Afleveringen
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In Episode 46 of the National Health Executive podcast, we were joined by Trish Greenhalgh, who is a professor of primary care health sciences at the University of Oxford, as well as a former GP.
Trish offered insight into how the primary care digital transformation journey is going, specifically since the explosion of innovation observed following the pandemic.
Trish highlighted some of the recent research she has been doing in general practices looking at digitalised aspects of care that have in fact impacted disadvantaged people negatively, widening already existing health inequalities.
âThe pandemic was a pretty big shock,â said Trish when explaining some of the theory around external shocks speeding up the innovation process.
She added: âWe had to immediately, or in the space of a fortnight-three weeks, shift general practice from a face-to-face model to a remote model and I think it is one of the major achievements of general practice in this country that we did that â we did it really quickly and we did it effectively.
âWe responded to the shock, and then the question is, âWell hang on a minute, what do we do now?ââ
Listen in full to learn more about government priorities, co-design and more.
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For episode 45 of the National Health Executive podcast, we were joined by Nathalie Kingston, who is the director the National Institute for Health and Care Research BioResource.
Nathalie explained everything from the inner workings of the BioResource and the UKâs research ecosystem, all the way to women in science and the NIHRâs inclusion strategy.
On three things to remember, she said: âMake sure to listen to members of the public â their views are key. Also make sure we donât lose sight of the fact we are safeguarding public data.â
To hear all of Nathalieâs insight, listen to the full podcast
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Zijn er afleveringen die ontbreken?
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For episode 44 of the National Health Executive podcast, we were joined by Tom Bell, who has held management roles in the public, private and third sector â working specifically with the NHS in digital, telehealth and now as a patient safety partner.
Tom offered his insight into what patient safety actually means for the NHS, the make-up of the NHS when it comes to patient safety, how data can factor into decision-making, and what the future could/should look like.
âThe lack of data in the NHS is criminal â if I wind you back through the mists of time, when I worked for Carlsberg at the turn of the century, we had access to lots of data about lots of things,â explained Tom.
He continued: âI could sit at my desk and download, in almost real time, whoâd bought what, which accounts were up, which accounts were down, which were in profit etc. â that data was there. That was a company, albeit a large company and very well-run company, that was selling sugary alcoholic liquidâŠ
âWhen I came into the NHS a number of years later, I remember saying to my director of strategy, âWhereâs the dashboard I can access?â and he looked at me as if I was speaking Swahili.â
Listen to the full podcast to learn more about the possibilities for the NHS.
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For episode 43 of the National Health Executive podcast, we were joined by Dr Penny Kechagioglou, who is a Consultant Clinical Oncologist at University Hospitals Coventry and Warwickshire NHS Trust. Penny spoke about the main challenges and opportunities in cancer care at the moment, as well as how should prevention factor in to policy decisions and the needs of the oncology workforce.
Penny said: âHow do we strive for excellence? Not just good. There are three points here, so looking upstream â there is a lot of work happening that needs to be consistent across primary and secondary care, when it comes to prevention.â
Listen to the full episode to hear Pennyâs thoughts and get a sneak peek of National Health Executiveâs upcoming digital magazine, where Penny will detail the Charter for Oncology.
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In episode 42 of the National Health Executive podcast we were joined by Steve Gulati who is an associate professor at the University of Birmingham as well as director of healthcare leadership at the universityâs Health Services Management Centre.
During the podcast, we discussed the difference between leadership when he first joined the NHS in the 90s and to now, plus the main levers for these changes. Steve also highlighted the âwell-known truthsâ about NHS leadership which are seldom voiced as well as what changes he would like to see in the future.
âLeadership in those days was almost synonymous with management â it certainly wasnât [like] the nuanced distinctions that you get today,â said Steve. âAllied to that, there was a concept that was more prominent of what I would call âstewardshipâ rather than leadership.â
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In episode 41 of the National Health Executive podcast, we were joined by Dr Angela Smith, research fellow at Bournemouth University, and Andy Oakey, research fellow at the University of Southampton, to discuss the viability of drones within the NHS transport system.
Angela and Andy talked about some of the misinformation about drones and suggested that drone travel is not quite ready for the NHS yet.
