Neil Tester Profile picture
Oct 21, 2022 11 tweets 11 min read Read on X
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
4/10 Good section in #StateOfCare on the impact on people of waits for care, combining @IpsosUK research with 4,000 over-65s with @HealthwatchE insights into what this means for people. Many people are still waiting for the health and social careHealthwatch has conducted research on how NHS waiting lists
5/10 #StateOfCare highlights the impact of people having to wait for social care assessments. Good to see it drawing upon @ageukcampaigns @candsalliance work to demonstrate how this relates to unmet need. Waiting for social care In our survey of more than 4,000 peoDuring our urgent and emergency care reviews we saw that red
6/10 Important shift noted in #StateOfCare from people avoiding making GP appointments from fear of Covid or not wanting to burden the NHS. Now people who want appointments can’t get them. 1/3 people struggling to get appointments simply going without diagnosis or treatment. More people overall have been trying to make appointments th
7/10 Stark section in #StateOfCare on NHS #dentistry, making good use of @HealthwatchE insight. Highlights access challenge and pressure on people to go private on the same day as this @guardian piece on @TheBDA letter to @Jeremy_Hunt: theguardian.com/society/2022/o… There is distress for people who have not been able to get rOther issues included being deregistered as an NHS patient a
8/10 Important messages in #StateOfCare about need to collect and use data to identify and tackle race and other #inequalities. Echoes what @HWHertfordshire said locally in recommendations in this recent report on the experiences of Black and Asian people: healthwatchhertfordshire.co.uk/news/2022-09-2… The importance of data We know that robust and reliable infoThis is supported by the NHS Race and Observatory report Eth
9/10 #StateOfCare sets out how #PatientExperience, while fluctuating regionally, has declined overall since before the pandemic. Good to see @CareQualityComm planning to dig deeper into this. Patient experience across England, as measured by PEP Health
10/10 A final reflection on #StateOfCare: in the past few years, especially at the height of Covid, these reports described and championed community engagement and partnership with the voluntary sector. Notably absent this year. Maybe a function but also a driver of the gridlock?
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More from @NTtweeting

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
Feb 4, 2022
Thread 🧵
This from @CAM_Paddison @NuffieldTrust is one of the best things I’ve read in ages. 1/4
nuffieldtrust.org.uk/news-item/digi…
2/4 Local population data on people with multiple conditions could provide a useful proxy to generate the focus Charlotte writes about. Resonates with @RichmondGroup14 work in this webinar series: and this report: richmondgroupofcharities.org.uk/sites/default/…
3/4 Yes, workforce issues, but much boils down to how general practice frames its approach. This e.g. from @RichmondGroup14 update of Multiple Conditions Guidebook shows how @padsbigsis + colleagues continued Year of Care work virtually during pandemic: richmondgroupofcharities.org.uk/sites/default/… GIF about Gateshead case st...
Read 4 tweets

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