mike Richards - 0:29:50

Esther Provins - 0:29:51

Sir Mike Richards - 0:30:36

Network Rep - 0:30:39

Esther Provins - 0:33:00

Sir Mike Richards - 0:37:08

Sir Julian Hartley - 0:37:12

Sir Mike Richards - 0:38:50

Esther Provins - 0:38:51

Sir Mike Richards - 0:40:24

Mr David Croisdale-Appleby - 0:40:27

Sir Mike Richards - 0:42:35

Esther Provins - 0:42:39

Sir Mike Richards - 0:48:15

3.2 Draft Business Plan

Sir Julian Hartley - 0:48:43

Sir Mike Richards - 0:53:27

Melianie Williams - 0:53:52

Sir Mike Richards - 0:54:13

CQC Board Meeting - June 2025
Wednesday, 25th June 2025 at 9:00am