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Ep 50. The future of brain cancer research22 Aug 202400:27:33

For episode 50 of the National Health Executive podcast, we were joined by Dr Nicky Huskens, CEO at the Tessa Jowell Brain Cancer Mission, to talk about everything from some of the recent investment being funnelled into the sector, to hopes for the future with the new Labour government.

Some of the funding includes the next stage in the government’s £40m pledge to develop new lifesaving research. That pledge was made by the previous Conservative government – on collaboration with the new government, Dr Huskens said: “I’ve spoken with the [DHSC] team before they came into power and they are big fans of the mission-led approach and the work that the brain tumour community has been doing

“I think going forward, in the first instance, will be working together with the civil servants to launch those three calls – the HP call, the consortium, the care call – and to do that really well and engage the community to participate. From there, I would say the sky is the limit!”

Listen to the full podcast to hear Dr Huskens’ thoughts on improving best practice sharing, the state of the neuro-oncology workforce, the importance of data in the sector, and more.

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Ep 49. What next for the NHS Estate?08 Aug 202400:16:27

For Episode 49 of the National Health Executive podcast, we were joined by David Hemming, who is service lead for major programmes at NHS Shared Business Services. We spoke to David before our Estates online conference, where he featured on our Building the Hospitals of the Future panel.

We asked him about the NHS estate, Hospital 2.0, and the New Hospital Programme (NHP)—right before chancellor Rachel Reeves announced a pause to the NHP so it could undergo a “complete rest”.

“Many people are aware of the NHP, [but] there are different levels of understanding of what its actually going to deliver—there is still quite a lot of work to actually get that level of communication and stakeholder engagement out.”

He continued: “Part of this is [that] I’m bringing my knowledge of NHP. Do I have a complete and full knowledge of the NHP? I would say ‘no’ because it’s such a large programme—there are many different elements, but I’m also keen to understand, from other people’s perspective, what is their perception of the NHP [and] where do they think there are issues because that helps my understanding.” Knowing this can help NHS SBS modify their service offering.

Listen to the full podcast to hear David’s thoughts and stay tuned for National Health Executive’s next magazine edition for what the NHP pause could mean for the health system.

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Ep 40. Is automation the future of stem cells?27 Nov 202300:14:22

In episode 40 of the National Health Executive podcast, we were joined by Lee Carpenter, who is the head of the Medicines and Healthcare products Regulatory Agency’s UK Stem Cell Bank (UKSCB).

During the podcast, Lee explained what the UK Stem Cell Bank is and the significance of its work, what its future holds and some of the opportunities in the world of stem cell research.

Speaking on how big a role automation will play in the future of the stem cell field, Lee said: “I think it is going to be fairly critical. We can see the manufacturing of stem cells is hugely labour-intensive, it is expensive too.”

Lee goes onto explain how automation can widen patient access and eliminate human errors. Listen to the full podcast to hear more of Lee’s thoughts on the future of stem cells.

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Ep 39. What makes a good NHS manager?07 Nov 202300:26:09

In episode 39 of the National Health Executive podcast, we were joined by Anthony Painter, who is the director of policy at the Chartered Management Institute (CMI), to discuss all things management within the UK health sector and NHS.

During the podcast, Anthony shared some of the recent research CMI conducted in partnership with the Social Market Foundation, which centred around the state of management and leadership within the NHS.

Anthony said: “One thing that was found [in the report] was that 27% of managers in the NHS think that the leadership in their organisation is not effective.

This is obviously very worrying, according to Anthony – especially because “research shows that, if you have above average leadership and management in your organisation, you’re far more likely, or three times more likely, to be a highly performing NHS organisation than if you have a less than average level”.

Anthony also discusses some of the calls for regulation of managers within the NHS, what makes a good NHS manager, and how senior leaders can go about recruiting the right way.

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Ep 38. Catering to Kitchen Equipment Demands: A New Era of Sustainable Rental Services26 Oct 202300:15:52

In episode 38 of the National Health Executive podcast, we were joined by divisional director at Rental+, Jon Steward, to discuss one of the foundational elements of any good health setting.

Rental+ offers the NHS cutting-edge foodservice and refrigeration equipment using a unique rental model.

Elaborating on the differences between this model and a typical procurement process, Jon explained: “First of all you just pay a monthly fee for the equipment; second of all, it is inclusive of service and maintenance – this is why the NHS loves this solution, because it reduces their capital outlay and gives them a fixed cost.”

This gives senior health leaders the peace of mind that sudden or hidden expenditures won’t wreak havoc with pre-determined budgets. A third point is that Rental+ guarantee the equipment will be working all the time.

Jon went onto say: “For healthcare executives considering Rental+, my key advice would be to view this as, not just a service, but as a partnership. We’ve worked with the NHS for so long – we’re not just a solution provider, we’re an extension of the trusts that we work with.”

Listen to the full podcast episode to hear more about how the NHS can benefit.

