Sebastian Rees

🍻 | NEW REPORT: A quarter of employees feel pressured to drink at work events, and a third have called in sick afterwards. Alcohol consumption isn’t just a health issue — it’s a national economic and productivity problem.

Find out more here: www.ippr.org/articles/tak...

Hmmm think you might be forgetting the piece William Temple wrote about strategic commissioning…

Public finances are a state, demographic trends are awful, public expectations on healthcare are unrealistic but… ambient scribes!

Too hard…seek magic tech/ai solution instead.

Please leave party conferences alone. 😢

📻 Context is key. NHS league tables can be helpful, but must be looked at alongside more detailed breakdowns to help professionals improve their services. @sebrees1.bsky.social on BBC Radio 2

How useful are NHS league tables for patients? @sebrees1.bsky.social for BBC Radio 2 on the importance of speaking to those using the system to understand what matters to them 👇

Taken to heart: Inequalities in heart disease in Scotland | IPPR Fortunately, advances in research and treatment mean that many of us can continue to live long, healthy lives while managing heart and circulatory conditio

HEART OF THE MATTER: There are significant differences in both the risk factors for, and the prevalence of, heart and circulatory conditions between different areas of Scotland.

Read the analysis by @jamie-ohalloran.bsky.social and @sebrees1.bsky.social ⤵️

www.ippr.org/articles/tak...

No disagreement there. I think the cost savings on prevention tend to be overstated - we should see this as being more about value of investment and resource allocation then shifting costs!

On that measure, this plan is a real success 💪

Hats off to @cthomashealth.bsky.social, @sallywarren.bsky.social and many many more! Enjoy some well deserved rest!

Ends/

Lots of questions (rightly) about implementation – Government should be clear on 'what happens when' questions in planning guidance.

But the purpose of this plan is not to micromanage change from the centre but to provide the right framework for transformation going forward.

8/

Transforming the app, which 35 million people use is especially welcome.

Making the app a fully integrated front-door will put more power in the hands of patients, and I'm particularly pleased to see a focus on improving channels for patient communication and feedback.

7/

Others will be much better placed to comment on genomics and cutting-edge clinical innovation, but it’s great to see focus placed in the plan on using tech to free up staff time and get the basics right for patients.

That's where the biggest digital opportunities are!

6/

The development of integrated neighbourhood health centres will reduce the need for hospital visits and improve quality.

Prioritising areas with the lowest healthy life expectancy in rollout is a welcome sign that this government is serious about tackling inequalities.

5/

Realising the neighbourhood NHS: A new deal for primary care in England | IPPR The Institute for Public Policy Research (IPPR) is an independent charity working towards a fairer, greener, and more prosperous society.

The strategy on shifting care from hospital to communities draws very heavily on
@ippr.org work: tinyurl.com/344czv9v

Of course, this shift will take time, but the focus on changing workforce model, approach to contracting, and payment mechanisms is the right place to start.

4/

Central to that vision is bringing about a prevention revolution.

The plan’s focus on tackling obesity, a Beveridge-sized challenge is esp. welcome. In the long-run a similar level of ambition should be applied to other risk factors but this is the right place to start!

3/

There’s a huge amount to like in the plan and it’s great to see how much of it has drawn on thinking from my
@IPPR colleagues (past and present!)

The plan sets out the right vision to shift our entire health system from reactive, sickness care to health creation.

2/

Great to be on @bbcnewslive.bsky.social‬ this morning talking about the long awaited 10 Year Health Plan.

The details of an 168-page document will be pored over in the coming days, but a few quick thoughts below...

1/

Absolutely - my comment above mainly reflects the fact that 'digital integration' is often seen as a panacea which can help resolve the irresolvable...

Informational integration (particularly through digital) doing a lot of heavy lifting IMO...

Here's hoping! Though as always, conversations around the 'left shift' start and end with org. structures and financial mechanisms. As important as they are, they aren't the fundamental drivers of behavior in the system. Policy makers will have to get a lot more comfortable with discussing culture!

I suspect you disagree with the final recommendation! But any others?

Spending review leaves a greater need for clarity on healthcare priorities The notion that the health service has emerged as a “winner” from the chancellor’s spending review is a bit like congratulating someone who has just won back the face value of a scratch card. It certa...

The government has set the NHS’s budget for the next 3 years, now it needs to be realistic about its priorities - my comment piece in the BMJ:

www.bmj.com/content/389/...

And the internal political/cultural dynamics of the medical profession that shape supply induced demand also need reckoning with.

Thorny issue!

This is an excellent piece @sallygainsbury.bsky.social but I've also found some commentary glosses over the mechanisms by which patient expectation leads to additional cost...

Given huge information asymmetries that exist in healthcare, the role of clinicians in shaping expectations also important.

🩺 @sebrees1.bsky.social‬, Head of Health at IPPR, talks to @itvnews.bsky.social‬ about the improvements we can expect to see in NHS service after the #SpendingReview

[Posted first on the other place but may get more interesting engagement here!]

3⃣ How should resources be allocated *within* healthcare to improve quality?

Of course, the NHS needs a plan for productivity - this is better pitched as a discussion about value and optimal allocation of time.

But this won't shift the fundamental and unique dynamics of healthcare as a sector...

1⃣ Where does the obligation of the state to finance a sector whose demand may be infinite end?

2⃣ Given healthcare spending will continue to grow over time (though at a slower pace), how can we increase the value we derive from it?

It's not to do with the usual candidates (ageing, poor population health, 'inefficiency'), but by the advancement of medical knowledge and the relentless increase in the volume and intensity of clinical practice.

Being clear on that opens up more interesting discussions...