Clearly heard the frustrations from some GPs when I posted three weeks ago on where the NHS is up to. New long🧵recognising and celebrating the central role that GPs and their teams play in the NHS in England. And some perspectives on the frustrations that I heard. 1/x. GPs/general practice are vital to the effective functioning of the NHS. They’re a key first point of contact to diagnose whether further care is needed and, if so, what care is required. They provide vital continuity of care for patients managing chronic long-term conditions. 2/x

Lots of comment on @NHSPracHealth support service. For clarity. @NHS England is committed to ensuring all NHS staff receive the mental health support they need. The vast majority of this provision is, and always has been, via their employer’s health and wellbeing schemes... 1/x ...There is no change to those services. Given the dispersed nature of Primary Care, the existing Practitioner Health service for doctors in Primary Care will continue as a single, NHS England commissioned, national service. 2/x

Latest British Social Attitudes Survey on public views of health and care published last week: . Data from Sept-Oct 2023, last Autumn. This has understandably triggered debate about where the NHS is up to. Some thoughts. New thread 🧵1/xnuffieldtrust.org.uk/research/publi… Good to see public commitment to underlying principles of NHS as strong as ever. 91% support for NHS being free of charge. 82% for NHS being primarily funded through taxation. And 82% for service being available to everyone. But overall satisfaction has fallen to 24%. 2/x

Proud to be @NHSEngland exec sponsor for @NHSMuslimNet. Completed my #NHSRamadanChallenge last Thursday – fasting (no food or liquid) between 0505 & 1933. I learnt a lot along the way which I thought it would be worth sharing in one of my tweet threads. New thread 🧵. 1/24 I’ve deliberately set out information on Ramadan first (about which I knew very little) and then shared my personal experience of the impact of fasting on me. Recognising that I only fasted for one day and fasting for a whole month over all of Ramadan is very different. 2/24

@UKHSA data today marks significant milestone. Since start of pandemic NHS has treated over one million hospital patients with COVID-19. Although we've returned, in many ways, to pre-pandemic ways of living and working, NHS still has major challenges from COVID. New🧵1/18 Firstly, on @mariecurieuk’s #DayOfReflection, I want to remember those who have lost loved relatives and friends over the course of the pandemic. Important we remember them appropriately. Particularly thinking of NHS staff who lost their life in line of duty. 2/18.

Polling out today from @IpsosUK & @HealthFdn shows an interesting picture. Concern about current pressures on NHS given record demand, but public’s commitment to the founding values of the service — almost 75 years on — are as strong as ever. 🧵 👇health.org.uk/publications/l… 1/13 Given huge pressure on services and the backlog built up over Covid, unsurprising that public confidence in NHS services in the short term has fallen. We have set out clearly how we will improve elective and urgent care. Plan to improve access to primary care next. 2/13

In 1948 the NHS was created as the world’s first universal healthcare system. The service has constantly adapted and changed ever since. To meet the changing needs of each new generation. To take full advantage of rapidly advancing changes in medical technology. 1/8 In 1958 the NHS delivered the first mass vaccination programme, with everyone under the age of 15 vaccinated against polio and diphtheria. In 1962 we performed the first full hip replacement and in 1972 the world’s first patient CT scan...2/8

What’s the impact of £500m and subsequent £250m to improve hospital discharge? Important to look beyond headline number of delayed discharges - only a top level indicator. Extra funding is buying extra capacity across country and NHS discharging patients into that capacity. 1/4 Issue is that hospital beds that are freed up are then being filled up with new patients, given scale of current pressure. This is keeping the top line number of blocked discharges high. Extra funding is therefore making a difference with positive impact...2/4

Great visit on Friday to the very impressive elective surgery hub at King George Hospital Ilford (bhrhospitals.nhs.uk/king-george-ho…), part of @BHRUT_NHS. New thread below on the things that most impressed or struck me, linked back to some important wider issues in the NHS. 1/24 Bit of background first. Vital NHS gets through planned care backlog as quickly as possible. NHS elective recovery plan, from Feb 2022, sets out how we will do this: bit.ly/3HCRyme. Elective surgery hubs form key part of plan (see attached extract from p34 of plan). 2/24

Interesting article on a proposal to significantly increase public spending on healthcare in Canada: bbc.co.uk/news/world-us-…. Five things that resonated strongly with me. 1. Promise of universal publicly funded healthcare central to the nation and its identity. 2. Canadian healthcare system facing significant challenge to recover from legacy of Covid. Care backlogs. Urgent care pressures leading to long waits that, in turn, are leading to worse patient outcomes. Similar story in many healthcare systems around the world.