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Ep 37. Does the NHS need to be rebooted? Sir David Haslam26 Sep 202300:20:34

In episode 37 of the National Health Executive podcast, we were joined by the former chair of the National Institute for Health and Car Excellence, Sir David Haslam, to discuss the current state of the NHS and whether it needs to be rebooted.

During the podcast, David discussed the piece he and David Pendleton, professor of leadership at Henley Business School, authored for the National Health Executive magazine, where he argues that the UK health sector needs to focus its financial support on bolstering primary care and community care on the one side, and social care on the other.

David said: “We came up with this vision: if you think of the health system like a bookshelf, you’ve got the hospitals as the big books on the shelf, but if your bookends aren’t working effectively then everything tumbles down. And the bookends at one end are primary care; the other end is social care.

“If both of those aren’t supported then the whole system is going to fall apart.”

Listen to the full podcast to hear David’s thoughts on prevention, the UK’s health spending and more about how leaders can rebalance the NHS for the future.

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Ep. 36 How interoperability can support the NHS's core goals, Ed Platt30 Aug 202300:24:03

In episode 36 of the National Health Executive podcast, we were joined by Omnicell’s UK professional services director, Ed Platt, to discuss interoperability in the NHS, practical examples of where it can be leveraged best, the importance of the health service's digital transformation journey and more.


During the podcast, Ed discussed Omnicell’s provenance and how the mismanagement of medical supplies led to the company’s founding in 1992, which, to this day, galvanises them to continuously deliver innovations that help improve the standard of care in hospitals.


When asked about how Omnicell started, Ed explained: “That story is about our CEO, Randall Lipps… he was in hospital, his daughter was being treated and he was stood there and noticed that the clinicians were looking for the products – I think catheters and some other items – but they couldn’t find them.


“He then went off to his garage and started developing the first automated dispensing cabinet, brought that to market in 1992 and now we have over 2000 systems in the UK.


“That story, that observation, still stands true today.”


To listen to more about Omnicell's founding principles, how they are already helping the NHS and how they can further support the UK health sector, listen to the full podcast above.

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Ep. 35 How to tackle health inequalities, Prof Durka Dougall & Dr Andy Knox16 Aug 202300:50:47

In episode 35 of the National Health Executive podcast, we were joined by Professor Durka Dougall who is the chair of The Health Creation Alliance and Dr Andy Knox who is Associate Medical Director at Lancashire and South Cumbria Integrated Care Board.

In the episode we spoke about population health, population health management, public health, health inequalities and everything in between. We also went into how all of the aforementioned phrases factor into combatting health inequalities.

The podcast explores how both guests first entered this particular part of the health sector and their passion behind it.

Dr Knox discusses the epiphany he had while working as a GP that allowed him to think differently and enter a role leadership role where he helped engage local communities in thinking more about their own health.

Prof Dougall also discusses her exasperation at the lack of progress on the health inequalities front despite widespread acknowledgement of the presence of avoidable issues.

Listen to the full podcast for more.

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Ep 34. Is the pandemic really over, Dr Matt Inada-Kim20 Jul 202300:26:32

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.”

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Ep 33. How the NHS can collaborate internationally, Dr Matt Harris and Dr Nav Chana16 Jun 202300:29:05

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.

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Ep 32. What digital actually means for the NHS, James Freed13 Apr 202300:30:58

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.

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Ep 31. How the NHS can recruit and retain better, David Jones03 Mar 202300:26:14

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.

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Ep 48. A gay man's experience of the 1960s NHS25 Jul 202400:20:35

For episode 48 of the National Health Executive podcast, we spoke to award-winning and internationally acclaimed broadcaster and journalist, Pete Price, about his life and experience with aversion therapy on the NHS. This episode contains explicit language and strong views

In the podcast, we explored how aversion therapy ties in with conversion therapy and what the Bill that has been making its way through parliament since last year means for the LGBTQ+ community and society as a whole.

Notably, the Bill was included in the King’s Speech this month, as it seems Sir Keir Starmer intends to press ahead with banning conversion practices.

“First of all, conversion therapy: I knew nothing about,” said Pete. “It’s reared its ugly head a few times, I’ve been on television and talked about it. Conversion therapy is where they brainwash you; aversion therapy is what they did to me, so that’s what we’re going to be talking about.”

In the podcast, Pete discusses his childhood, family and the period of time he spent in a ‘hospital’ undergoing aversion therapy.

He explained: “Growing up was very difficult for me because at the age of 12 I discovered I was a homosexual and didn’t understand it, didn’t know what it was about — all I knew was my pals were all going out with girls and I wasn’t.

“I wasn’t attracted to girls but I went out with girls, so I fought my sexuality; growing up I fought my sexuality because, in those days, I was a criminal — it was against the law to be a homosexual!”

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Ep 30. The real problem with patient waiting times, Adrian Boyle03 Feb 202300:20:25

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.

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Ep 29. How the health sector can improve patient pathways, Rachael Millward, Sue Moore, and Rob Music08 Dec 202200:47:28

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.

 

Communication

One 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.

