Alf Collins
@alfcollins.bsky.social
Doctor, patient advocate, Trustee Patients Association and Picker Institute. Person centred, high value care, esp. shared decision making and support for self management. Ex Health Foundation, NHS England. Rugby, family, good food, trying to stay alive.
I’ve learned today- again- that if you are an ‘expert’ in a consensus group and they don’t listen to you, don’t blame them. Blame yourself for not articulating your case clearly enough.
November 25, 2025 at 7:55 PM
I’ve learned today- again- that if you are an ‘expert’ in a consensus group and they don’t listen to you, don’t blame them. Blame yourself for not articulating your case clearly enough.
Reposted by Alf Collins
On the Expressions of Sheep
November 25, 2025 at 7:25 PM
On the Expressions of Sheep
Wow. This should be headline news. But guess what, it’s not (on the BBC).
I wish I didn’t have to share this. But the BBC has decided to censor my first Reith Lecture.
They deleted the line in which I describe Donald Trump as “the most openly corrupt president in American history.” /1
They deleted the line in which I describe Donald Trump as “the most openly corrupt president in American history.” /1
November 25, 2025 at 12:26 PM
Wow. This should be headline news. But guess what, it’s not (on the BBC).
I’ve said it before and I’ll say it again (and again and again…). An integrated team is necessary but not sufficient to deliver coordinated care- let alone care that aligns with patient goals and priorities, minimises the burden of treatment and enables people to live well.
What is the neighbourhood health service?
Ruth Rankine, the director of our Primary Care Network, spoke to BBC Politics London to set it out.
🟡With the NHS, but not just the NHS
🟡Delivering more joined-up care
🟡A new kind of relationship between services and communities.
Ruth Rankine, the director of our Primary Care Network, spoke to BBC Politics London to set it out.
🟡With the NHS, but not just the NHS
🟡Delivering more joined-up care
🟡A new kind of relationship between services and communities.
November 23, 2025 at 8:04 PM
I’ve said it before and I’ll say it again (and again and again…). An integrated team is necessary but not sufficient to deliver coordinated care- let alone care that aligns with patient goals and priorities, minimises the burden of treatment and enables people to live well.
Paid my tax today and reflecting on how well the money is spent. Answer re: NHS is poorly. At least 20% of NHS spend is waste: over diagnosis and over treatment, low value treatments and processes, provider capture of the market, unwarranted variation. Did anyone spot any of this in the 10YP?
November 20, 2025 at 9:50 PM
Paid my tax today and reflecting on how well the money is spent. Answer re: NHS is poorly. At least 20% of NHS spend is waste: over diagnosis and over treatment, low value treatments and processes, provider capture of the market, unwarranted variation. Did anyone spot any of this in the 10YP?
Reposted by Alf Collins
This is why it is very important to design targets very carefully so they align with the goals you want to achieve.
November 20, 2025 at 1:35 PM
This is why it is very important to design targets very carefully so they align with the goals you want to achieve.
Reposted by Alf Collins
LinkedIn is all very well but shouldn’t there also be CheckedOut for retired folk like me?
November 19, 2025 at 5:41 PM
LinkedIn is all very well but shouldn’t there also be CheckedOut for retired folk like me?
Could I propose that ‘Reimagining medicine’ is not going to help?
Public health and medicine have extended lives and got us into the situation we are in. But medicine itself is not going to get us out of the NHS crisis.
We need to fundamentally rethink healthcare and what it is to be healthy..
Public health and medicine have extended lives and got us into the situation we are in. But medicine itself is not going to get us out of the NHS crisis.
We need to fundamentally rethink healthcare and what it is to be healthy..
Better use of technology, the transition from analogue to digital, and greater innovation are at the heart of the NHS 10 Year Health Plan.
But what are the potential benefits - and risks?
Watch or listen to our event 📺🎧 www.instituteforgovernment.org.uk/event/nhs-te...
But what are the potential benefits - and risks?
Watch or listen to our event 📺🎧 www.instituteforgovernment.org.uk/event/nhs-te...
November 19, 2025 at 1:01 PM
Could I propose that ‘Reimagining medicine’ is not going to help?
Public health and medicine have extended lives and got us into the situation we are in. But medicine itself is not going to get us out of the NHS crisis.
We need to fundamentally rethink healthcare and what it is to be healthy..
Public health and medicine have extended lives and got us into the situation we are in. But medicine itself is not going to get us out of the NHS crisis.
We need to fundamentally rethink healthcare and what it is to be healthy..
I visited Kaiser Permanente in SanFran about 20 years ago. Their mantra ‘every unscheduled admission is a system failure’ had face validity and led to a massive and long lasting impact here.
Yet we’ve never quite solved the problem. It’s high time we dropped the idea as a marker of system quality.
Yet we’ve never quite solved the problem. It’s high time we dropped the idea as a marker of system quality.
November 19, 2025 at 9:27 AM
I visited Kaiser Permanente in SanFran about 20 years ago. Their mantra ‘every unscheduled admission is a system failure’ had face validity and led to a massive and long lasting impact here.
