There is a strong correlation between compassionate leadership, clinical engagement and person-centred care. But the NHS is bursting at the seams and a focus on ‘productivity’- no matter how worthy- could well be contributing to the poor patient experience described in this report…

Abolishing NHS England entails 50% job cuts (and a disproportionately larger loss of organisational memory & wisdom, since those with best prospects elsewhere take redundancy). All set in motion with no plan beyond (including for workforce and education). And by a man who's now left. Insanity.

I wonder how engaged James Murray is going to be with his new job. If the leadership contest goes ahead and Starmer loses, he’ll probably be out of a job by the end of summer.

fwiw Alf, you write very nice emails :)

New passport arrived today Name: Alf Collins DOB: 23/02/1960 Profession: answering emails

Yes, it's difficult when people are both personally invested in an intervention working and in many cases have conflicts of interest (like anyone evaluating their own service would). For the avoidance of doubt, I think the arts probably are good for health and should be funded even if they weren't.

I’ve said this before but I’m going to say it again. The digital world is leaving me behind. Most platforms assume a level of digital literacy I don’t have- and frankly don’t want. It’s far easier to just give up than to try hard and get frustrated. Biggest culprit is Adobe- never using it again.

Can anyone tell me about a NHS long term conditions policy initiative in the last 20 years that *wasn’t* evaluated according to reductions in hospital admissions? Hearing that most of the work in the INTs isn’t changing this vital (?) indicator.

My son- a 28 year old barrister- has just picked up his asthma meds from his usual pharmacy. He was interrogated about why he was so late (it was 15.30) and told about the most appropriate time to turn up (not then apparently). Ah, the joys of public service eh?

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Polanski sounding cornered/defensive to me on radio 4 right now.

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Questions of sustainability and purpose. Sneaking suspicion that have NHS reform really aimed simply at improving hospital use data. Recent slip by NHSE seemed to set target on reducing hospital attendances set off alarm bells and accusations of healthcare rationing - it backtracked pretty sharpish

I’m no Royalist, but Charles is playing a blinder over the pond.

I’m 66 and still do some consultancy work. HMRC are falling over themselves to help me- they have a new service called making tax digital which I love. It only took 3 hours to set up and looks like less than a day a month to file my accounts. Ah the blue skies of self employment…

Thinking about coming back into NHS for another crack. Asked Chat GPT to coach me. It was an astounding hour. I’m no AI convert but bloody hell…..

There is a clear correlation between position in the Premier League table and the initial letter of the club (A=1, Z=26). It is also clear that the north-west of England is an outlier. Is this why it is known as association football? @arsenalfc.bsky.social belong in first position, obvs. #football

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Think recall when received my results via NHS app last year it also gave ranges. Remember being a bit puzzled that GP never said a word about one result that seemed well outside the ‘healthy range’. But I therefore assumed it was not going to kill me

When we are unwell, in pain, anxious wouldn’t it be fab if the NHS was there for us unconditionally?

Trying to make sense of Trump by concluding he’s mentally ill is sloppy thinking. He’s a thin-skinned, power-crazy narcissist with absolutely no moral compass.

Very much this!

And it's fairly unlikely potential candidates will have equal skills and experience in both, so will need to have a team to compensate for whichever deficit, and demonstrably value that.

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Just seen the ad for the new director of patient experience at DHSC. Interesting JD. And….although there’s *much* the NHS can learn from customer service industries, patients are not customers- they are co-producers of health. A vital distinction imho.

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Just rang my (generally lovely) GP surgery to ask about a repeat prescription. Told I had ordered it incorrectly on the app and need to ‘go back and put it on the spine’. Right….

For the nth time today, the British Social Attitudes Survey is not a patient experience survey. Sleep well.

BREAKING: Bruce Springsteen just announced that his band will be doing a tour in effort to fight back against Donald Trump's authoritarian overreach. The Boss is back! Great. Bring down the ICE

Last night, I bought a day return train ticket for a 30 min journey. Good news: I downloaded the ticket straight away. Bad news: I’ve since had 4 emails to confirm/remind me about my trip.

RIP Tessa Richards, of BMJ fame. #medsky www.theguardian.com/society/2026...

Alf🖐️i've met people lately with progressive lung conditions, who didnt want to take meds (bc of side effects). These people are trying to stay active & have stable lung function & we were reflecting on how if they WERE on meds, the stability would be attributed to the meds (which cost £25k/year btw)

Blimey I missed the Ides of March again.

Weird how politicians who claim they speak for those that don’t have a voice are all multimillionaires.

Yes, annoying thing programmed in. Rather than say ‘I just made it up cos m’algorithm/training data not good enough’ it tries to cover up with a ‘dog are my homework’ excuse. Not endearing just pathetic!

My son just asked ChatGPT to do a complex financial task. It got it wrong so my son asked how. ChatGPT explained using very human words (‘forgot’, ‘too much pressure’, ‘mind’, ‘brain’). Weird.

I really enjoy Bluesky but am increasingly concerned that it is a liberal echo chamber. Maybe I am following too many people like me…. So (probably daft) question: Is there a simple way to tap into right of centre sentiments on Bluesky?

Aww you're kind Alf, thanks. We're pretty fortunate in Southmead tbh, so many good people. You can't get away though from a pervasive sense of grief & moral distress. I'd say a general sense of numbing as a way to cope...

I’m in the final stage of my career and went freelance 2 years ago. From an accounts/tax perspective I have found the whole sole trader malarkey remarkably complicated. The new digital tax rules (MTD= making tax difficult) have almost defeated me. They feel like the final straw- I might just retire

Good that Leeds maternity unit is being reviewed by Ockenden *but* failings are systemic and (notwithstanding the fact that we are awaiting the full Amos review), isn’t it blindingly obvious that maternity services require root and branch national reform?

Clinical empathy may enhance patient satisfaction and outcomes, but the interaction between it and ethnicity is underexplored. This web-based experiment using film vignettes explored how people from different ethnicities perceived GPs' communication of clinical empathy ➡️ doi.org/10.3399/BJGP...

‘When a lazy aristocrat from a dying dynasty uses a helicopter to travel seventeen miles, the edifice shakes. But when that same man rapes a 17-year-old and calls her a liar, it is the end of days.’ Andrew O’Hagan on Andrew Mountbatten-Windsor. www.lrb.co.uk/the-paper/v4...

I’m increasingly finding that the digital world is more intrusive than enabling. Even ‘simple’ instructions for new products are written in a language I don’t understand. You could say I have low digital literacy. And I would say ‘design your products with people like me in mind’