 

Technology

Guidance 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 thoughts

Rachael 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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Ep 28. What do we not know about obesity and how can we quash the stigma? Dr Giles Yeo and Dr Stephanie De Giorgio04 Apr 202200:28:34
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.

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Ep 27. How can ICSs help to transform digital innovations in care settings, Alex Church17 Mar 202200:20:37
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.

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Ep 26. Making the difference in mask manufacturing & design, Jon Constantine-Smith07 Mar 202200:17:30
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.

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Ep 25. Exploring the best ways to implement digital innovation into our health sector, Anne Cooper02 Mar 202200:20:00
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.

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Ep 24. The role of Plus Sutures in an evidence-based care bundle to reduce SSIs and NHS burden, Giles Bond-Smith17 Dec 202100:20:55

“What we’ve got to do is look at what is the impact of having a wound infection, or a surgical site infection, on the patient, on the doctor and the healthcare professionals, as well as the economic burden within the NHS.”

As somebody who has become highly knowledgeable on these what these impacts of a surgical site infection (SSI) are, it is why Giles Bond-Smith is so passionate around improving the processes and attention paid to it within the NHS.

The Emergency General/HPB surgeon at Oxford University Hospitals NHS Trust joined host Matt Roberts on NHE’s Finger on the Pulse podcast discussing some of the challenges commonly faced around this type of infection prevention, but also the opportunities to innovate as well.

“We should be doing everything possible to look at how we can mitigate surgical site infections for our patients.

“Typically, as surgeons, we don’t really pay much attention to our wounds, but the patients do. How does a patient judge whether an operation went well or not? They look down at their wound; they see how big it was.

“If the wound is less in size than the wound is in their mind, they think we’ve done well. If the wound heals beautiful, people show it and say the operation went very well.

“Whereas, if someone’s had a complete wound dehiscence due to infection, they feel the operation was a disaster. Now, it might not have been, but that’s how the patient perceives it, and we’ve got to take this more seriously.”

But how do we tackle surgical site infections and ensure the wounds can heal neatly, safely and quickly for the patient?

One of the ways, as Giles explains during the podcast episode, is to look at some of the really simple but innovative technology out there – such as the antibacterial Ethicon PLUS sutures he and his team uses – as ways to improve patient outcomes without having to drastically alter the way in which these surgeries are performed.

Much of the success instead can come from small, incremental gains in the procedures, awareness and tools being utilised by surgeons.

Listen to Ep 24. of NHE’s Finger on the Pulse podcast with Giles Bond-Smith 

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Ep 22. Improving care through interoperable data-driven systems, Piyush Mahapatra16 Sep 202100:23:56

What leads to a digital healthcare solution being adopted?

Every situation is unique across the healthcare service, but often these innovations span out of some of the simplest of circumstances. For Open Medical’s Innovation Director, Piyush Mahapatra, he remembers the instance of a cleaner accidentally wiping down a whiteboard which had been used to track orthopaedic patients. A momentary lapse in the system, which presented a sudden challenge and an opportunity for a digital alternative.

“I’m a practising orthopaedic surgeon in London, and an NHS clinical entrepreneur.

“Most patients who have surgery for broken bones within the NHS are often managed on systems such as Excel sheets, Word documents or physical whiteboards.

“In our particular organisation, it was a physical whiteboard and, we came in one weekend and the cleaner had rubbed the whiteboard off.

“After that, version one [of our trauma digital solution] was created. It was a fairly simple database system at that point, designed to help manage those lists of patients in a better way.

“Since then, things have really moved on [at Open Medical]. We became a cloud native platform in 2017, and things really escalated. Now, we’re helping about 70 NHS trusts around the country manage their patients.

“We’ve got over a million patients on our systems today.

Through Open Medical, Piyush and the team have been able to leverage their own personal clinical experiences to develop a solution which addresses a significant need felt in the NHS, with patient management, pathways, and efficiencies. It has been built to address a need Piyush and his colleagues themselves feel in their regular NHS roles, and allows the team to talk clinically with partners, as well as technologically.

“One of the things that I tell everyone is that I use [our Open Medical system] when I’m working clinically. We all use our systems quite a lot.

“We get a real understanding of what it is like to utilise the platform, so if things are not user-friendly or don’t work as well as they should, we can adapt and change them.

“We can get that feeling if something doesn’t provide the functionality clinicians need, because we see it from that perspective too.” 

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Ep 21. The power of pulse oximetry during the pandemic, Matt Inada-Kim, Irem Patel & Catherine Dale17 Jun 202100:25:46
On Episode 21 of NHE's Finger on the Pulse podcast, host Matt Roberts is joined by Matt Inada-Kim, Irem Patel and Catherine Dale to discuss how pulse oximetry was identified and scaled out during the pandemic to support the pandemic response. Matt, Irem and Catherine offer a range of different perspective, brought together by the Health Innovation Network South London.