Angela said: âThe eDrone project has been focused on NHS case studies, but what we have found is that the reporting around these case studies â the trials in particular â has led to some misconceptions about what the trials are achieving and the future benefits of drones.â
Andy explained: âIf you actually look back at our project bids, we were sucked into this rhetoric of drones being the next big thing. The original idea was to look at whereâs best to use them [drones], with a positive spin, but as we have gone into it we have learnt more and understood how there is a lot more than meets the eye.â
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In episode 40 of the National Health Executive podcast, we were joined by Lee Carpenter, who is the head of the Medicines and Healthcare products Regulatory Agencyâs UK Stem Cell Bank (UKSCB).
During the podcast, Lee explained what the UK Stem Cell Bank is and the significance of its work, what its future holds and some of the opportunities in the world of stem cell research.
Speaking on how big a role automation will play in the future of the stem cell field, Lee said: âI think it is going to be fairly critical. We can see the manufacturing of stem cells is hugely labour-intensive, it is expensive too.â
Lee goes onto explain how automation can widen patient access and eliminate human errors. Listen to the full podcast to hear more of Leeâs thoughts on the future of stem cells.
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In episode 39 of the National Health Executive podcast, we were joined by Anthony Painter, who is the director of policy at the Chartered Management Institute (CMI), to discuss all things management within the UK health sector and NHS.
During the podcast, Anthony shared some of the recent research CMI conducted in partnership with the Social Market Foundation, which centred around the state of management and leadership within the NHS.
Anthony said: âOne thing that was found [in the report] was that 27% of managers in the NHS think that the leadership in their organisation is not effective.
This is obviously very worrying, according to Anthony â especially because âresearch shows that, if you have above average leadership and management in your organisation, youâre far more likely, or three times more likely, to be a highly performing NHS organisation than if you have a less than average levelâ.
Anthony also discusses some of the calls for regulation of managers within the NHS, what makes a good NHS manager, and how senior leaders can go about recruiting the right way.
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In episode 38 of the National Health Executive podcast, we were joined by divisional director at Rental+, Jon Steward, to discuss one of the foundational elements of any good health setting.
Rental+ offers the NHS cutting-edge foodservice and refrigeration equipment using a unique rental model.
Elaborating on the differences between this model and a typical procurement process, Jon explained: âFirst of all you just pay a monthly fee for the equipment; second of all, it is inclusive of service and maintenance â this is why the NHS loves this solution, because it reduces their capital outlay and gives them a fixed cost.â
This gives senior health leaders the peace of mind that sudden or hidden expenditures wonât wreak havoc with pre-determined budgets. A third point is that Rental+ guarantee the equipment will be working all the time.
Jon went onto say: âFor healthcare executives considering Rental+, my key advice would be to view this as, not just a service, but as a partnership. Weâve worked with the NHS for so long â weâre not just a solution provider, weâre an extension of the trusts that we work with.â
Listen to the full podcast episode to hear more about how the NHS can benefit.
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In episode 37 of the National Health Executive podcast, we were joined by the former chair of the National Institute for Health and Car Excellence, Sir David Haslam, to discuss the current state of the NHS and whether it needs to be rebooted.
During the podcast, David discussed the piece he and David Pendleton, professor of leadership at Henley Business School, authored for the National Health Executive magazine, where he argues that the UK health sector needs to focus its financial support on bolstering primary care and community care on the one side, and social care on the other.
David said: âWe came up with this vision: if you think of the health system like a bookshelf, youâve got the hospitals as the big books on the shelf, but if your bookends arenât working effectively then everything tumbles down. And the bookends at one end are primary care; the other end is social care.
âIf both of those arenât supported then the whole system is going to fall apart.â
Listen to the full podcast to hear Davidâs thoughts on prevention, the UKâs health spending and more about how leaders can rebalance the NHS for the future.
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In episode 36 of the National Health Executive podcast, we were joined by Omnicellâs UK professional services director, Ed Platt, to discuss interoperability in the NHS, practical examples of where it can be leveraged best, the importance of the health service's digital transformation journey and more.
During the podcast, Ed discussed Omnicellâs provenance and how the mismanagement of medical supplies led to the companyâs founding in 1992, which, to this day, galvanises them to continuously deliver innovations that help improve the standard of care in hospitals.
