Neil Tester Profile picture
Oct 22, 2021 15 tweets 14 min read Read on X
Today’s #StateOfCare report from @CareQualityComm assesses impact of the pandemic and the challenges for health/care integration. cqc.org.uk/publications/m…
Highlights issues CQC will need to focus on in its new ICS oversight role. Here’s a thread of what leaps out at me 🧵👇 1/15 Cover of CQC report: The state of health care and adult soci
2/15 Throughout #StateOfCare I can see signs of how closely @CareQualityComm has listened to what @RichmondGroup14 and other voluntary sector organisations have said consistently during the year. Also good to see insight from @ageukcampaigns @Rethink_ @RedCrossPolicy being used.
3/15 Strong message in #StateOfCare about unmet need (a key issue we’ve highlighted) and risk that failure to address social care workforce issues would turn ripple of knock-on effects into a “tsunami”. Good to see call for further discharge funding, noting role of VCSE here. Text from State of Care foreword: “The alternative is thatText from State of Care foreword: “Increased stability in
4/15 Glad to see this in #StateOfCare about need for new ways of working to enable the right focus on and care for people with multiple conditions. A major focus of @RichmondGroup14 work and a big inequalities issue, as our #YouOnlyHadToAsk report shows: richmondgroupofcharities.org.uk/taskforce-mult… Text from State of Care foreword: “Ultimately, however, ne
5/15 Important theme in #StateOfCare about need to balance benefits of remote care with focus on those for whom it doesn’t work so well. @RichmondGroup14 @BritainThinks research has shown how these needs also vary with the type of need on any occasion: richmondgroupofcharities.org.uk/news/new-resea… Section describing pros and cons of remote care.Section on innovation.
6/15 This bit of #StateOfCare needs to ring in the ears of ICS decision-makers. It can’t be remotely acceptable that “tackling inequalities was often not a main priority”. I know hearts and minds have been captured but systems need to follow the lead from @BolaOwolabi8 and *act*. Over the last year, we have been looking at how local system
7/15 Glad to see from this section of #StateOfCare how clearly @CareQualityComm has heard what we’ve said about the need to guard against political pressure focusing recovery efforts just on headline waiting list numbers to the exclusion of people’s needs for personalised care. Providers and representatives from the voluntary and communiText from pages 70 and 71 on recovery of services.
8/15 Strong focus in #StateOfCare on rising mental health need. These figures on how many more people needed support from @RichmondGroup14 member @Rethink_ paint a clear picture. This isn’t about the stresses everyone has felt. It’s a serious escalation of severe mental illness. Rising demand for mental health care. The impact of the pand
9/15 #StateOfCare rightly highlights huge pressures health and care staff have faced and what that implies for the future. National/ICS leaders must maintain focus on this and Govt must fund necessary workforce development. @RichmondGroup14 members keen to help relieve pressure. Workforce stress and burnout. Since our last State of Care r
10/15 The section in #StateOfCare looking at flexible responses to the pandemic paints an even starker picture of the breadth and depth of the continuing challenges than last year’s report did. We’re nowhere near normal, and @CareQualityComm has role in maintaining transparency. Text from start of section 2 of State of Care report - Flexi
11/15 Amidst the overwhelmingly gloomy picture #StateOfCare paints, @CareQualityComm has been careful to find examples of how people have done things well. I love this example of how consistent domiciliary care has supported someone with multiple conditions. Case study describing how consistent home care has supported
12/15 This example in #StateOfCare about how a GP practice maintained and improved the important proactive care that people with long-term and multiple conditions need shows that it can be done, even in extreme circumstances. Case study showing how a GP practice maintained patient revi
13/15 That example in #StateOfCare from Rishton and Great Harwood Surgery reminds me of the can-do attitude @padsbigsis and colleagues in Gateshead took to adapting @YearofCare approach: richmondgroupofcharities.org.uk/sites/default/…
14/15 @CareQualityComm sets out a clear to-do list for ICSs in #StateOfCare. New system oversight role presents a big opportunity to help systems get a grip on issues like the need to tackle inequalities and population health management by using a multiple conditions lens. Key points from section 4 - challenges for systems.
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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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