Categories
Accountable Care Ageing Health and Social Care Prevention

Children, healthy ageing and the opportunity in the transformation of health and social care.

I read this amazing blog last week, partly focused on on the marginalisation of the children’s agenda in the STP landscape. Building communities with resilient children at their hearts | The Nuffield Trust https://www.nuffieldtrust.org.uk/news-item/building-communities-with-resilient-children-at-their-hearts …….Powerful words by Professor Sir Al Aynsley-Green argues that the UK now needs a long-term, coherent, cross-party ideology and overarching policies that […]

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Accountable Care Health and Social Care Outcome

What outcome measure for an Accountable Care System – how will we know its working

Third go at this one. Th other two are referenced This one attempts to distill the essence We’re all on this path. I keep getting ask d what outcome measures we should use…….. Hers my take This isn’t a paper about clinical performance measures. This short paper sets out some recommendations for how might we know […]

Categories
Clinical Health and Social Care Health Care Public Health

how to cut the incident AF stroke rate by 15% in 18 months. Turning science in to change.

        This is a very old story. Its also a very long one. It is one I have wanted to tell for a time. It is the story of how we increased performance by 33% on a “difficult indicator” that was known to be problematic to change. It is also the story […]

Categories
Health and Social Care Health Care Public Health Prevention Value

 If the NHS were better at preventing stuff. 10 thoughts.

I got asked a q today about “how might the NHS address “prevention” more strategically. 10 off the cuff thoughts.   These thoughts are NHS focused…….and medical model focused. Maybe I’ll write more about NHS and social model stuff in the future   1) In many cases screening doesn’t prevent anything. It finds disease. Often […]

Categories
Clinical Health and Social Care Healthcare Reform Inequality Primary Care Value

The GP 5 Year Forward View, the importance of inequality and the Deep End

So we are all doing responses to the GP 5 Year Forward view Who knows whether there’s any REAL investment fund. Meanwhile the world keeps revolving. General Practice, you know the bit that everyone says is the jewel in the NHS crown, gets ever more fragile. The point re General Practice in the most disadvantaged […]

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Accountable Care Health and Social Care Health Care Public Health Healthcare Reform Public Health STP Value

Using routinely collected data to demonstrate where the NHS is going wrong

 This is someone else’s work, it’s amazing. Genuinely amazing. And deserves wide coverage.  In some ways a macro analysis of the history of NHS problems, using lots of readily available NHS data with a heavy dose of  intelligence and interpretation  It’s Scottish. Is Scotland like England – ie questions of generalisability. I think many of […]

Categories
Accountable Care Health and Social Care Health Care Public Health Healthcare Reform Prevention STP

the transformation that are missing from current iterations of thinking

There is consistent evidence from a macro perspective that the key drivers of cost growth are: disease incidence (prevention), high cost technology (manufacturer pressure & patient expectation) and over diagnosis (clinical culture and system pressure) And NOT demographic pressure or the “ageing population” Similarly, the Glasgow work found that the current problems in NHS in […]

Categories
Ageing Health and Social Care Healthcare Reform Prevention

Is it the ageing population, need, demand or supply that is causing pressure

  How much of the current NHS and social care pressure is due to ageing, other causes of population ill health, changing public demands, changing supply, or other issues. This is a question I keep being asked. I don’t know the answer. It is probably impossible to quantify precisely.My effort is a complex answer, it […]

Categories
Health and Social Care Health Care Public Health Smoking

Stop before your op – great plan if done well for the right reasons. Terrible idea if done to save money

Another policy zombie  Ban on elective surgery till you have stopped smoking. Pitched as a policy device to save money. My own view, based on this is that there is NOT a case for this I’d advise (strongly) against heading down this path Some thoughts: Ethics issues The policy should be considered through the standard […]

Categories
Ageing Health and Social Care Prevention Value

prevention – ultimately futile in broad economic terms as folk will likely live longer and get dementia….discuss….

I’m asked this a lot.  Depressingly it’s also expressed with increasing regularity that prevention is ultimately futile in broad economic terms as folk will likely live longer and get dementia….SighThis one crops up with depressing regularity.Today’s iteration was as follows:-“Some was telling me today that the more we prevent people stopping smoking then people stop […]