Episode 14 Dr Charlotte Refsum - Tony Blair Institute
Niall Dickson CBE and Roy Lilley with their latest guest Dr Charlotte Refsum In their latest In The Loop podcast Niall and Roy lock horns with Dr Charlotte Refsum Director of Health Policy at the Tony Blair Institute. In a frank discussion Charlotte a former GP, reveals how the former Prime Minister is still closely involved in policy development and she lays out the stark choices facing the NHS if it is to survive in the face of the enormous challenges it currently faces. Charlotte is a former GP who has specialised in health policy. She worked for the consultancy firm KMPG and has been involved in supporting change in 25 countries. She contributed to the government’s NHS plan and has worked with Sir Patrick Vallance and Sir John Bell on technology and how the arrival of the AI era will transform health and care.In the podcast Charlotte defends the Institute’s links with big tech companies and non- democratic governments and insists she and her colleagues have editorial independence and have never felt under any pressure to write anything or hold a view because of those relationships or funding. What follows is a frank assessment of the current government’s strategy but hard questions about what will be needed to implement the changes needed and whether the absolute priority, which concentrates so much of its resources on older people with long term conditions, is justified. Charlotte suggests the current budget may be all we can afford, and in her view the NHS needs to find ways of living within its means. That will involve thinking like an insurer, assessing future risks and taking prevention much more seriously. And there is also talk of copayments for some new treatments for those who can afford it and the need for the NHS to start decommissioning some services if it is to embrace the technological revolution that is underway. And she suggests we need a revolution in primary care. As for the professions, she suggests the impact on doctors and others is uncertain but will be profound. One of the changes she identifies is how new technology will continue to undermine the asymmetry of information that underpins the professions and how it will become easier and cheaper for people to seek advice from elsewhere. But she adds, that does not mean a dystopian future where we send out someone with an NVQ and an iPad to get and manage complex cases! Send us a text
--------
36:11
--------
36:11
Episode 13 Rob Webster CBE
Niall Dickson CBE and Roy Lilley with their latest guest Rob Webster CBE For this next edition of In The Loop podcast Niall and Roy come together with Rob Webster one of the most prominent NHS managers and a huge advocate of integration. Rob heads up the West Yorkshire and Harrogate Health and Care Partnership an integrated care system. And like every other system in the country he is grappling with a huge financial challenge, a big reorganisation, redundancies and staff threatening industrial action. So how is he managing as he faces a 45% reduction is his workforce and key staff in an angry mood? Rob reveals this is the most frustrating period in his 36 year career with enormous pressure on everyone and he admits it is causing harm to his staff. But he insists it will not distract from the work. While he acknowledges the difficult financial position, he says the transition is incredibly difficult, supports the aims of the reorganisation and believes that close working relationships between health, local authorities and the third sector can and will deliver meaningful change. He says the NHS must put its people first and argues that staff have quite rightly become dissatisfied and that the job of NHS leaders is to do something about this. He notes how painful it has been to see the attrition of standards over the past fifteen years but suggests this can be a period where the NHS has to recover and transform services.Niall and Roy remain concerned about what can be achieved given all the headwinds but here again is a leader who says they can make progress.This podcast was recorded before the government announced the go-ahead for widespread redundancies in ICBs and NHSE. Speaking at a Providers conference on 12th November the Secretary of State said; ‘...Funding arrangements [for voluntary redundancies] have been agreed with HM Treasury and will be from within the existing funding settlement. We will not be cutting any investment to the NHS frontline. Further detail will come forward in the coming weeks.’It is widely anticipated that NHS organisations will be permitted to overspend budgets in the current year and the amounts reclaimed over subsequent years through efficiency savings. Send us a text
--------
40:40
--------
40:40
Episode 12 Sarah Woolnough
In their latest podcast Niall and Roy engage with Sarah Woolnough the Chief Executive of The King’s Fund, one of the country’s leading health think tanks. In a frank discussion, Sarah defends the role of think tanks and laments the government’s failure to embrace public health and prevention in its first year in office. She is highly critical too of the decision to kick the social care can down the road and says the Fund is now exploring radically different ways it could be funded, including social insurance.She is no fan either of the current reorganisation, arguing that she would have done it differently and quoting NHS leaders warning that it is already a major distraction. And she calls on the government to be honest about what it can and cannot be achieve within current funding constraints.Sarah reveals one of the most powerful moments she has had since joining the Fund: listening to leaders revealing the moral injury they have felt for not being totally transparent about their financial position for fear of being placed under greater performance scrutiny. And while she wishes pharmaceutical bosses better understood NHS funding challenges she understands their ‘immense frustration and anger’ because they feel the government has led them up the garden path.Send us a text
--------
45:34
--------
45:34
Sir Jim Mackey, chief executive NHS England
EXCLUSIVESir Jim Mackey, Chief Executive NHS England in conversation with Niall Dickson & Roy Lilley... in a frank interview Sir Jim talks about the difficulties he is facing and the fact taking on what he thought would be the job and how it's actually worked out, are two very different things!In this wide ranging conversation he accepts the pending redundancies are a cause for great concern and says that he does not anticipate any compulsory redundancies although the time scales are still uncertain.Managing the complexity of reorganisation, the pressures to deliver waiting lists and the Ten Year Plan are all on his 'to-do-list'.Listen to how he prioritises and how he sees the future.Send us a text
--------
45:07
--------
45:07
Episode 10 - Claire Murdoch
In their latest venture In the Loop, Niall and Roy turn to mental health and conduct the first interview with Claire Murdoch, NHS England’s outgoing mental health director since she dramatically resigned earlier this month after nearly ten years on the job. In the podcast, Claire says she quit because she felt she no longer had political support and reveals her dismay at the failure of the new government to maintain the share of NHS spend on mental health. In a strong defence of what has been achieved on her watch, including more than doubling the number of professional staff working in child and adolescent services, much improved access for young people, despite a huge increase in demand, and great progress on a nationwide roll out of mental health support in schools. Looking forward, she says the share of NHS spend has been phenomenally helpful and must be protected and that as far as she is concerned it was ‘job begun not job done’. But this discussion also reflects the reality of mental health care in England today with services desperately struggling to meet the explosion in demand and with patients of all ages unable to access the support and treatment they need.Send us a text
UK