Where Digital and Regulators Meet: Interview with Helen Louwrens, Care Quality Commission


This month, we sat down with Helen Louwrens, Director of Intelligence at the Care Quality Commission and we can tell you now, it was FULL of brilliant insights.

Have read!


Helen! Lovely to meet you! So what is the CQC, and what is your role there?


CQC stands for the Care Quality Commission – we are the independent regulator of health and adult social care services in England. We register the providers who deliver regulated activities, monitor the quality of care they provide, inspect them and form judgements on the quality of care by rating against key questions, and when needed we take enforcement action to keep the people who use those services safe from harm. We also publish annual and one-off reports on the state of care across England to influence leaders and policy change and help inform people using services.


I’m the Director of Intelligence at the CQC and lead a team of Analysts and Data Scientists. Our key aim is to turn the data we hold on the services we regulate into insight to support the work of CQC. We provide regular insight products to our inspector colleagues (some of these get shared with providers) and custom insight as needed to understand the quality of care from providers, we run the National Patient Survey programme on behalf of the NHS, and we are continuously researching and developing new ways of using data to understand quality. My team is also instrumental in producing the evidence that supports our statutory and thematic reports which influence leaders of health and care organisations and governments to change what they do – for example right now we are working on a review into the use of restraint, seclusion and segregation in places that provide care for people with a learning disability and/or autism and mental health problems.


What’s been your background to lead you to this point?



I’ve always loved maths and problem solving and feel ridiculously fortunate that I’ve been able to build a career around this. I studied Economics & Statistics at the University of Bath because I enjoyed the subjects, but I didn’t really know what I wanted to do when I left university – the internet was only just becoming an everyday thing, so the careers office and word of mouth were the go-to sources for research! When I was interviewing for a 12-month work placement as part of my degree I wasn’t feeling overly inspired by what was available until I saw an advert for an Insight analyst job within the Customer Analytics team at Sainsbury’s. At the interview they asked me to describe the length of time it takes a customer to go through the checkout in the form of a mathematical equation and that was the moment I realised that solving practical problems using maths and stats was the career for me!


After university I joined dunnhumby (more on that later) and continued to use customer data to help solve business problems and opportunities. The thing that has persisted right through my career and where I get my kick from is to deliver actionable insight that when implemented makes a real difference to people’s lives. CQC felt like the right next step to continue this passion and while we have made great progress in the last two and a half years, there is much more opportunity for data and analysis to drive how we work and the day to day decisions that we take that impact the quality of care for service users.



To what extent can the work regulators do be automated?


There is plenty of room for improvement in the technology that underpins our regulation and more to do to ensure we maximise the use of the data we hold by applying new and different analytic techniques to it to better understand the activities of those we regulate. We also need to ensure we are spending our budgets wisely so not only is better use of data and analytics helpful in finding patterns we wouldn’t have otherwise seen, it is also necessary given the volume of organisations being regulated. At CQC we regulate 45,000 providers, the Financial Conduct Authority has over 50,000 companies that they regulate, and the Health & Safety Executive regulate well over a million. The only viable way to have a handle on this breadth of organisations is to use technology, data and analysis to support our work.


I certainly don’t believe we are in the position where we can take regulatory decisions using tech, data and analysis alone. The way that health and care is delivered today is highly personal through human interaction and the robots won’t fully take over for many more years yet. This human interaction is very difficult to measure in data alone, so while we can receive feedback from clinicians, care givers, people who use services and their families, there will always be an element of needing to see this in some way to assess how well it is delivered. How often we need to do this can be driven by the other data we hold which can indicate when something that needs to be looked at but looking is the important word here. I also think the public would feel highly uncomfortable with a fully automated approach to regulation, particularly in health and care. Trust in regulators is critical and transparency is important. I’d like us to be testing which decisions can be automated so we can free up the time of inspectors to focus on the areas where human input and judgement is most needed. But we would need to do this in a very open way, so we can take the public and providers with us on that journey.



What’s your general barometer check on how data-ready regulators are? What could improve it?


I think regulators are already at the stage where we know we need to use data more actively in our decisions, with many already well on this journey. Technology is a critical factor. The ability to use data well is dependent not least on having access to the right data of sufficient quality and the right tools and technology to collect, manage, use and share that data well and there is more we can and are doing at CQC to improve the use of the data we already have with a number of technology initiatives underway to enable this. One of the major challenges we have in health and care is the pace at which modern technologies have been adopted over the years. As we digitise more of the administration of health and care delivery, the data this generates will importantly be available to speed up continuous improvement in services, but this could also be available to regulators like CQC to understand how well services are delivering and how they are improving. There is a challenge for regulators in that there can be a level of nervousness about sharing data and how we might use it ‘against’ a provider. We need to increase our transparency and bring providers and the public along with us as we change the way we use data within the organisation to ensure this is well understood and trusted. We’ve done some really good work in this space in the past two years looking at how providers within local health and care systems work together to deliver services to people aged 65 and over – our Local System Reviews. The data we shared with the local teams we worked with has been valuable in bringing the providers together and shaping improvement plans so we know that us sharing the right data can have real benefit for people using services.



