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.
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.
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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.
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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.
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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.
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Reposted by Alf Collins
📢 ISDM 2026 Conference: Call for Abstracts is OPEN
📝 Submission deadline: December 8, 2025, 11:59 PM EST
(*Check: www.worldtimebuddy.com)
🎟 Early bird reg opens: Sept 30, 2025
Join us for the 13th International #SharedDecisionMaking #ISDM2026 Conference!
👉 More Info: sites.dartmouth.edu/isdm2026/
📝 Submission deadline: December 8, 2025, 11:59 PM EST
(*Check: www.worldtimebuddy.com)
🎟 Early bird reg opens: Sept 30, 2025
Join us for the 13th International #SharedDecisionMaking #ISDM2026 Conference!
👉 More Info: sites.dartmouth.edu/isdm2026/
September 18, 2025 at 1:36 AM
📢 ISDM 2026 Conference: Call for Abstracts is OPEN
📝 Submission deadline: December 8, 2025, 11:59 PM EST
(*Check: www.worldtimebuddy.com)
🎟 Early bird reg opens: Sept 30, 2025
Join us for the 13th International #SharedDecisionMaking #ISDM2026 Conference!
👉 More Info: sites.dartmouth.edu/isdm2026/
📝 Submission deadline: December 8, 2025, 11:59 PM EST
(*Check: www.worldtimebuddy.com)
🎟 Early bird reg opens: Sept 30, 2025
Join us for the 13th International #SharedDecisionMaking #ISDM2026 Conference!
👉 More Info: sites.dartmouth.edu/isdm2026/
Wes Streeting talking passionately about ‘patient power’ on radio 4. Yet the NHS plan pays scant attention to patient engagement, and shared decision making is not mentioned at all.
‘Choice’ encompasses choice of treatment and choice of provider…
‘Choice’ encompasses choice of treatment and choice of provider…
October 23, 2025 at 9:24 AM
Wes Streeting talking passionately about ‘patient power’ on radio 4. Yet the NHS plan pays scant attention to patient engagement, and shared decision making is not mentioned at all.
‘Choice’ encompasses choice of treatment and choice of provider…
‘Choice’ encompasses choice of treatment and choice of provider…
Reposted by Alf Collins
As a result, the system is good at managing and averting crises, but much less good at doing other things like improving productivity, improving experience, changing service models, planning ahead etc.
October 19, 2025 at 11:30 AM
As a result, the system is good at managing and averting crises, but much less good at doing other things like improving productivity, improving experience, changing service models, planning ahead etc.
Reposted by Alf Collins
I'm still frustrated at the staff engagement for the plan. Zoom calls with 200+ people, with Menti. It just repeated predictable dominant narratives, there was minimal space for critical thinking, dialogue, or getting underneath the surface. But it led to claims that 'we engaged with 1000s of staff'
October 18, 2025 at 3:19 PM
I'm still frustrated at the staff engagement for the plan. Zoom calls with 200+ people, with Menti. It just repeated predictable dominant narratives, there was minimal space for critical thinking, dialogue, or getting underneath the surface. But it led to claims that 'we engaged with 1000s of staff'
Reposted by Alf Collins
Exhausted but elated after incredible week rethinking clinic letters for the modern era. Brought GPs, @uclh staff, patients together for a huge push. The time, safety challenges, cost & impact on GP & hospital staff is vast. Got down to 9 key solutions, 1 worked up prototype & we’re done ✔️
October 17, 2025 at 5:17 PM
Exhausted but elated after incredible week rethinking clinic letters for the modern era. Brought GPs, @uclh staff, patients together for a huge push. The time, safety challenges, cost & impact on GP & hospital staff is vast. Got down to 9 key solutions, 1 worked up prototype & we’re done ✔️
Reposted by Alf Collins
And symptoms can be very “total”- not just physical but emotional, spiritual as well. The meaning of pain (reminder of cancer diagnosis for example) can exacerbate it hugely for good reason
October 16, 2025 at 11:50 AM
And symptoms can be very “total”- not just physical but emotional, spiritual as well. The meaning of pain (reminder of cancer diagnosis for example) can exacerbate it hugely for good reason
The 10 year NHS plan and what it means for patients. Been re-reading and thinking. Bottom line is that there’s some good stuff but overall the plan is regressive. There is scant mention of coproduction which imho should be the core cultural shift. Disappointing for the future of the nations health.
October 16, 2025 at 9:28 AM
The 10 year NHS plan and what it means for patients. Been re-reading and thinking. Bottom line is that there’s some good stuff but overall the plan is regressive. There is scant mention of coproduction which imho should be the core cultural shift. Disappointing for the future of the nations health.