Yet we’ve never quite solved the problem. It’s high time we dropped the idea as a marker of system quality.
Yet we’ve never quite solved the problem. It’s high time we dropped the idea as a marker of system quality.
Having been involved in the roll out of social prescribing it’s good to see that there is indeed an impact. This team used sensible outcome measures and showed a small but definite change in multiple indicators.
Time to stop trying to answer daft questions about SP tho (eg reductions in admissions)
Time to stop trying to answer daft questions about SP tho (eg reductions in admissions)
ICYMI: A #mustread on #socialprescribing. First - at-scale - quant evaluation of effect in general practice i've seen. Small individual impacts, scaling significantly at population level. Congrats to @lukemunford.bsky.social and colleagues bjgp.org/content/earl...
Impact of the rollout of the national social prescribing link worker programme on population outcomes: evidence from a repeated cross-sectional survey
Background Social prescribing link workers have been rolled out nationally through the Additional Roles Reimbursement Scheme. Link workers connect people to advice and support to address the non-medic...
bjgp.org
November 19, 2025 at 9:11 AM
Having been involved in the roll out of social prescribing it’s good to see that there is indeed an impact. This team used sensible outcome measures and showed a small but definite change in multiple indicators.
Time to stop trying to answer daft questions about SP tho (eg reductions in admissions)
Time to stop trying to answer daft questions about SP tho (eg reductions in admissions)
Reposted by Alf Collins
PRIMM2025 has a fantastic line up of keynote speakers covering digital medicine, data to AI and polypharmacy.
Join us in Manchester 12 Dec 2025. Register here…
primm.org.uk
Join us in Manchester 12 Dec 2025. Register here…
primm.org.uk
PRIMM | Prescribing and Research in Medicines Management (UK & Ireland)
primm.org.uk
November 16, 2025 at 10:27 PM
PRIMM2025 has a fantastic line up of keynote speakers covering digital medicine, data to AI and polypharmacy.
Join us in Manchester 12 Dec 2025. Register here…
primm.org.uk
Join us in Manchester 12 Dec 2025. Register here…
primm.org.uk
Reposted by Alf Collins
1/2 Our update of the PREDICT breast prognostic and treatment benefit model is now published by BMC Research Notes.
rdcu.be/ePXTJ
rdcu.be/ePXTJ
PREDICT breast v4.0: an update to the PREDICT breast prognostic model
rdcu.be
November 15, 2025 at 6:30 PM
1/2 Our update of the PREDICT breast prognostic and treatment benefit model is now published by BMC Research Notes.
rdcu.be/ePXTJ
rdcu.be/ePXTJ
We are a long way indeed from systematically collecting and acting on the voices of patients. Abolishing Healthwatch and handing responsibility for its work to ICBs (which are themselves undergoing massive reorganisation) is in my own view a very bad move indeed by DHSC.
NEW: Andy Burnham will issue a warning to Wes Streeting over the government’s abolition of a national network of “patient voice” bodies
Burnham's intervention comes amid fears locally that the move could “silence” residents' views
By me, for Politics Home www.politicshome.com/news/article...
Burnham's intervention comes amid fears locally that the move could “silence” residents' views
By me, for Politics Home www.politicshome.com/news/article...
Andy Burnham To Warn Wes Streeting About Closure Of Health Bodies
Andy Burnham will issue a warning to Health Secretary Wes Streeting over the government’s abolition of a national network of “patient voice” bodies...
www.politicshome.com
November 14, 2025 at 10:17 AM
We are a long way indeed from systematically collecting and acting on the voices of patients. Abolishing Healthwatch and handing responsibility for its work to ICBs (which are themselves undergoing massive reorganisation) is in my own view a very bad move indeed by DHSC.
Reposted by Alf Collins
💻Today our chief executive, @chrisgrahamuk.bsky.social, chaired @hcuknews.bsky.social's 'Patient Involvement and Partnership for Patient Safety' virtual conference.
It was a great day of insightful sessions about the power of patient collaboration, including discussions on: [1/3]
It was a great day of insightful sessions about the power of patient collaboration, including discussions on: [1/3]
November 12, 2025 at 4:27 PM
💻Today our chief executive, @chrisgrahamuk.bsky.social, chaired @hcuknews.bsky.social's 'Patient Involvement and Partnership for Patient Safety' virtual conference.
It was a great day of insightful sessions about the power of patient collaboration, including discussions on: [1/3]
It was a great day of insightful sessions about the power of patient collaboration, including discussions on: [1/3]
Listen to this lovely guy.
It needs to be said: Trump is a thin skinned, self absorbed, wicked (yes, wicked) tyrant.
It needs to be said: Trump is a thin skinned, self absorbed, wicked (yes, wicked) tyrant.
“There was a time when those kinds of attacks were just words.
“Now there are people who are willing to carry out those words.”
Former FBI general counsel & deputy to Robert Mueller @weissmann.substack.com responds after Trump labels him a “bad guy” who should be investigated.
“Now there are people who are willing to carry out those words.”