When asked about how Omnicell started, Ed explained: âThat story is about our CEO, Randall Lipps⊠he was in hospital, his daughter was being treated and he was stood there and noticed that the clinicians were looking for the products â I think catheters and some other items â but they couldnât find them.
âHe then went off to his garage and started developing the first automated dispensing cabinet, brought that to market in 1992 and now we have over 2000 systems in the UK.
âThat story, that observation, still stands true today.â
To listen to more about Omnicell's founding principles, how they are already helping the NHS and how they can further support the UK health sector, listen to the full podcast above. -
In episode 35 of the National Health Executive podcast, we were joined by Professor Durka Dougall who is the chair of The Health Creation Alliance and Dr Andy Knox who is Associate Medical Director at Lancashire and South Cumbria Integrated Care Board.
In the episode we spoke about population health, population health management, public health, health inequalities and everything in between. We also went into how all of the aforementioned phrases factor into combatting health inequalities.
The podcast explores how both guests first entered this particular part of the health sector and their passion behind it.
Dr Knox discusses the epiphany he had while working as a GP that allowed him to think differently and enter a role leadership role where he helped engage local communities in thinking more about their own health.
Prof Dougall also discusses her exasperation at the lack of progress on the health inequalities front despite widespread acknowledgement of the presence of avoidable issues.
Listen to the full podcast for more.
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In Episode 34 of the National Health Executive podcast, we are joined by NHS Englandâs national clinical director for infection, antimicrobial resistance and deterioration, Dr Matt Inada-Kim, to discuss whether the pandemic is really over, how the NHS has learnt from Covid-19 and what the NHS needs to do to prepare for the next global health incident.
Dr Inada-Kim said: âWhilst technically it [the pandemic] might be over in terms of the numbers, certainly from a Covid perspective, weâre very much still in maelstrom of the effects of it â particularly the backlog.
âBut itâs not just catching up on the elective work in terms of surgery, operations or appointments but itâs also a backlog of preventative and chronic disease management that I donât think we were optimally able to provide during the lockdown.â
Dr Inada-Kim went onto explain how he believes the health service needs a âsea changeâ to ensure patients are cared for in the right place and not just the most convenient one as well as highlighting the need to make use of industry partnerships to further accelerate the â explosion of digital techâ.
He also went on to note need for better âmeasurementâ in terms of how the NHS benchmarks quality and safety of care against both itself and other health systems.
âA lot of our initiatives appear to be focused around avoiding work â reducing activity, avoiding an admission, avoiding an attendance, reducing general practice appointments for instance â [but] we also need, with 50% of our energy, to be focusing on quality of care, the safety of care [and] ensuring outcomes for patients remain at the very forefront of everything we do.â
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In Episode 33 of the National Health Executive (NHE) podcast, we spoke to Dr Matt Harris who is a clinical senior lecturer in public health at Imperial College London and Dr Nav Chana who is the former chair of the National Association of Primary Care.
They told us about a scheme imported from Brazil that uses community health workers to increase NHS health checks, enhance cancer screening numbers and drive immunisation.
Dr Harris said: âWhat was interesting about the way in which they [Brazil] deployed their community health workers was that there was a very efficient and effective system that has scaled nationally and is actually the biggest publicly-provided, taxpayer-funded, free-at-the-point-of-use primary care system in the world now â they have 275,000 community health workers!â
Dr Harris went onto explain what was so unique about the way Brazil uses their community health workers citing their intimate knowledge of their community, how they are paid full time and the catchment areas they are responsible for.
Dr Harris and Dr Chana then explained the attitudes around learning from countries like Brazil and how they need to change.
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In episode 32 of National Health Executiveâs (NHE) Finger on the Pulse podcast, I was joined by Health Education Englandâs Chief Digital and Information Officer, James Freed, to discuss how he got into the healthcare industry, what the word âdigitalâ actually means for the NHS and why most digital initiatives fail.
During the podcast, James said: âThe biggest reason why digital projects fail â and 70% of them do â is [because of] cultural issues. And the biggest cultural issue is the breakdown between different siloes and this most often manifests when you give someone a really nice piece of kit and they do their job theyâve always done [but] just using a digital tool instead. Which often adds more time, creates more harm and doesnât realise in adding more value.â
In addition to more commentary on the topic of digital, James notes how the NHS has created a governance process where it is not ok to fail, meaning everything assumes success. James believes a change of direction is needed on this front and that we need to establish governance routes that assume and allow for failure as long as it is caught quickly.
