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Accountable Care Health Care Public Health Healthcare Reform population health Prevention Public Health Shared decisions STP

Population health, population health care, population managemen

More than 30 years ago Rose set out the importance of focusing on population factors and not just individuals. We’ve not really made good on the hypothesis yet. Population health is still all the rage, if not properly defined. I’ve had a few gos at defining. Firstly trying to distinguish “public health” and “population health”. […]

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Ageing Clinical Health Care Public Health Healthcare Reform Prevention

Ageing population lazy thinking for when you cant be bothered to understand the real issues

By me and Steve Laitner I’ve (GF)  blogged a lot on the myth that is the “demographic timebomb”, and set out a set of data and arguments to make up case argument wise. See references at the bottom.    Here are our collected summary thoughts on why getting the narrative wrong on this is harmful […]

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Health Care Public Health Healthcare Reform Public Health

Over diagnosis – a new frontier in green and carbon

I got asked a q re my thoughts on greening health care I think the asker was expecting me to mutter something about light bulbs They were surprised to see I had no real interest in light bulbs We’ve all said warm words (pun not intended) on carbon and stuff.  Climate change is perhaps the […]

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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 […]

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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 […]

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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 […]

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Clinical Health Care Public Health Healthcare Reform

The centralisation of hyper acute stroke care will save lives and money, won’t it?

how many lives will be saved by the centralisation of hyper acute stroke units. How much money will this save. Warning – this is long and pretty tricky. The short answer is not many & not much. There may be higher value things to do. I’m often asked thisWe are centralising hyper acute stroke care. […]

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Accountable Care Health Care Public Health Healthcare Reform STP

 where next for STPs

 So they are all in.  Simon is going to be busy over the summer reading them. No trashy novels by the poolside for him.What next is anybody’s guess.I was having a think about what next.  Some reflections below. Don’t know whether I’m right and I’m happy if you want to disagree and argue with me….that […]

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

ACOs and the like – will or won’t they save us from certain doom?

ACOs and the like – will or won’t they save us from certain doom This remains hot space in STP thoughts up and down the country About 18 months ago I was asked by a FT chief exec “I’ve read about these ACO things, but what does the evidence really tell us and if we […]