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Ep 20. Early pioneers of video consultations, Dr Shanti Vijayaraghavan & Will Warburton27 May 202100:39:19
On Episode 20 of NHE's Finger on the Pulse podcast, Dr Shanti Vijayaraghavan of Barts Health NHS Trust and Will Warburton, Director of Improvement at the Health Foundation, join host Matt Roberts to discuss the innovative work on video consultations that Shanti and her team have been carrying out for a number of years in Newham, in London.

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Ep 47. Magic, epiphanies and collaboration: How to lead in the NHS04 Jul 202400:43:30

For episode 47 of the National Health Executive podcast, we were joined by Sue Holden, the CEO at the Advancing Quality Alliance — otherwise known as Aqua.

Sue spoke about her leadership philosophy, where that mindset comes from and the epiphanies she’s had while working in the NHS.

She said: “We can focus on the ‘what’ and forget the ‘how’ is where the magic happens, so — from my point of view — I’ve had the privilege to work with a lot of organisations in various different guises.

“Certainly when I was working with trusts that were really challenged, not one of those organisations didn’t have magic in it, didn’t have a brilliant service, didn’t have a team that was going above and beyond, and didn’t have people that were doing exciting things.”

There were also small pockets that needed support and the mark of a good leader is fostering an environment that enables the people who are struggling to access the help they need, explained Sue.

Sue also highlighted the four times in her career she has had an epiphany or “things that have really sat me back on my heels and made me rethink my own perspective” as she puts it.

“The first one was when I was a student nurse — that was back in the 80s...”

Listen to the full podcast to hear Sue’s insights and the pivotal moments in her career.

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Ep 19. A structured but tailored offer of support, Annie Laverty & Will Warburton04 May 202100:28:55

On Episode 19 of NHE’s Finger on the Pulse podcast, host Matt Roberts is joined by Annie Laverty, Chief Experience Officer at Northumbria Healthcare NHS Foundation Trust, and Will Warburton, Director of Improvement at the Health Foundation, discussing an innovative ‘Corona Voice’ staff wellbeing programme being ran at the trust.

Annie explained: “Looking after your workforce is really important. It makes sense from a human perspective, as you want to hold onto good staff.

“The NHS relies on the goodwill of people being deeply committed to a purpose to provide the best care to patients, but we know that providing that care sometimes comes at a cost to individuals.

“NHS organisations need to do all that they can to protect staff wellbeing because we know that it is inextricably linked to the care that patients receive, and also the safety and reliability of those organisations.”

The trust’s Corona Voice programme came out of a project being undertaken before the pandemic, to provide more up-to-date data and staff feedback to the trust and which allowed Northumbria Healthcare NHS FT, alongside support from Will and the Health Foundation team, to expand the scope of the project and better understand and support their trust colleagues through the challenges of dealing with Covid-19 and hospital care.

Listen to the full episode of NHE’s Finger on the Pulse podcast with Annie and Will above.

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Ep 18. Innovation in primary care has never happened so fast, Dr Anshu Bhagat18 Mar 202100:27:40

Dr Anshumen Bhagat, Founder and Chief Medical Officer of GPDQ - alongside continuing to be a practicing NHS GP - joined us on episode 18 of NHE’s Finger on the Pulse podcast, talking us through primary care, its challenges over the last 12 months and his visions for its future. We talk difficulties, solutions and ambitions in this insightful episode of the podcast.

GPDQ is an organisation well-placed to be assisting with the NHS’ primary care challenges right now, because each and every one of it’s members experiences those challenges in their own daily working lives.

That is because one of the core values at the heart of GPDQ is that it is run by working NHS staff. Be it a GP, specialist nurse or paramedic, should a healthcare professional move entirely into private practice, then they won’t be found among GPDQ’s roster of staff.

And having that skin in the game, so to speak, is important. As Anshu explains: “We lose about 90-100 GPs a month in this country. We need more coming through.”

So, to be able to provide opportunities to work differently, to work with different teams and provide services perhaps outside of their day-to-day NHS duties, including private practice, all without removing staff from an already waning health service pool is essential.

It is a belief seen in one of GPDQ’s convictions when it does provide private healthcare. In part, due to its staff’s continued involvement in the NHS side of affairs, moving treatment and care to private provision is less about seizing on a commercial opportunity, and far more about the knock-on implications that can have for those who do have to rely on the NHS to provide their care.

“Every patient we see in the private sector is one less patient who needs to be seen in the public sector.”

With the pandemic, that has become truer than ever before. The NHS is facing a significant treatment backlog, to overcome which it will have to work with and rely on services like those which GPDQ provide. And to their credit, these services have innovated significantly in response to the pandemic’s demands too.

Anshu describes how his organisation and colleagues have worked to deliver necessary services, including virtual clinics - including being able to step in at short notice for NHS staff absences (minimising disruption for patients) - through to running home visitations still where necessary using Covid ‘hot’ car systems.

It is a period of substantial change for primary care right now, with the likes of Anshu being able to provide a great insight into it from both sides of the NHS/private debate.

To hear much more from Anshu, listen in to episode 18 of NHE’s Finger on the Pulse podcast… 

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Ep 17. Patient Power, Antonis Papasolomontos, Rachel Power & David Pilbury25 Jan 202100:36:11

“What do you want from your care?”

