Charles Tallack

The argument that’s often made for why we need an alternative model to the NHS or radical reform is that the NHS is unsustainable. The latest to make the argument is Sajid Javid. But *is* the NHS unsustainable? A Friday🧵

@SW_Help Thank you. That's very helpful

@CharlesTTHF Hi Charles, as the train has been cancelled your ticket will be accepted on the 08:48 service. ^DM

@SW_Help I have an advance ticket for the 0855 from Winchester to Waterloo. But that train's been cancelled. Can I get on the 0848 to enable me to get into London for my appointment?

@Billmorgan82 @gooroohealth Nice that the unreported removals numbers tally with the validation ones!

@CharlesTTHF @gooroohealth Yeh 100k is for the 6 week validation exercise from 1 April, so if it’s uniformly spread it’d be 66k in April and 33k in May. But probably took some time to get going

England's RTT waiting list shrank by 31,628 patient pathways in April, more than needed (19,795) to put the NHS on course for 18 week recovery by March 2029. This is a new monthly chart, and it's explained here insource.co.uk/tracking-progr… #nhswaits

@Billmorgan82 @gooroohealth Good spot Bill. I think we would expect those validation removals to be showing up as "unreported removals" ie the fall in the waiting list in excess of (treatments - referrals). Unreported removals look a bit higher than usual in April - more like 50k than 100k.

@gooroohealth they've done well to overcome the seasonal headwinds in april. tho I think they removed the best part of 100k pathways from the list through the validation exercise mentioned here (which is more of a one-off thing): england.nhs.uk/long-read/the-…

The NHS leadership needs to use reliable metrics for improvement programmes. Propaganda will blur the ability to tell failure from success: hsj.co.uk/daily-insight/…

@elonmusk It's the side that erected tariffs to keep goods from leaving and arriving.

That is the true test of which system is worse: it’s the side that built the wall to keep people from escaping

@BenGershlick And just last week the NHS was being lauded for delivering the 2m extra appointments the govt promised, 7 months early. gov.uk/government/new…

Amanda is easily one of the most impressive, hard working, and diligent people I have worked with. The cards were stacked against NHS performance over the past three years—covid, strikes, budget cuts, political instability—but she somehow kept finding a way through for the NHS.

@SW_Help I'm on train from Waterloo to Winchester. But the train has only 5 carriages rather then 10 and I'm crammed into a small area between carriages with 20 others. Can I claim any kind of compensation perhaps funded from your savings from running a short train?

@BrineHealth @HSJnews The NHS is a resource constrained system. This inevitably means that people can't get every treatment they might want.

@BrineHealth @HSJnews And does it really undermine choice? It just means that with some providers you'll have to wait longer - which is exactly the same as now

Well down to the @HSJnews for following this up and publishing such an informative story.

Hitting the 2m early tells us little new about progress on 18 weeks. The key figure here is the growth in waiting list treatments. From Jul-Nov 23 to Jul-Nov 24 that was 2.6%. This is in line with our estimate of growth rate needed to achieve 18w by 2029. health.org.uk/reports-and-an…

So it seems like the extra appointments haven’t resulted in as many extra treatments as we’d expect. Is this an example of a target distorting behaviour? Whatever, on the plus side, 2m was hit after 5 months. So there’s plenty of time for even more appointments if money allows.

This week the government announced that after only 5 months in power, it had met its promise of 2 million extra appointments in its first year. What does this mean for the related pledge, to achieve 18 week waits by 2029? A 🧵

@profchrisham And choice of GP relies on spare capacity which is lacking across the system. It's difficult enough to see your own, named/usual GP let alone one of your choice.

If money follows patients to hospitals they choose, how does the shift from hospitals to community happen? NHS will compete with itself in Streeting’s productivity reforms thetimes.com/article/90fcc3…