2/18 My foreword highlights how rarely voices like these are *really* listened to. Yesterday Lord Stevens, in his farewell to @NHSEngland staff, said that the NHS is at its best when it listens hardest. If that’s the case, it needs to be all ears now. We all do. #YouOnlyHadToAsk
3/18 This bit of the foreword is about the power of the voices that don’t shout the loudest. That can be just as true of frontline professionals as it is of the people who told us about deeply personal, sometimes traumatic experiences. Thanks to all of them. #YouOnlyHadToAsk
4/18 Clear needs shine through. Understanding communities and individuals that services are supposed to be there for. Bridging the trust gap. Role for ICSs in developing partnerships to tackle the social determinants of health. Supporting people to take control. #YouOnlyHadToAsk
5/18 Our research agency @RR_research had a tough job on their hands to undertake detailed ethnographic work, virtually, in deprived communities during a pandemic. Thanks to them for their insight and stamina. We’re also publishing the initial evidence review. #YouOnlyHadToAsk
7/18 The people who tell their stories in #YouOnlyHadToAsk bring health theory to vivid life. Kumar (names are all pseudonyms) makes the point that medicine is only part of the picture.
8/18 Vera highlights how a lifetime of working long hours can make it hard to switch into “healthy” habits later in life. #YouOnlyHadToAsk
9/18 Ibrahim shines a spotlight on the #WeAreUndefeatable message that moving in ways that work for you is really important - and that people need practical, empathetic support with it. @undefeatable#YouOnlyHadToAsk
10/18 Even with her daughter’s help, Sabba struggles to find out exactly which conditions she’s dealing with. She also saw her women-only physio sessions stopped and is unable to join the replacement mixed-sex sessions. #YouOnlyHadToAsk
11/18 Roger’s story shows how huge a part housing can play. It also rams home the human impact of inflexible rules. Assisted living or staying with your pet cats in an old, cold home, when you’re bereaved: the ‘choice’ is yours. #YouOnlyHadToAsk
12/18 Like several participants, Nathan has experienced abuse. He’s able to travel long distances to see a consultant he believes finally understands him. If he couldn’t afford it, he’d be stuck with the frustration of feeling no-one sees him as a whole person. #YouOnlyHadToAsk
13/18 Bekele is very conscious of how ethnicity, language and geographical location can combine to reduce access to and quality of care. He’s been there, seen it and lived it. #YouOnlyHadToAsk
14/18 I was lucky to sit in on a focus group of people living with multiple conditions that @RR_research ran during the design stage. Shaima highlights an issue that came up then: caring for others without the right support can mean your own health suffers. #YouOnlyHadToAsk
15/18 There’s a sense in the report of professionals sometimes struggling to understand why people won’t or can’t take what seems like obviously good advice. It’s clear that the answer lies in the web of issues that constitute people’s real lives. #YouOnlyHadToAsk
16/18 The social determinants of health, even if that’s not the term they use, loom large in people’s stories. This is bigger than the NHS but the NHS has a crucial chance now to work with councils and employers and leverage the role of anchor institutions. #YouOnlyHadToAsk
17/18 You shouldn’t need sharp elbows to get what you need from health and care services but these voices say that you do. The system needs to change. But so does the way we all too often think about it. We’re still in the foothills of shared decision-making. #YouOnlyHadToAsk
18/18 As the Taskforce ends, we at @RichmondGroup14 have made this agenda central to our future plans. We’ve responded to the report and made recommendations to a wide range of organisations. We in the VCS are part of this shared challenge too. richmondgroupofcharities.org.uk/sites/default/…
The annual @CareQualityComm#StateOfCare report’s out today, just in time to focus minds as decisions are made about future health and care funding. Here’s my thread, picking out some of the nuggets that have got me thinking. 🧵 1/10 cqc.org.uk/publication/st…
2/10 Overall #StateOfCare message: gridlocked care, growing risks of harm and a need to tackle inequalities. Summarised here in the foreword. Stresses need for workforce investment at system level. Rightly says need to understand people’s experiences overall not in isolation.
3/10 Good to see this reminder in #StateOfCare that ICSs need to use insights from local people to drive and track improvement. Key role for #Healthwatch and #VCSFE organisations there, I’d say. Very relevant to the need for shared learning described in section on collaboration.
Last big #RaceAgainstHunger training walk today, b4 solo walk of full Marathon course on 2/4 for @TrussellTrust. Today doing 2nd half of course from Tower Hill, East around Docks then West to The Mall. Add on 2 miles to Baker Street and that’s 16-17 miles. trusselltrust.enthuse.com/pf/neil-tester…
Old meets new(ish) as I approach Westferry from Limehouse via Narrow Street. First of these training walks when I haven’t had to wear a big coat.
About to put these on for a @TrussellTrust#RaceAgainstHunger training walk, chosen in my Twitter poll. Before the 12 miles from the Marathon course start on Blackheath to the Shard via Woolwich, I’ll do 8 miles from Euston to Blackheath. Bring on 2 April. trusselltrust.enthuse.com/pf/neil-tester…
It felt rude to take a photo so you’ll just have to believe me when I say I hadn’t got very far south of Euston when I saw possibly the most British thing ever: a town crier in full regalia and carrying a Waitrose bag. Stay tuned for more exciting megawalk updates…
So the actual White Paper has now appeared: gov.uk/government/pub…. I’ll leave the experts to ponder the vagaries of what it might really mean for pooled budgets, single accountability etc, but here are some instant-ish thoughts. 🧵 1/10
2/10 Overall, don’t think anyone will disagree with most of the ambitions but I can’t see many people saying that this is the clear, funded, holistic plan that’s needed to realise the vision. I’d rather have a light shone on these issues than not. But solid action’s better.
3/10 The national priorities in this shared outcomes framework need to articulate what will improve for people with multiple conditions, at the sharp end of inequality. And when local leaders agree their local outcomes, that has to be *with* communities, not just *for* them.
🧵 1/6 The Integration White Paper arrives today. We’re in the limbo of being told by this @DHSCgovuk press release what it’s going to do, while having to wait until this afternoon to see how it says it’s actually going to do it. I’ll be looking out for… gov.uk/government/new…
2/6 Agree with Paul Najsarek of @Solace_UK that the voluntary and community sector is a key part of this vision. @NHSEngland ICS design framework recognises that takes funding. Will @DHSCgovuk@luhc act accordingly? Hope so. Not holding my breath. Surprise me!
3/6 I’ve spent years banging the drum about the multiple conditions challenge, so I’m glad the press release aspires to tackle it. Hope White Paper puts meat on bones. Great examples of how to think differently in @RichmondGroup14 Guidebook and update: richmondgroupofcharities.org.uk/sites/default/…
Thread 🧵 1/5
It’s never reassuring when people’s health needs have to wait in a queue behind political considerations. What’s trailed here will help but fundamentally people need the money unlocked so the NHS can move lists forward with the wider plans. thetimes.co.uk/article/2a4afd…
3/5 Tackling waiting lists quickly and well must be central for the NHS. An end to the physical and mental pain so many people suffer while waiting for treatment can’t come too soon. We’re being told today that “the grown-ups are in charge” of government. A chance to prove it.