It seems a quite basic question for a clinician to ask. However, in its simplicity is an inherent power. By beginning the conversation in such a way, we naturally shift the patient journey and our interactions with that patient towards a process of shared decision making; we offer the patient a level of involvement and autonomy in their own care.

And by facilitating that informed involvement in their own treatments and journey, there are real benefits for everyone involved: for the patients, the clinicians and the wider system alike. For the patient, there can be no better barometer of what is and is not important to them individually in their care, based on their personal experiences, priorities and desires, while clinicians will equally benefit from more engaged patients who are likely to be invested in managing their condition and sticking to the treatment plans that they’ve had a hand in deciding on.

Read the full article here: http://btpubs.co.uk/publication/?m=62920&i=691004&p=34&pre=1

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Ep 16. A completely normal reaction to an abnormal situation, Dr Lloyd Humphreys08 Dec 202000:29:49

On Episode 16 of NHE's Finger on the Pulse podcast, host Matt Roberts is joined by SilverCloud Health's Head of Europe Dr Lloyd Humphreys as we discuss mental health, Covid-19 and digital mental health services. As a leading digital mental health service provider, SilverCloud Health saw a significant uptick in people using their digital mental health service; was that anticipated, and what are the implications longer-term?

As Dr Humphreys explained: "Uncertainty plays a critical role. [The rise in digital mental health services usage] was down to people having a completely normal reaction to an abnormal situation [in Covid-19].

"It's really important we need to not talk about mental illness but talk about mental health. It's a universal truth that we all have mental health."

And accessing support is naturally going to change and develop to meet the needs of people at that time, such as shifting more towards remote and digital services as the virus restricted our movements and increased concern among people. As Dr Humphreys described, people "want to access support and help in their own way".

Listen to the full conversation to on Episode 16 of NHE's Finger on the Pulse podcast...

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Ep 15. A better understanding of tech benefits the patient, Ged Cairns & Matt Jones24 Nov 202000:26:51

On Episode 15 of NHE's Finger on the Pulse podcast, brought to you by Brother UK, regular host Matt Roberts is joined by Ged Cairns and Matt Jones of Brother UK to discuss how IT and technology can directly impact and improve patient care - the only real "currency" which matters across the health sector, as Matt Jones explains.

Our discussions with Brother come on the back of a body of work carried out in partnership between our two organisations, culminating in an audience survey and whitepaper report - which can be downloaded now here - which we reflect on the findings of during the episode.

Patient care is the ultimate goal for all across the health service, as seen throughout our survey of both primary and secondary care members. As Matt Jones explained: "Moving into the public sector, it was something I was immediately struck by. The currency that people talk about it patient care.

"Their ultimate goal is to increase levels of patient care."

And as we discuss, both through Brother's products and more widely, there are real opportunities to be found across the health service. That can be everything from significant changes, from the labelling of blood bottles as one example from the episode, through to the marginal gains which all add up across an NHS employee's shift or working day.

Want to find out more, jump in and give Episode 15 of NHE's Finger on the Pulse podcast a listen...

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Ep 14. Health messaging is a science, Professor Craig Jackson12 Oct 202000:33:46

On Episode 14 of NHE's Finger on the Pulse podcast, we're joined by Professor Craig Jackson, Professor of Occupational Health Psychology
Birmingham City University to discuss the coronavirus pandemic, the health messaging around it and how those in power have missed a trick by overlooking the key role of psychology in informing the public of restrictions, measures and the ever-changing situation.

Together, Professor Jackson and regular host Matt Roberts discuss the things the government got right in the early stages, the uncertainty and vagueness caused by a second set of messaging open to interpretation and how things could be pulled together once more - including through the use of psychology, creativity and more individual messaging.

We also discuss the risks of an impending Christmas turkey shortage... ensuring it's not all doom and gloom in what is quite a difficult and ever-present subject in all of lives right now.

Join the discussion and let us know across social media what your thoughts are. We're always keen to engage with our listeners and hear different points of view. Whether you agree or disagree, discussion is at the core of how we learn and improve: as a society, as an industry and as individuals.

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Ep 13. Accessing the full range of careers available, Anthea Hockly02 Oct 202000:22:20

Anthea Hockly, Associate Director of Workforce Development and Learning at Essex Partnership University NHS FT (EPUT), joins us to talk about the new Health and Care Academy which has been founded in Essex through the work of the trust and a number of other partners from across the region's health and social care delivery spectrum.

Giving young people in the area an opportunity to directly engage with NHS and care professionals from a very diverse range of roles, including both clinical and non-clinical positions, the sessions were a great way to help the young people answer the questions they wanted to know and directly engage with people they perhaps otherwise would not have had the opportunity to do so with and discover job roles they may not have ever considered.

Having originally been planned as a face-to-face event, the coronavirus pandemic caused EPUT and the other partners to have to flex and shift quickly to a digital offering instead - something which has since become a preferred outcome after it worked well, resonated with the young people who remained highly engaged and opened more doors to provide a wider, more interesting cohort of professionals.

