Ms Angela Fitzgerald:

I thank Deputy Daly. There are two points to make on our powers. First, the powers we have allowed us to take action with the provider. Ms Cliffe and Mr. Colfer can speak about how we execute those powers.

On the question on the move towards large corporate entities, we agreed that it is a shift. We currently do not have powers to direct or require them to do anything. We work on the basis of co-operation. I want to put on record today that the vast majority of the corporate entities and individual providers co-operate and work with us. The regulations are to provide action and a deterrent. It is important, when there is a changing landscape, to pause to consider whether we need additional regulatory powers in circumstances such as those in question to allow us to hold the entity to account. The action by the entity itself to restrict all admissions to all units, based on discussion with us, is one we welcome, but it might be one that we would require of a corporate entity. That is an example of where having the powers would be very important.

One can see in all our inspection reports that we comment on staffing, but we do not have a standardised framework for determining what good staffing looks like. The work being done on healthcare by the Chief Nursing Officer will give a much more objective lens and allow us to comment much more forcibly where we need to. More important, it will require providers and owners to be bound by the staffing frameworks in a way that they are not currently. The safe staffing framework has two roles: giving the power to us to appraise and critique; and being able to challenge the provider.