Listen to full episode of NHEâs Finger on the Pulse podcast with James Freed above.
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For episode 31 of National Health Executiveâs (NHE) Finger on the Pulse podcast, I was joined by University Hospitals Southampton NHS Foundation Trustâs Director of Estates, Facilities and Capital Development, David Jones, to discuss everything from the ongoing industrial action, funding, some of the research he is doing and his three wishes for the NHS.
David said: âAs a manager, I obviously uphold the right of people to strike and, on this occasion, I fully understand and appreciate why the NHS is currently striking. I know that thereâs a lot of focus on nurses and junior doctors at the moment, however weâve also got to remember that this is across the board â itâs all colleagues such as estates, facilities, IT etc. â that have received below inflation pay rates.â
To make the NHS a more attractive employer, David believes the health service needs to be more flexible in how it renumerates its staff, especially against the backdrop of the private sector. He also thinks the NHS should improve the way people move through the various pay grades, drawing specific attention to how some managers have to wait nearly five years to get a pay rise that isnât just inflationary.
Listen to the full episode of NHEâs Finger on the Pulse podcast with David Jones above.
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On Episode 30 of National Health Executive's (NHE) Finger of the Pulse podcast, our host Louis Morris is joined by the Royal College of Emergency Medicine's President, Adrian Boyle, to discuss what the actual problem with patient waiting times is.
Adrian explained: "The problem we've got is we're not able to look after people properly, who come into type 1 Emergency Departments and get stuck on trollies for long periods of time. This means that then the Ambulance Service isn't able to offload them and we're seeing this all over the press at the moment.
"When we say 'Demand management is not the problem' that's true because the big problem is actually the flow [of patients] through the Emergency Departments and that's because we just don't have enough beds in our hospitals and we don't use our beds as efficiently as we could.
"[Bed blocking] is the single biggest part of this [patient waiting times] problem. In December, we recorded almost the very highest level of hospital bed occupancy that we've ever seen."
Adrian believes that encouraging people to just make better choices about what they do or launching public health campaigns to stop people from going to Emergency Departments won't fix the problem.
"We need to try and introduce the concept of different queues..."
Listen to the full episode of NHE's Finger on the Pulse podcast with Adrian Boyle above.
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With the brunt of winter fast upon us, and the flurry of increased demand that has followed, the NHS is drawing upon all its nous and creativity to see how it can generate efficiencies and optimise patient pathways.
With that in mind, National Health Executive sat down with three leading industry voices to discuss how we can arrest the backlog and keep patients flowing in and out of the door this winter.
Communication
One of the more notable things that was addressed during our discussion was the necessity of not just communication but effective communication â that doesnât just apply to patients either, it also includes colleagues and sector partners too.
Sue Moore, the Director for Outpatient Recovery and Transformation at NHS England suggested that by collaborating with the NHSâs various regional bodies, Primary Care, the Royal Colleges, and sector providers, the healthcare industry has an opportunity to identify what âbest practiceâ is â or, at the very least, what best practice is not.
This is one of the âkey areasâ being focused on by biopharmaceutical research and development experts AbbVie, according to its Head of Medical Affairs for Immunology, Rachael Millward.
She said: âOne of the key areas that we are trying to establish is how do we, as an organisation, partner better with the NHS?â
Because it is only through that communication and collaboration with providers and stakeholders that the health sector can establish what best practice â the best practice that will help serve the seven million people who are currently waiting for treatment.
One of the best examples that was mentioned was Super September, where providers are given the chance to trial small initiatives and ideas that might help expedite treatment pathways.
What Sue and her colleagues at NHS England found was that, during the two-week period in which the Super September scheme ran, over 66,000 more patients were seen and âsignificantâ inroads were made into the lists housing the very longest waiters.