Training the next generation, across a range of different methods, and upskilling the existing workforce are essential to the continued success of the NHS and schemes like these are a vital way of ensuring the health service doesn't miss out on any potential future talent; even if they fall outside of the traditional, university/academic-focused route into the service.

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Ep 12. The key words: 'cashless, user experience and revenue', Michelle Nix18 Aug 202000:26:37
On Episode 12 of NHE's Finger on the Pulse podcast, I'm joined by Michelle Nix of Parking Eye as we discuss the ways their car park solutions can assist healthcare providers in improving revenues, creating a better user experience and allowing greater accessibility and the introduction of touchless and cashless technologies.

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Ep 11. Using automation technology to make time matter, Darren Atkins06 Aug 202000:24:58
On this episode of NHE's Finger on the Pulse podcast, host Matt Roberts is joined by Darren Atkins, Chief Technology Officer (Artificial Intelligence & Automation) at East Suffolk and North Essex NHS Foundation Trust to talk about digital technology, automation and AI and how it all fits into the modern health sector.

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Ep 10. One part of the mental health toolkit, Nicholas Rowley15 Jul 202000:30:15
Mental health has always been an area of significant discussion in the health sector, from clinicians to solution through to prevention. But, on Episode 10 of NHE's Finger on the Pulse podcast host Matt Roberts chats with Nicholas Rowley of the Manchester branch of Andy's Man Club, a mental health charity aimed at supporting men to talk about their mental health problems and overcome some of the stigma, to understand what services are out there to address mental health provision beyond the traditional clinical settings.

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Ep 46. Primary Care and the Pandemic - What's Happened?20 Jun 202400:24:54

In Episode 46 of the National Health Executive podcast, we were joined by Trish Greenhalgh, who is a professor of primary care health sciences at the University of Oxford, as well as a former GP.

Trish offered insight into how the primary care digital transformation journey is going, specifically since the explosion of innovation observed following the pandemic.

Trish highlighted some of the recent research she has been doing in general practices looking at digitalised aspects of care that have in fact impacted disadvantaged people negatively, widening already existing health inequalities.

“The pandemic was a pretty big shock,” said Trish when explaining some of the theory around external shocks speeding up the innovation process.

She added: “We had to immediately, or in the space of a fortnight-three weeks, shift general practice from a face-to-face model to a remote model and I think it is one of the major achievements of general practice in this country that we did that — we did it really quickly and we did it effectively.

“We responded to the shock, and then the question is, ‘Well hang on a minute, what do we do now?’”

Listen in full to learn more about government priorities, co-design and more.

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Ep 9. Telemedicine: Effectiveness at all levels of the organisation, Glenn Smith08 Jul 202000:29:22
Telemedicine has been one of the emerging areas of progress during the coronavirus pandemic, with a much more widespread and rapid adoption of remote technology. But how effective is the technology for the clinicians using it - and how do we as a health sector decide which options are the best suited for adoption from organisations? To answer this and more, we speak with Glenn Smith, advanced nurse practitioner and one of NHE's newest editorial board members.

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Ep 8. Engagement with the community & industry was vital, Paul Dunn & Sarah Rose17 Jun 202000:23:16

Throughout this coronavirus period, the topic of personal protective equipment (PPE) and the availability of supplies for our healthcare workers has dominated the headlines. Shortages have been reported up and down the country, while centrally the government has slowly sought to reign in the problem and address the vast, unprecedented global demand.

It’s been a competitive marketplace to battle in, while domestic production capabilities have taken time to ramp up to the level we’re now reaching. Around the country, there was and continues to be an acute need for PPE, from gloves and masks to isolation gowns. And up in the North East of England, one particular trust has looked to address demand regarding the latter of those items.

Northumbria Healthcare NHS Foundation Trust took steps to work with local industry to set up its own PPE factory, producing isolation gowns directly for both its own staff and its fellow local trusts. On Episode 8 of NHE’s Finger on the Pulse podcast, Northumbria Healthcare’s Director of Finance, Paul Dunn, and local textiles industry expert, Sarah Rose, join regular host Matt Roberts to discuss the work they’ve been doing in more detail.

PPE just wasn’t being made at the necessary levels in the UK and with demand at maximum throughout the country, something needed to be done to ensure there wasn’t a complete shortage and staff remained protected as they worked to save lives. That response involved everyone, evolving as Paul tells us, from the way the local community and businesses responded locally.

Yet as Sarah explains, setting up a scheme such as this was “not just a matter of opening a factory, sticking a load of sewing machines in and getting somebody to sit at them” but rather required that input and expertise on products, materials and meeting the correct, necessary standards with the goods. As such, Sarah’s input and network were equally vital in seeing this work through from an idea to reality.

Now the vision has been realised, however, the opportunities are immense. Not only are Northumbria able to supply PPE gowns to their own staff and local staff in other trusts but they’re helping work to build a wider network around the country. Significant, vital lessons have learned from this process, with Paul explaining: “We’re very happy to give advice to any other organisation as well.