Jesus would be proud of this guy who wants to bring ‘Christianity back into the heart of Government’
UKIP have been taken over by the COO of the UK branch of St Charlie's Turning Point
October 15, 2025 at 9:10 AM
Jesus would be proud of this guy who wants to bring ‘Christianity back into the heart of Government’
Reposted by Alf Collins
aheblog.com/2025/10/14/c...
Cost-effectiveness thresholds under political pressure: where are the health economists
There have been occasions I've disagreed with Chris's take on some matters
Im 100% with him on this one
Cost-effectiveness thresholds under political pressure: where are the health economists
There have been occasions I've disagreed with Chris's take on some matters
Im 100% with him on this one
Cost-effectiveness thresholds under political pressure: where are the health economists? - The Academic Health Economists' Blog
The UK government is reportedly preparing to raise NICE’s cost-effectiveness threshold by 25%, as a bargaining chip to avoid US pharmaceutical tariffs. It’s time for health economists t…
aheblog.com
October 14, 2025 at 8:25 PM
aheblog.com/2025/10/14/c...
Cost-effectiveness thresholds under political pressure: where are the health economists
There have been occasions I've disagreed with Chris's take on some matters
Im 100% with him on this one
Cost-effectiveness thresholds under political pressure: where are the health economists
There have been occasions I've disagreed with Chris's take on some matters
Im 100% with him on this one
Reposted by Alf Collins
Theres soon to be a test on whether those who opine about screening actually understand the principles on which screening programmes are based
Get your revision done
In the meantime here is a masterclass from Prof Baum
(More advanced classes are available)
Get your revision done
In the meantime here is a masterclass from Prof Baum
(More advanced classes are available)
October 14, 2025 at 7:59 PM
Theres soon to be a test on whether those who opine about screening actually understand the principles on which screening programmes are based
Get your revision done
In the meantime here is a masterclass from Prof Baum
(More advanced classes are available)
Get your revision done
In the meantime here is a masterclass from Prof Baum
(More advanced classes are available)
Posting this again because I am now using ChatGPT as my coach to help me reduce my cardiac risk. I’m health literate, I have my data, I know where to look for the evidence but *I am now not relying on the NHS to help me make decisions about managing my cardiac risk* @finnikin.bsky.social
Me: 65 years, relatively fit for age, recently retired doctor . BP trending up (135/80)
I’ve just spent 30 mins discussing pros and cons of treatment with ChatGPT. A wonderful *dialogue*.
Question: Why choose the NHSApp when we have ChatGPT?
I’ve just spent 30 mins discussing pros and cons of treatment with ChatGPT. A wonderful *dialogue*.
Question: Why choose the NHSApp when we have ChatGPT?
October 14, 2025 at 11:05 AM
Posting this again because I am now using ChatGPT as my coach to help me reduce my cardiac risk. I’m health literate, I have my data, I know where to look for the evidence but *I am now not relying on the NHS to help me make decisions about managing my cardiac risk* @finnikin.bsky.social
Reposted by Alf Collins
Thanks to the many coauthors of this primer for clinicians about shared decision making ... link.springer.com/article/10.1...
October 9, 2025 at 5:33 PM
Thanks to the many coauthors of this primer for clinicians about shared decision making ... link.springer.com/article/10.1...
Reposted by Alf Collins
Indeed. I've quoted it recently to demonstrate the absurdity of raising the QALY threshold since NICE already approves too many low value (high cost/QALY) interventions.
October 8, 2025 at 9:00 PM
Indeed. I've quoted it recently to demonstrate the absurdity of raising the QALY threshold since NICE already approves too many low value (high cost/QALY) interventions.
A 2025 review in the Lancet (www.thelancet.com/journals/lan... shows that our current spending on new medicines skews overall health spend away from more effective interventions. But it looks like we are about to spend more on meds, thus depriving our population of more effective healthcare.
October 8, 2025 at 5:23 PM
A 2025 review in the Lancet (www.thelancet.com/journals/lan... shows that our current spending on new medicines skews overall health spend away from more effective interventions. But it looks like we are about to spend more on meds, thus depriving our population of more effective healthcare.
Reposted by Alf Collins
Don’t get me started on “brave” people who “fight” cancer or “lose their battle with” a disease 😡
October 8, 2025 at 2:24 PM
Don’t get me started on “brave” people who “fight” cancer or “lose their battle with” a disease 😡
I just walked for an hour through Belgravia and I didn’t see a single Black person. It’s a disgrace.
October 7, 2025 at 2:04 PM
I just walked for an hour through Belgravia and I didn’t see a single Black person. It’s a disgrace.