It’s vital NHS makes best possible use of digital technology. To improve patient care and experience. To improve efficiency. To reduce error and unwarranted variation. There is a huge amount of work going on in the NHS to increase use of digital, much of it unheralded.....1/9 Today is the 18th anniversary of the NHS's electronic prescription service (digital.nhs.uk/services/elect…). Nearly 1 billion prescriptions were dispensed electronically in the last 12 months. Less than 1 in 20 are still paper-based. 11,400 pharmacies now signed up to the service. 2/9

One of the key strategic challenges facing NHS is how to transform models of care to meet the rapidly increasing demand for health and care as we live longer. Throughout its 74 year history, NHS has always adapted & transformed to meet needs of next generation. New thread 1/18 This excellent article, worth reading in full, shows how @NHSSomerset is rapidly developing new models of care: thetimes.co.uk/article/f4e641…. In the words of the article "Health leaders in Somerset recognise many traditional models of healthcare are not fit for the future". 2/18

Like many advanced western health systems (e.g. see here – bit.ly/3jfWDYr), NHS is currently under huge pressure, as we recover from the biggest global pandemic in a century. Significant pressures and care backlogs in a wide range of different areas. NEW THREAD 1/22 The NHS prepared more extensively for winter than ever before, creating thousands more beds, setting up 24/7 care control centres and respiratory hubs, rolling out falls services and ramping up virtual wards. That could not stop a ‘twindemic’ of Covid and flu...2/22

Thoughtful column from @jameskirkup in today's Times: thetimes.co.uk/article/who-ha… Don’t agree with all that’s written (e.g. the headline) and three important omissions. But he makes some important points on NHS and the future that are worth highlighting. New thread. 1/25 The NHS does not exist in isolation. Social care and public health policy both have a huge impact on how many people come through NHS front door and how many can be discharged promptly from its back door. All three are vital, inter-linked, and need to be tackled together. 2/25

Today’s NHS statistics show two things. 1. NHS staff working flat out to deliver best possible care amidst difficult challenges. 2. NHS under significant pressure, particularly urgent care, with intensive work to stabilise and improve services in train. New thread 1/25 Important to remember how much is being delivered due to commitment and professionalism of NHS staff. England has a population of around 56 million. Today the NHS expected to complete around 1.3 million appointments in General Practice, 40% same day, over 65% face to face…2/25

Good to join @rcgp for 70th anniversary dinner last night. Thanks to @martinrcgp for asking me to speak (see below). Our GP list based system, with GPs systematically taking responsibility for the health and wellbeing of a defined local community, is a key jewel in NHS crown 1/12 There are 56 million people in England. Every single working day, GP teams deliver 1.3 million appointments. Between 40 and 50% of those appointments are on the same day. But it’s not just how much GP teams do. It’s also the complexity of their work….2/12

1/25 NEW THREAD. Where's NHS up to? Flat out, doing its best for patients, as ever. But struggling with covid and impact of long term fault lines. Concerning pressure, despite front line effort. Sits alongside interview today with @thesundaytimes : bit.ly/3jIXNIy 2/25 At last week’s @NHSProviders Board, 20 experienced chairs & CEOs from all NHS geographies & sectors universally agreed this was longest and most sustained period of NHS pressure they had seen in their careers. Incredibly grateful, yet again, for commitment of staff but...

There’s been a lot of discussion this week on the potential future size of the NHS elective waiting list, the link to extra NHS investment and what are legitimate and realistic expectations of the NHS, given the context. A new thread from an NHS perspective. 1/24 Two quick starter points. This mustn’t just be about elective backlogs – the backlogs in mental health and community services are just as important and need focus and attention too. Trust leaders also very clear about need to clear backlogs as fast as possible…2/24

Lots of media today on NHS elective recovery plan. New thread on what NHS trusts need to tackle care backlogs across all services. Why elective plan is important but some details taking time to finalise. How much NHS is doing to tackle backlogs and prioritise this work. 1/25 Key starting place is, as ever, the patient. Despite trusts’ best efforts NHS now has record care backlogs due to covid disruption. NHS regularly reports, in detail, on surgical/cancer waits. But significant and important care backlogs in community and mental health too. 2/25

NEW, largely data led, thread for 8 Jan. @NHSProviders we particularly concentrate on the daily covid-19 hospital inpatient data: england.nhs.uk/statistics/sta…. It’s the key public, daily, up to date, source of relevant data on “what does hospital demand pressure look like?” 1/19 Lots of caveats. Only hospital data, when pressure is across whole health & care system. Just looks at covid caseload, which is only part of hospital pressure. Only national/regional level data - very aggregate, top level, data points. Only looks at demand side of equation…2/19

NEW thread 5 Jan. SUMMARY. NHS stretched like never before. London still showing lower hospitalisation growth. But growing concerns that the assumption the rest of country will match London pattern may be wrong. Also must recognise impact of pressure on patients & staff. 1/24 Thread covers today’s data (5 Jan '22) and important intel gathered in last 24 hours from CEOs outside London. Looks at how to best describe and calibrate NHS pressure. Also why we need to be open, clear and transparent on how serious current pressure is and its impact… 2/24