National Health Executive Podcast

In Episode 34 of the National Health Executive podcast, we are joined by NHS England’s 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: “Whilst technically it [the pandemic] might be over in terms of the numbers, certainly from a Covid perspective, we’re very much still in maelstrom of the effects of it – particularly the backlog.“But it’s not just catching up on the elective work in terms of surgery, operations or appointments but it’s also a backlog of preventative and chronic disease management that I don’t think we were optimally able to provide during the lockdown.”Dr Inada-Kim went onto explain how he believes the health service needs a “sea change” 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 “ explosion of digital tech”.He also went on to note need for better “measurement” in terms of how the NHS benchmarks quality and safety of care against both itself and other health systems.“A lot of our initiatives appear to be focused around avoiding work – reducing activity, avoiding an admission, avoiding an attendance, reducing general practice appointments for instance – [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.” Hosted on Acast. See acast.com/privacy for more information.

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: “What 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 – they have 275,000 community health workers!”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. Hosted on Acast. See acast.com/privacy for more information.

In episode 32 of National Health Executive’s (NHE) Finger on the Pulse podcast, I was joined by Health Education England’s Chief Digital and Information Officer, James Freed, to discuss how he got into the healthcare industry, what the word ‘digital’ actually means for the NHS and why most digital initiatives fail.During the podcast, James said: “The biggest reason why digital projects fail – and 70% of them do – 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 they’ve always done [but] just using a digital tool instead. Which often adds more time, creates more harm and doesn’t realise in adding more value.”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 NHE’s Finger on the Pulse podcast with James Freed above. Hosted on Acast. See acast.com/privacy for more information.

For episode 31 of National Health Executive’s (NHE) Finger on the Pulse podcast, I was joined by University Hospitals Southampton NHS Foundation Trust’s 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: “As 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 there’s a lot of focus on nurses and junior doctors at the moment, however we’ve also got to remember that this is across the board – it’s all colleagues such as estates, facilities, IT etc. – that have received below inflation pay rates.”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 isn’t just inflationary.Listen to the full episode of NHE’s Finger on the Pulse podcast with David Jones above. Hosted on Acast. See acast.com/privacy for more information.

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. Hosted on Acast. See acast.com/privacy for more information.

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. CommunicationOne of the more notable things that was addressed during our discussion was the necessity of not just communication but effective communication – that doesn’t 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 NHS’s various regional bodies, Primary Care, the Royal Colleges, and sector providers, the healthcare industry has an opportunity to identify what ‘best practice’ is – or, at the very least, what best practice is not.This is one of the “key areas” being focused on by biopharmaceutical research and development experts AbbVie, according to its Head of Medical Affairs for Immunology, Rachael Millward.She said: “One of the key areas that we are trying to establish is how do we, as an organisation, partner better with the NHS?”Because it is only through that communication and collaboration with providers and stakeholders that the health sector can establish what best practice – 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 “significant” inroads were made into the lists housing the very longest waiters.Sue explained: “Some 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] – a whole range of things.”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 isn’t one thing that is going to solve everything; there is no panacea for patient backlog and treatment pathways – one size does not fit all.The answer: That word again – 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 – by empowering patients and seeing them more “as a partner”, 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. TechnologyGuidance 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: “It 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.”It was then flagged how a lot of “myth busting” needs to be done around PIFUs and how some staff’s notion that they would be overwhelmed by an avalanche of triggered appointments isn’t actually true – or doesn’t necessarily need to be true.As long as you have the right technological infrastructure in place, implementing successful, effective, and efficient PIFUs is “not that difficult to do,” according to Sue.Sue explained: “There 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.”Sue added: “For me, this is about confident patients, clinical leadership, and being really respectful that not one model fits all.”In support of that mantra, Sue’s 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: “It 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.” Final thoughtsRachael Millward·         There isn’t one thing that is going to solve everything – 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. Hosted on Acast. See acast.com/privacy for more information.

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. Hosted on Acast. See acast.com/privacy for more information.

On Episode 26 of NHE's Finger on the Pulse podcast, host Matt Roberts is joined by Jon Constantine-Smith, Managing Director of Bluetree Medical, to discuss how the organisation adapted it's manufacturing line to produce face masks for the NHS, and why it has now become a long-term direction for the business. Hosted on Acast. See acast.com/privacy for more information.

On episode 25 of NHE's Finger on the Pulse podcast our host Saskia Hicking spoke to Anne Cooper, former Chief Nurse for NHS Digital about the benefits and drawbacks of implementing technology and digital within the NHS. Hosted on Acast. See acast.com/privacy for more information.