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… 
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
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
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/…
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