“Pragmatic advice on how they can take initiatives like this forward if they want to set them up locally.”

For the staff too, being involved in the process has allowed for the creation of PPE which better suits their needs. This wasn’t a case of selecting an item from a catalogue, ordering it in bulk and getting on with the job as so often is the case. Instead, throughout the process, they could offer their input, making a huge difference and ensuring its effectiveness.

Spawned out of the desire of the local community to support and give back to the NHS, it has also allowed the healthcare service to help and protect local industries and workers in jobs such as the textiles field which have been hit hard by coronavirus. Collectively, through outside of the box collaborations such as these, both a demand for PPE has been met locally, protecting frontline staff, as well as bolstering and potentially reviving the local economy in some sectors.

Northumbria Healthcare NHS FT’s work is just one of so many examples of innovative working throughout the UK. At NHE’s Finger on the Pulse podcast we want to hear from you about innovations your trust or organisation might be doing. Get in touch through the form on our podcast page.

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Ep 7. Keep the doors open to creativity, Baroness Ilora Finlay15 May 202000:20:41
Baroness Ilora Finlay, Chair of the National Mental Capacity Forum and a Professor of Palliative Care, joins NHE's Matt Roberts to talk about efforts during the ongoing coronavirus outbreak, the potential longer term effects of bereavement, loss and trauma during Covid-19 and the potential positives we can find out of the difficult circumstances.

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Ep 6. Unless we change the game we are going to lose, Henry Jones26 Mar 202000:26:42
In Episode 4 of #WeAreNHE podcast we are joined by Henry Jones, CEO of digital mental health organisation Big White Wall. As Henry explains, with demand fast outstripping our capacity, we cannot simply treat mental health in the traditional ways. We require innovation and new thinking, such as Big White Wall has brought to the table.

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Ep 5. Mental health is not a life sentence, Stewart Lucas13 Mar 202000:33:02
Strategic Lead for Mind in Greater Manchester, Stewart Lucas, joins us for this on the go podcast to discuss mental health care in the UK and how he feels it is at present about 100 years behind where we are with physical health.

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Ep 4. Shifting the burden of care, Mark Duman07 Feb 202000:28:26

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Ep 3. From Turning Point to NHS Confed, Lord Victor Adebowale CBE31 Jan 202000:26:57

Chief Executive of social care enterprise, Turning Point, Lord Victor Adebowale, joins us for the third NHE podcast, giving us insight into the difference he’s made during his 20 years at Turning Point and what he hopes to achieve in his new role at NHS Confederation.

With hosts Emily Rodgers and Matt Roberts, and our first on-the-go podcast, from Angel square in Manchester, the conversation covers the three key challenges of healthcare in the West and how the third challenge needs to serve the first two.

 

Main topics include technology in the healthcare industry and new models of service delivery to benefit the end user.

 

Victor talks at length about the challenges of the industry, but with unwavering optimism for the future, as long as “It’s about thinking long and learning short.”

Whether you are in the healthcare industry or not, this podcast will bring you insightful information from a man brimming with experience.

 

Victor is also chair of Social Enterprise UK and is passionate about improving the lives of people, particularly those “on the sharp end of universal care law”, and working towards a one stop healthcare shop for citizens. 

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Ep 2. Mental health doesn't happen in isolation, Dr Claire Watson05 Dec 201900:31:03

Claire Watson, recovery academy lead at Greater Manchester Mental Health NHS Foundation Trust, joins us on the second-ever NHE podcast, talking us through general mental health and the state of care for it currently, as well as what she sees in her role as the potential solutions, and causes, of the problem.

The Recovery Academy, set up in 2013, is where Claire now spends her time, helping facilitate shared learning around mental health at the facility – which acts as a college within a functioning mental health hospital.

As she describes, it wasn’t the initial route she’d planned but a “series of fates” saw her end up in the current role, where as of October 1, 2019 she assisted in launching the academy’s 14th prospectus, now offering 66 courses and catering to more than 7,500 learners.

Mental health remains, understandably therefore, a huge pressing issue in Claire’s mind for the modern-day health and social care sector. In her eyes, as a mum to a teenage daughter, there is immense and constant pressure on young people and as such there needs to be real care and attention put into addressing mental health concerns they might have.

“Mental health doesn’t happen in isolation” – that was the most powerful statement of Claire’s during the podcast, and rings true as she discusses just how we should look to help address wider problems if we are to genuinely tackle mental health issues.

There is so much great, important conversation to indulge yourself with in this podcast, but equally we bring a little bit of a light onto who Claire is herself.

So, what two songs keep our incredible guest in good spirits, and can you beat her score on our health news quiz?!

Finally, who would Claire most want to sit down with at a dinner party and pick their brains? It’s a dinner table we certainly think many would be interested to listen into!