You haven’t always been in health, what were you doing before moving to the CQC?


Prior to CQC I spent 16 years working at dunnhumby, a customer data science company. I started there as an analyst working with Tesco on a variety of projects such as building their strategic customer segmentation to drive their tailored customer offering including one to one Clubcard communications and understanding how the different features of promotions such as price point, discount level, the number of promoted lines etc. impact promotion performance. I joined dunnhumby at a brilliant time – the company was quite small then with around 120 people and I was fortunate to grow with it to reach the UK leadership team when the company was over 3,000 people. I worked in the UK business as well as in our global team and had incredible opportunities to live and travel to different countries. As we were expanding globally I was our Solutions Lead for our international business development team. I would regularly be in front of the Boards of multibillion-dollar retailers talking about how a customer-first approach, founded on data and analytics, can support their strategic ambitions, then leading the solutions teams who would run pilot projects to secure long-term partnerships. My last major project was the renegotiation of our services agreement with Tesco across nine markets – so while I started out as an analyst and still am at heart, I’ve had a broad set of experiences that have led me to where I am today.



Which things have been transferable?

There is so much that is transferable. Ultimately my role is still about helping maximise the use of data for strategic, tactical and operational decisions. As we have automated more of our standard outputs we are freeing up analyst time to bring more understanding of what the insight means so we can have greater impact which is welcomed by those we work with. I love the fact that I can still have technical conversations about our data and analysis although I am starting to feel out of my depth on the more technical data science approaches my team are using now which pains me!


Which things have been the least transferable?


The beautifully clean computer-generated data in the retail world is a thing I miss! We have such a breadth of data that we are using at CQC but it often requires a lot of cleaning and processing to make it usable. One thing I personally didn’t have much exposure to at dunnhumby, but which is of critical and growing importance to us at CQC, is the emphasis on text data. A lot of our data comes through narrative answers to questions we ask providers, through the description of what our inspectors observe that is published in our inspection reports, through contacts to our customer service centre and through the feedback on providers from service users and their loved ones. We are testing several approaches to automate our use of this which is exciting. Ultimately though it still boils down to understanding the question you are trying to answer, selecting the appropriate data and analytic techniques to answer it, and providing this to the decision-maker in the most appropriate way.


There are numerous hypotheses that supermarket loyalty card data could give us great insight into people’s health. Can you ever see that happening - going as far as linking those data to medical data?


There is no doubt that looking into the supermarket shopping habits of consumers enables you to build up a very good view of their lifestyles – when, where, how often they shop and obviously what they buy can create a rich view of the lifestyle of an individual or family.

I think that linking this to medical data in an anonymised way could massively benefit public health policy development and this is probably happening in pockets around the world already. As personal medical records become more available to individuals through apps, and retailers take further steps for customers to see their own purchasing history I think it is feasible that individuals will take more interest in the correlation in those two sources of data and may choose to share this with their GP or specialist consultant for example. As far as a national dataset with all of this joined together goes, I think we have a long way to go to develop trust in national bodies holding this level of personal data together and the more we hear of companies like facebook using personal data in questionable ways, the harder this becomes.


As Director of Intelligence, what is the one thing you wish those who you regulate would do?


I would love to see more providers putting greater emphasis at leadership level on technology, data and analytics but I know this can come with demands on resources. This would benefit CQC as we could use more of the outputs but, more importantly, I truly believe this can help providers improve for themselves the quality of care they deliver to their service users and the working lives of their staff.




What’s the most useless/product/tool you have in your house?

A lawn-mower in our shed for the grass we no longer have


What do you think about when you’re alone in your car?

There’s not really much time for thinking when I’m belting out The Greatest Showman at the top of my voice!


If I gave you £250,000 to start a company, what would it do?

Build an outdoor swimming pool in my neighbourhood to run at cost and encourage the neighbours to switch off their lights at night so we could swim under the stars. I think £250k might be wishful thinking.


What fictional character do you identify the most with and why?

Hermione Granger – is that too obvious? She is curious, calm under pressure and never shies away from a challenge.



Helen Louwrens, Care Quality Commission

I’m the Director of Intelligence at the Care Quality Commission (CQC). I lead all the analytic work we do to understand the quality of care being provided in England by health and adult social care services. This is used to support our regulation – we register, monitor, inspect and rate services and take enforcement action when needed. We also use it to speak publicly about our views on what we are seeing in health and care to influence policy change and improvements in quality. I’ve been at CQC around 2.5 years. Prior to this I worked at dunnhumby, a customer data science company, for 16 years, helping grocery retailers and their suppliers to understand their customers and improve their offering.


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