Charles Tallack

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What would it take for the government to fulfil its promise to halve the gap in healthy life expectancy across the country?

TLDR: improving health care won’t be enough on its own, govt urgently needs to reduce deprivation.

Full analysis here ⬇️⬇️

www.health.org.uk/features-and...

A puzzling BBC headline yesterday, following publication of the ONS inflation estimates.

Bread and cereals together account for only 1.8% of the CPI basket. Their price dropped by 2% between Dec and Jan, but the contribution to the fall in inflation is surely minimal?

Great analysis. It was also clear from the beginning it wouldn't work. Guy's and St Thomas's was the model for all this, but after starting the programme the trust's wait times fell slower than the national average and the theatre staff went on strike...

Excellent thread as the Health Foundation adds further evidence the government are not being entirely transparent with claims of reduced waiting lists

Fixing the NHS requires an honest appraisal of the challenges so we can allocate resources appropriately.

The gov really needs to do better

This is really fascinating. Reads like a detective story, offers striking insights into the numbers on waiting lists.

Thanks to @jamesillman.bsky.social at @hsj.co.uk for covering our analysis (£)
www.hsj.co.uk/quality-and-...

Our full analysis is here:
www.health.org.uk/features-and...

NHSE’s evaluation of the programme didn’t address this question. It focused on the programme's impact (good for press releases) but not the equally important question of how the impact was achieved (useful for learning/wider spread).

All of this raises the question of how the programme worked. On the face of it (comparing FF20 to other trusts), not by increasing throughput as intended but, instead, by increasing the removal of untreated patients from the waiting list, and reducing (unnecessary?) referrals.

Completed pathways grew by 0.3% in the FF20 trusts, compared to 3.7% elsewhere (12 times slower.)

Total removals from the waiting list did grow slightly faster because “unreported removals” (cases that shouldn’t be on the waiting list being taken off) grew much more quickly.

So far, so good. But how the programme worked is not at all clear. It aimed to reduce waiting lists by speeding up hospital processes so surgeons could do more. If this happened we’d expect to see completed pathways (people treated from the waiting list) growing more quickly. But we don’t…

The difference is unlikely to have arisen by chance: there’s a 1 in 20 chance that a random selection of trusts would give the same results or better. We can’t, however, tell to how much of the difference is down to the characteristics of the 20 areas, and how much down to the FF20 programme.

We found that in the year from Oct 24 to Oct 25 waiting lists in the FF20 (crack team) trusts fell by 5.7% compared to a fall of 1.3% elsewhere. This supports the headline claim.

Waiting lists cut 3 times faster in highest joblessness areas Waiting lists in 20 areas in England fall 3 times faster than the national average thanks to experts deployed by government to help supercharge NHS care.

On 14 January Wes Streeting said that waiting lists had fallen three times faster in 20 areas of the country where crack teams had been deployed. We’ve looked at this claim and have questions. 🧵
www.gov.uk/government/n...

It's an odd document. Usually you'd have an impact assessment with policy objectives, options and their costs and impacts - aligning with policy choices.

But the Impact Statement seems like it was produced retrospectively, justifying (not always very convincingly) the 10YHP policy choices.

The 10YHP made the bold, false & easily refutable claim that there's unequivocal evidence that shifting care to the community is cheaper.

The Impact Statement says their literature review found mixed impacts on costs.

Suggesting the literature review was undertaken after the 10YHP was finalised?

What explains the divergence between consumer confidence of the over- and under-50s? @faisalislam.bsky.social for BBC
www.bbc.co.uk/news/article...

DHSC published its impact statement for the 10 Year Health Plan this week (yes, that is 6 months after it published the plan)

It's more measured and clear-eyed than the original document and quite a contrast to some of the effusive optimism in the plan

Some of the things that caught my eye 👇

Footnote: it's not immediately obvious where the government's estimates come from but the 2 calories a day reduction is consistent with the previous government's assessment of the impact of advertising bans (option F).
assets.publishing.service.gov.uk/media/60d352...

All of this underlines the point that many obesity experts are making: the ban is a good first step but, without wider action on our food environment, will be insufficient to address the obesity challenge.
bsky.app/profile/heal...

The reduction of 7.2 billion calories is equivalent to around 6 cans of coke per child per year. Or, put another way, around 2 calories per child per day – around 0.15% of daily consumption.

To put those numbers into context, there are around 9m children aged 5-15, of whom around 1.5m are living with obesity. Reducing that by 20,000 is a reduction of less than 1.5%. That’s nowhere near the 50% reduction needed to halve childhood obesity (the aim of the 2018 childhood obesity strategy).

Landmark junk food ad ban to protect kids' health Children will be protected from exposure to junk food ads under new regulations, in a bid to tackle childhood obesity.

The government says its ban on junk food ads will reduce the number of children living with obesity by 20,000 and remove 7.2 billion calories from diets. These numbers show that the ban is a step in the right direction. But they also reveal that it's a very small step.
www.gov.uk/government/n...

Interesting - sounds a big collision is bound to happen one day; we just don't know when. What are the consequences of a collision?

Read more in our new analysis.
www.health.org.uk/reports-and-...

@healthfoundation.bsky.social

This isn't a problem amenable to short term fixes (like winter money for social care). A long-term, sustainable solution will involve investment in out-of-hospital capacity (social care and intermediate care), and in management for process improvement.

Only 7 of 103 hospital trusts improved between Jul-Sep 2024 and Jul-Sep 2025. How they achieved this is not clear from the observable data. They increased nursing staff by more than other trusts, but the answer is likely to involve in wider process improvement.

This rise is mainly due to an 8% increase in the percentage of patients delayed, which rose from 14% of all discharges to 15%.

But this opportunity is not being taken, despite delayed discharge being an enduring policy priority. Compared to last year, we entered this winter with 9% more beds (1000+) occupied by delayed patients. (Jul-Sep 25 compared to Jul-Set 24).

Long A&E waits are usually the result of a lack of free hospital beds. With 11% (13,000) beds, each day, occupied by patients who are "medically fit for discharge", reducing delayed discharges offers the opportunity to create more capacity without adding more beds.