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Ep 1. This is quite controversial. Health in GM, Dr Tracey Vell MBE18 Nov 201900:31:36

Dr Tracey Vell MBE, chief executive of Manchester LMC, clinical director of Health Innovation Manchester and associate lead for primary care at the Greater Manchester Health & Social Care Partnership, joins us in the studio for our first NHE podcast, giving us exclusive insight into the health environment and innovation going on in Greater Manchester.

This timely half hour episode takes a deep dive into the roles of Dr Vell, discussing NHS frustrations, health innovation and why there needs to be fewer meetings.

Meaningful change in NHS leadership is a hot topic of the episode, with a couple of "this is quite controversial..." moments, Dr Vell gives us an unfiltered and honest opinion to the current health care sector and why she wants to start a new conversation regarding NHS' "falling workforce."

Find out how she thinks that the use of digital will bring about better access into healthcare and why digital innovation is everywhere.

With a medical quiz taking her back to her training days and her call for "disrupting culture", this debut NHE episode is not one to be missed.

Can you guess who she would invite to her dinner party? I'll give you a clue - he divides the nation.

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Bonus Ep. Live from EvoNorth 2019: Health, Social Care & Wellbeing27 Feb 201900:35:13

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Ep 45. What's next for health research?29 May 202400:18:48

For episode 45 of the National Health Executive podcast, we were joined by Nathalie Kingston, who is the director the National Institute for Health and Care Research BioResource.

Nathalie explained everything from the inner workings of the BioResource and the UK’s research ecosystem, all the way to women in science and the NIHR’s inclusion strategy.

On three things to remember, she said: “Make sure to listen to members of the public – their views are key. Also make sure we don’t lose sight of the fact we are safeguarding public data.”

To hear all of Nathalie’s insight, listen to the full podcast 

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Ep 44. What does patient safety actually mean?14 May 202400:28:43

For episode 44 of the National Health Executive podcast, we were joined by Tom Bell, who has held management roles in the public, private and third sector – working specifically with the NHS in digital, telehealth and now as a patient safety partner.

Tom offered his insight into what patient safety actually means for the NHS, the make-up of the NHS when it comes to patient safety, how data can factor into decision-making, and what the future could/should look like.

“The lack of data in the NHS is criminal – if I wind you back through the mists of time, when I worked for Carlsberg at the turn of the century, we had access to lots of data about lots of things,” explained Tom.

He continued: “I could sit at my desk and download, in almost real time, who’d bought what, which accounts were up, which accounts were down, which were in profit etc. – that data was there. That was a company, albeit a large company and very well-run company, that was selling sugary alcoholic liquid…

“When I came into the NHS a number of years later, I remember saying to my director of strategy, ‘Where’s the dashboard I can access?’ and he looked at me as if I was speaking Swahili.”

Listen to the full podcast to learn more about the possibilities for the NHS.

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Ep 43. The Way Forward in Cancer Care26 Apr 202400:19:44

For episode 43 of the National Health Executive podcast, we were joined by Dr Penny Kechagioglou, who is a Consultant Clinical Oncologist at University Hospitals Coventry and Warwickshire NHS Trust. Penny spoke about the main challenges and opportunities in cancer care at the moment, as well as how should prevention factor in to policy decisions and the needs of the oncology workforce.

Penny said: “How do we strive for excellence? Not just good. There are three points here, so looking upstream – there is a lot of work happening that needs to be consistent across primary and secondary care, when it comes to prevention.”

Listen to the full episode to hear Penny’s thoughts and get a sneak peek of National Health Executive’s upcoming digital magazine, where Penny will detail the Charter for Oncology.

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Ep 42.Leadership in the NHS11 Mar 202400:25:57

In episode 42 of the National Health Executive podcast we were joined by Steve Gulati who is an associate professor at the University of Birmingham as well as director of healthcare leadership at the university’s Health Services Management Centre.

During the podcast, we discussed the difference between leadership when he first joined the NHS in the 90s and to now, plus the main levers for these changes. Steve also highlighted the ‘well-known truths’ about NHS leadership which are seldom voiced as well as what changes he would like to see in the future.

“Leadership in those days was almost synonymous with management – it certainly wasn’t [like] the nuanced distinctions that you get today,” said Steve. “Allied to that, there was a concept that was more prominent of what I would call ‘stewardship’ rather than leadership.”

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Ep 41. The truth about drones in the NHS08 Feb 202400:22:50

In episode 41 of the National Health Executive podcast, we were joined by Dr Angela Smith, research fellow at Bournemouth University, and Andy Oakey, research fellow at the University of Southampton, to discuss the viability of drones within the NHS transport system.

Angela and Andy talked about some of the misinformation about drones and suggested that drone travel is not quite ready for the NHS yet.

Angela said: “The eDrone project has been focused on NHS case studies, but what we have found is that the reporting around these case studies – the trials in particular – has led to some misconceptions about what the trials are achieving and the future benefits of drones.”

Andy explained: “If you actually look back at our project bids, we were sucked into this rhetoric of drones being the next big thing. The original idea was to look at where’s best to use them [drones], with a positive spin, but as we have gone into it we have learnt more and understood how there is a lot more than meets the eye.”

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