the government's plans to establish integrated care systems as statutory bodies and to end the legacy of 30 years of market reforms to the NHS are welcome and feel different from previous reorganisations (1)
every previous reorganisation I've worked through has been imposed by politicians. This time the main changes have been in development for 5 years and the law is catching up with work led locally by the NHS and its partners (2)
the response to Covid has depended on collaboration within the NHS and between the NHS, councils, the VCS and many others. Formalising collaboration in ICSs should make this easier in future (3)
ICSs will take a lead in joining up care around people and using all assets to tackle inequalities and improve population health - building on progress since 2016. This is even more important in the social and economic recovery from Covid (4)
legislation is necessary but not sufficient: the really hard and work happens locally and centres on relationship building and bringing health and care teams together to deliver the best possible care to patients and users. This takes time but is the right thing to do (5)
Three thing are missing: a sustainable settlement for social care, a cross govt commitment to tackle health inequalities, and a properly resourced workforce strategy for health and care (6)
finally, why does the govt want to take back control when the NHS has done a magnificent job during the pandemic? Politically led initiatives like test and trace have performed much less well and the case for Ministers to be more involved with the NHS is unproven at best (7)

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More from @profchrisham

2 Feb
There are many lessons - positive and negative - on the response to the pandemic and we need to learn them now to be more effective in future
newlocal.org.uk/articles/covid…
Let's start with three positives: partnership working at a local level through local resilience forums and integrated care systems enabled public services to use resources more effectively with focus on place and community @NHS_RobW
The voluntary and community sector made a huge contribution in meeting needs working alongside public services and providing distinctive capabilities and support @GrapevineCEO @Voa1234
Read 14 tweets
11 Nov 20
take home points from yesterday' session with @CommonsSTC @CommonsHealth led by @GregClarkMP @Jeremy_Hunt
my evidence and that of others underlined need for contact tracing to be led locally and for councils to have the resources to do this effectively @Jeanelleuk
@BWDDPH gave a compelling and detailed account of how he and colleagues are doing this and achieving high levels of success in reaching contacts
Read 15 tweets
3 Nov 20
the govt must use the next 4 weeks to sort out test, trace and isolate. Here are the priorities @Jeremy_Hunt @GregClarkMP @JonAshworth @leicesterliz @didoharding @MattHancock @AndyBurnhamGM
weekly testing of asymptomatic NHS staff in all settings should be routine
weekly testing of care home staff and monthly testing of residents should be routine
Read 12 tweets
18 Jun 20
Just explained @BBCEngland that test and trace has picked up 10K new cases in last 2 weeks which is minority of new cases as reported by @ONS. National tracers have reached 10,000 out of 87,000 reported contacts thru 25,000 staff
Remaining 77,000 contacts (complex cases) have been reached by @PHE_uk and council led local health protection teams who have been brought into test and trace late in the day
Balance of work to date raises question of whether 25,000 staff are needed at national level and why govt has preferred outsourcing to private companies instead of building from public sector expertise
Read 9 tweets
12 Jun 20
A tale of English exceptionalism - or how not to manage a pandemic like C-19
Lockdown later than other countries thereby resulting in many avoidable deaths (ref Edmund and Ferguson among others)
Don't control entry via airports and ports until way too late and fail to introduce quarantine like many other countries
Read 13 tweets
10 Jun 20
questions about today's easing of the lockdown announced by the PM @KateAlvanley @jimmcmanusph @Jeanelleuk @GregClarkMP @Jeremy_Hunt
test and trace is still in development. When will it be ready to provide the protection we need to avoid a resurgence of C-19? when will every LA have a local outbreak plan and enough staff to do contact tracing?
the PM referenced the Joint Biosecurity Centre which is now on its second leader in 4 weeks. Exactly what is it doing and when will it be fully operational?
Read 9 tweets

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