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Reposted by Charles Tallack

John Appleby @jappleby123.bsky.social · 29d

Those confidence intervals in full!

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Charles Tallack @charlestallack.bsky.social · Aug 18

So sorry to hear this Sam and wishing you all the best.

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Charles Tallack @charlestallack.bsky.social · Aug 13

You started off talking about people you know. Now you're talking about friends, which is even more prescriptive.
Do most people really know how everyone they know votes? I don't tell everyone I know!

Charles Tallack @charlestallack.bsky.social · Aug 11

Nice report, covering our analysis and more, by @jamesillman.bsky.social for @hsj.co.uk here:
www.hsj.co.uk/quality-and-...

‘Extra appointments’ celebrated by govt deliver ‘modest impact’ on waiting lists

The "4.6 million extra NHS appointments" championed by the prime minister and health secretary have only had a "modest impact" on reducing waiting list clock stops, a vital part of cutting the NHS's elective care backlog, according to new analysis shared exclusively with HSJ.

www.hsj.co.uk

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Charles Tallack @charlestallack.bsky.social · Aug 11

It’s not clear why appointments are growing faster than growth in completed pathways. More diagnostic tests per pathway is a longstanding trend linked to rise in demand for diagnostic tests. But 9% growth in outpatients, when there's a drive to avoid unnecessary outpatient appointments, is puzzling.

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Charles Tallack @charlestallack.bsky.social · Aug 11

If the ratio had been maintained at 3.9, completions pathways would have grown by 7.9% or 1.16m rather than 344,000. Under this hypothetical scenario, the waiting list would have been 820,000 smaller.

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Charles Tallack @charlestallack.bsky.social · Aug 11

Completed pathways increased by 2.3% vs 7.9% for appointments. They haven’t risen as quickly as appointments because appointments per completed pathways has increased from 3.9 in July 23 – April 24, to 4.1 a year later.

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Charles Tallack @charlestallack.bsky.social · Aug 11

Second – how have the extra appointments translated into completed pathways (treatments) from the waiting list?

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Charles Tallack @charlestallack.bsky.social · Aug 11

First – is it a notable achievement? 4.6m extra appointments is an increase of 7.9% (table 1). But applying exactly the same approach to the previous year, (ie Jul 23 – Apr 24) the growth in appointments under the Conservatives was 5.5m, an increase of 10.5% (table 2).

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Charles Tallack @charlestallack.bsky.social · Aug 11

The methodology is sound (they standardise baseline to adjust for different working days). Some might quibble that the growth is artificially inflated because of strikes in the earlier period. But there are other issues.

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Charles Tallack @charlestallack.bsky.social · Aug 11

4.6 million is the number of appointments between July 2024 and April 2025 in excess of the number delivered in the same period in the previous year. It’s all set out in an NHS E publication.
www.england.nhs.uk/statistics/s...

Statistics » Recovery of Elective Activity

www.england.nhs.uk

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Charles Tallack @charlestallack.bsky.social · Aug 11

At the end of July, the government said that it had delivered 4.6 million extra appointments since it came to power, more than double its manifesto pledge of 2 million.
www.gov.uk/government/n...

Millions more appointments as more than 2,000 extra GPs recruited

Boost is part of Plan for Change to rebuild the NHS by shifting healthcare from hospitals into the community and ending the 8am scramble.

www.gov.uk

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Charles Tallack @charlestallack.bsky.social · Aug 8

If the elasticity turns out to be as HMRC estimate, the measure wouldn't raise much money (from gamblers), but it would reduce gambling, including that which causes harm?

Reposted by Charles Tallack

Jo Bibby @jobibby.bsky.social · Jul 23

How can the government meet its commitment to halve the gap in healthy life expectancy between regions?

Reading this excellent summary of some of the @healthfoundation.bsky.social latest analysis from @charlestallack.bsky.social would be a good place to start!

⬇️⬇️⬇️

Charles Tallack @charlestallack.bsky.social · Jul 19

In its 10 Year Health Plan, the government recommitted to halving the gap in healthy life expectancy (HLE) between the poorest and richest regions. But how? Our new analysis with the ONS points to the underlying factors which any plan will need to take account of. 🧵

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Reposted by Charles Tallack

Hugh Alderwick @hughalderwick.bsky.social · Jul 23

Policy exchange, backed by Sajid Javid, think we need to switch the NHS funding model to social insurance, and introduce new charges for NHS services, like to see a GP

policyexchange.org.uk/publication/...

These are not new ideas, but they are bad ideas

A thread with some evidence

The NHS – a Suitable Case for Treatment? - Policy Exchange

Download Publication Online Reader ‘The NHS – a Suitable Case for Treatment?’ makes the case that the NHS is not fit for purpose and is in urgent need of reform.The report finds that NHS performance r...

policyexchange.org.uk

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Charles Tallack @charlestallack.bsky.social · Jul 19

100% agree with that. The government's approach so far, and measures in the 10 year plan, place far too much emphasis on personalised prevention approaches.
These can be beneficial but won't work at the scale necessary to address the vast health inequalities

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Charles Tallack @charlestallack.bsky.social · Jul 19

Our full report on our analysis with the ONS is here:
www.health.org.uk/reports-and-...
The ONS write-up and underlying data is here:
www.ons.gov.uk/releases/geo...

Geographic inequalities in premature mortality

Our new analysis explores the role of socioeconomic factors and ethnicity in premature deaths across England and Wales.

www.health.org.uk

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Charles Tallack @charlestallack.bsky.social · Jul 19

(2) reducing the link between socioeconomic factors and the proximate causes of ill health (eg smoking, alcohol, diet/obesity, physical activity). This will require both population level approaches (eg regulation of unhealthy food) and more targeted interventions (eg weight loss).

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Charles Tallack @charlestallack.bsky.social · Jul 19

Given the importance of socioeconomic factors, narrowing the difference in healthy life expectancy between regions will require both: (1) reducing socioeconomic inequalities e.g. through regional investment and economic development; and

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Charles Tallack @charlestallack.bsky.social · Jul 19

What does all this mean? It’s well known that socioeconomic factors are amongst the most important wider determinants of health. But this analysis uniquely quantifies their impact drawing on individual level Census data.

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Charles Tallack @charlestallack.bsky.social · Jul 19

These are the baseline and adjusted rates (for socioeconomic factors etc) for local authorities in all regions. When adjusted, around half have lower rates than Richmond. Compared to those in other regions, authorities in the North East do well.

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Charles Tallack @charlestallack.bsky.social · Jul 19

This chart shows how the premature mortality rates of local authorities in the NE compare to those in Richmond. Some LAs have rates more than twice as LA.
But if the LAs had the same socioeconomic and ethnicity make-up as Richmond, all except Darlington would have lower rates.

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Charles Tallack @charlestallack.bsky.social · Jul 19

They estimated what the premature mortality rate of each local authority would be if they had the same population make-up, on these characteristics, as Richmond upon Thames. This is uniquely possible through ONS’s linkage of Census 2021 to death on deaths.

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Charles Tallack @charlestallack.bsky.social · Jul 19

What explains these differences? ONS looked at the contribution of individuals’ occupation, education level, deprivation level of the area in which they live, ethnicity and migration status (born in the UK or not).

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Charles Tallack @charlestallack.bsky.social · Jul 19

Unsurprisingly, the ONS analysis shows premature mortality rates (adjusted for differences in age and sex) in the North East are higher than those any other region.

Amongst all local authorities, Richmond-upon-Thames has the lowest premature mortality, Blackpool the highest.

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