Categories
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”. […]

Categories
Accountable Care Determinants Inequality Social Value STP

Role of anchor institutions in sustainable economic growth.

Went to an excellent session a month or two back Ted Howard  of the Democracy Collaboraborative was the headline act With a few able support acts I learned a lot in a short space of time In the spirit of democratising knowledge, here is my note of the meeting 1. What is the Democracy Collaboraborative […]

Categories
Accountable Care Public Health STP

The role of Directors of Public Health in STP. 5 thoughts.

This is niche, and mainly for DPH types. Been thinking a lot re the q of what is the role of a DPH in the STP land.here are some thoughts – as always thanks to others who helped develop these thoughts. It’s not quite finished yet, and I’d welcome views. I’ll be clear this isn’t about […]

Categories
Accountable Care Public Health STP

STPs, prevention and the the ever changing ask of “public health”

Been thinking a lot on this.I’m thinking there’s a standard assumption that PH = “prevention” and thus prevention aspects of our STPs will be “done” by PH. Two fab studies have focused my attention on this issue of prevention how it fits in STP world, one on obesity, one on hip fracture. I could have […]

Categories
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
Accountable Care Health Care Public Health STP

ACO – how to guide and considered thoughts

ACO – how to guide and considered thoughts Ding ding. Round 2There is increasing discussion of this as a solution to current problems. One read of NHS England narrative would be that this is THE direction of travel. It is a policy idea imported from the USA where it is ONE of the three arms of […]

Categories
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 […]

Categories
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 […]

Categories
Healthcare Reform Public Health Smoking STP Value

Scaling up prevention – an STP thought experiment around the benefit of smoking reduction in economic terms

Here’s a thought experiment on smoking, poverty, inequality and the economyYesterday I set a challenge for the leaders of the health and care system in South Yorkshire  I suggested it would be rather ambitious to get smoking prevalence to 10% (Yes those that don’t “do” lifestyle stuff…. I agree there’s far more to it than lifestlye […]