Former FBI general counsel & deputy to Robert Mueller @weissmann.substack.com responds after Trump labels him a “bad guy” who should be investigated.
November 12, 2025 at 6:00 PM
Listen to this lovely guy.
It needs to be said: Trump is a thin skinned, self absorbed, wicked (yes, wicked) tyrant.
It needs to be said: Trump is a thin skinned, self absorbed, wicked (yes, wicked) tyrant.
People living with multiple LTCs currently experience multiple condition specific annual reviews. This study attempts to reduce the burden on patients through offering a more holistic review.
Evaluating the impact of a comprehensive review template for personalised care in general practice for patients with multiple long-term conditions
➡️ doi.org/10.3399/BJGP...
➡️ doi.org/10.3399/BJGP...
November 12, 2025 at 2:32 PM
People living with multiple LTCs currently experience multiple condition specific annual reviews. This study attempts to reduce the burden on patients through offering a more holistic review.
Reposted by Alf Collins
In the upcoming #UKBudget, does it make sense to "protect the NHS"? Our #NHSProductivityCommission analysis suggests we were already getting poor value for money pre-pandemic, relative to comparator countries. Full report here: bit.ly/3WPxu76 #dataisbeautiful
November 11, 2025 at 11:25 AM
In the upcoming #UKBudget, does it make sense to "protect the NHS"? Our #NHSProductivityCommission analysis suggests we were already getting poor value for money pre-pandemic, relative to comparator countries. Full report here: bit.ly/3WPxu76 #dataisbeautiful
Reposted by Alf Collins
Reposted by Alf Collins
Which one is more English?
November 6, 2025 at 11:58 AM
Which one is more English?
Reposted by Alf Collins
Inbox— next cover of the New Yorker: “Mayor Mamdani,” by Edel Rodriguez
November 5, 2025 at 3:19 AM
Inbox— next cover of the New Yorker: “Mayor Mamdani,” by Edel Rodriguez
Reposted by Alf Collins
There are some very important and very neglected lessons here about NHs management: www.kingsfund.org.uk/insight-and-...
But there are two big issues with it...
But there are two big issues with it...
Why Management Matters To The NHS 10 Year Health Plan | The Kings Fund
Professor Judith Smith, Suzie Bailey and Professor Sir Chris Ham explore why strong, well-trained NHS management is essential to delivering the ambitions of the 10 Year Health Plan.
www.kingsfund.org.uk
November 5, 2025 at 3:02 PM
There are some very important and very neglected lessons here about NHs management: www.kingsfund.org.uk/insight-and-...
But there are two big issues with it...
But there are two big issues with it...
I’ve been told about a nationally significant piece of work, led by academics and now far too complex to actually implement. I’ve heard this story so many times in my career.
IMHO academics should know as much about implementation as they do about their research topic. This is rare
Over and out 🙂
IMHO academics should know as much about implementation as they do about their research topic. This is rare
Over and out 🙂
November 4, 2025 at 12:48 PM
I’ve been told about a nationally significant piece of work, led by academics and now far too complex to actually implement. I’ve heard this story so many times in my career.
IMHO academics should know as much about implementation as they do about their research topic. This is rare
Over and out 🙂
IMHO academics should know as much about implementation as they do about their research topic. This is rare
Over and out 🙂
‘In order to improve the efficiency of our railways, we are going to remove the engines from our trains so that we can pay for twice as many train drivers’ …..ends
This is absolutely hilarious from Young Master Wesley: the NHS middle managers in question haven’t been sacked yet, because there’s no redundancy budget www.telegraph.co.uk/politics/202...
Access Restricted
www.telegraph.co.uk
November 2, 2025 at 10:25 PM
‘In order to improve the efficiency of our railways, we are going to remove the engines from our trains so that we can pay for twice as many train drivers’ …..ends
Reposted by Alf Collins
The #NHS10YearPlan sets out a clear ambition: to build a healthcare system fit for the future, shifting care from hospitals to communities, from analogue to digital, and to strengthen quality, safety, and equity for all. Delivering that vision will also depend on how people experience care.
[1/2]
[1/2]
October 29, 2025 at 11:43 AM
The #NHS10YearPlan sets out a clear ambition: to build a healthcare system fit for the future, shifting care from hospitals to communities, from analogue to digital, and to strengthen quality, safety, and equity for all. Delivering that vision will also depend on how people experience care.
[1/2]
[1/2]
Reposted by Alf Collins
We’ve published ‘Learning from the Best – celebrating patient experience innovations to help deliver the 10 Year Plan’, which maps the #PEN25 Awards winners to the Plan’s key chapters, and now includes direct links to the project presentations for easy learning: bit.ly/PEN10YearPlan.
[2/2]
[2/2]
October 29, 2025 at 11:43 AM
We’ve published ‘Learning from the Best – celebrating patient experience innovations to help deliver the 10 Year Plan’, which maps the #PEN25 Awards winners to the Plan’s key chapters, and now includes direct links to the project presentations for easy learning: bit.ly/PEN10YearPlan.
[2/2]
[2/2]