Neil Tester Profile picture
Jul 28, 2021 19 tweets 14 min read Read on X
1/18 I know you love a thread, so here’s one about today’s new report #YouOnlyHadToAsk from the Taskforce on Multiple Conditions, led by @RichmondGroup14 and @ImpUrbanHealth. Hear the voices of people living where multiple conditions meet health inequity. richmondgroupofcharities.org.uk/taskforce-mult… Image of report cover. ‘You only had to ask: what people w
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 Foreword. There are crucial decisions ahead for health and s
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 Very little is as deeply powerful as a clear, quiet human vo
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 In particular, policymakers and professionals need to consid
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 Method and sample. The research utilised an ethnographic app
6/18 The people with multiple conditions and professionals we spoke to were in 4 localities across England. This report will interest @HWLambeth @HwMiddlesbrough @HWBrum @HealthwatchBfd #YouOnlyHadToAsk Living with multiple long-term conditions In this chapter weManningham & Toller wards, Bradford.North Ormesby, Middlesbrough.Sparkbrook & Balsall Heath East, Birmingham.
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. Portrait of Kumar, 40, Indian, Stockwell. A loving dad, befo
8/18 Vera highlights how a lifetime of working long hours can make it hard to switch into “healthy” habits later in life. #YouOnlyHadToAsk Portrait of Vera, 74, Portuguese, Stockwell. A retired clean
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 Portrait of Ibrahim, 70, Pakistani, Bradford. A practical maHe takes painkillers regularly but also increasingly aims to
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 Portrait of Sabba, 63, Pakistani, Bradford. Loves her daily
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 Portrait of Roger, 70, White British, Middlesbrough. Loves f
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 Portrait of Nathan, 33, White British, Middlesbrough. Intere
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 Portrait of Bekele, 26, British Somali, Birmingham. An ambit
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 Portrait of Shaima, 32, British Pakistani, Birmingham. A kee
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 Managing health inequity and multiple long-term conditions.
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 What factors in people’s lives make it more difficult to m
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 What elements of the health system make it more difficult toMany of the challenges people face in maintaining their heal
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/… Tackling these issues will be an acid test of how serious th
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More from @NTtweeting

Oct 21, 2022
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… Cover of CQC report: The state of health care and adult soci
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. Text of first page of report foreword.Text of second page of report foreword.
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. The aim of ICSs is to deliver joined-up care that better meeAlthough services were under great pressure, we have raised
Read 11 tweets
Mar 12, 2022
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… London Marathon course map.
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. Skyscrapers behind old brick buildings.
Do I have to walk this bit backwards? Street sign: Milligan Street E14.
Read 24 tweets
Feb 26, 2022
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… Walking trainers.
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…
About 5 miles in and the Shard’s in sight. I’ll be back here in 15 miles’ time. Nice day for a walk. Also a good day to support @TrussellTrust #RaceAgainstHunger if you can:
trusselltrust.enthuse.com/pf/neil-tester…
#TeamTrussell The Shard.
Read 32 tweets
Feb 9, 2022
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. Shared outcomes which prioritise people and populations Shar
Read 12 tweets
Feb 9, 2022
🧵 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! Paul Najsarek, Solace spokesperson for Health & Social Care,
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/… Despite the best efforts of staff, the current system means
Read 7 tweets
Feb 7, 2022
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…
2/5 People aren’t waiting for the right target to be set. They’re waiting for action and the help they need. They see Government providing the resources as the key. See this @RichmondGroup14 @BritainThinks research: richmondgroupofcharities.org.uk/sites/default/… Chart from p51 of report.
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.
Read 6 tweets

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