Sue explained: âSome people did some work on Did Not Attends, some people did work on the validation of lists and asking patients if they still wanted or needed that appointment, there was work on looking at how clinics are constructed and the templates [they used] â a whole range of things.â
But the question is, how do we take initiatives like Super September and scale them up? How do we ensure the best and most effective methods are adopted nationally? Because as is said a lot in this industry, and indeed many times during our discussion, there isnât one thing that is going to solve everything; there is no panacea for patient backlog and treatment pathways â one size does not fit all.
The answer: That word again â communication.
One of the first things Sue noted on the podcast was what the Outpatient and Recovery Programme is focusing on. Two of those things were ensuring that patients see the value of even going to an appointment in the first place and the other centred around exploring and developing the idea of creating clinical environments where patients, who are medically suitable, can initiate their own follow-up appointments. Or in other words a patient-initiated follow-up (PIFU).
The key to achieving success in both those areas goes hand-in-hand â by empowering patients and seeing them more âas a partnerâ, as Rob Music the CEO of The Migraine Trust alluded to, the health sector can help patients see the value of appointments and give them more ownership over their care.
By doing this, and providing patients with the requisite education around the relevant diseases, clinicians can help the public optimise their own treatment pathways and reduce delays and waiting times.
Technology
Guidance around how best to implement PIFUs was released by NHS England back in May 2022; the document detailed everything from how many specialities to start up with and what specialities are even suitable, all the way to the benefits and potential pitfalls of this method of care.
This is also something AbbVie have been able to help other providers with. Rachael explained that when they collaborated with some rheumatology services and explored the potential of PIFUs, a lot of services said they still needed help developing and then establishing their PIFUs.
She said: âIt became very clear to us that we needed to help services connect together, so that they could understand what the pitfalls are, what the hurdles are, and what are the things you need to consider in order to set up a PIFU service that would be successful, whilst also mitigating some of the challenges.â
It was then flagged how a lot of âmyth bustingâ needs to be done around PIFUs and how some staffâs notion that they would be overwhelmed by an avalanche of triggered appointments isnât actually true â or doesnât necessarily need to be true.
As long as you have the right technological infrastructure in place, implementing successful, effective, and efficient PIFUs is ânot that difficult to do,â according to Sue.
Sue explained: âThere needs to be a really effective tracking mechanism to enable patients to trigger an appointment, if they meet the criteria. But similarly for the clinical team to know that a patient has triggered an appointment.â
Sue added: âFor me, this is about confident patients, clinical leadership, and being really respectful that not one model fits all.â
In support of that mantra, Sueâs Outpatient Recovery and Transformation Programme worked in conjunction with the Getting It Right First Time team to produce outpatient guidance for the top 10 by-volume specialties that identifies, by subspecialty, which people would be suitable for PIFUs and which people would not.
Sue commented: âIt collates all the best practice guidance of really where you start, and what we've said on an individual basis is we're very happy to support and make the connections for people to do that.â
Final thoughts
Rachael Millward
· There isnât one thing that is going to solve everything â it will be a range of different factors and measures that combine to achieve the desired outcome.
· But we also need to be clear on what those desired outcomes are and understanding that patients present in very complex ways.
· PIFU and education around things like remote monitoring will be a key part of that solution.
Sue Moore
· Providers need look at the entire pathway when exploring innovations and they need to employ an enthusiastic approach and drive themselves forward to implement the necessary change.
· Communicate, collaborate, and congratulate.
· Use technology for the right reasons and when it is necessary, rather than for the sake of it.
Rob Music
· More people need to be trained as specialist GPs and nurses, drawing upon some of the best practice in the community.
· Better leadership from ICSs in terms of their service design and how patients interact and ...
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In this episode of NHE's Finger on the Pulse podcast our host, Saskia Hicking, speaks with Dr Giles Yeo,a Geneticist at Cambridge University and Dr Stephanie De Giorgio, a General Practitioner, about the stigmas that surround obesity and why we as a society suffer, not only physically, but also mentally with the affects of being overweight. Whilst our guests look to help raise awareness and educate health professionals on how to correctly treat and talk to obese patients, we delve into the solutions our healthcare system could adopt to abolish obesity stigma.
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In this episode of Finger on the Pulse, NHE's Saskia Hicking spoke to Alex Church, programme lead at Norfolk and Waveney CCG about some of the ways his group are preparing for the introduction of the ICS and how he thinks this new way of working combined with digital technology will help to create a better care system for all.
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