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nhsManagers.net

17th December 2025


News and comment from

Roy Lilley



Everything...

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Short on time? Get yer ears-on and listen to Roy Lilley read this morning's eLetter... free!

There’s an annual problem we all share…


… what do you buy someone who already has everything?


The answer is… more!


Well, probably not.


For someone who has everything material, I suppose the right answer is ‘experiences’.


You can wrap them up in fluffy towels on a spa day. You could send them off for a cooking class and have them shouted at by a Gordon Ramsey wanna-be. 


Throw them out of an airplane?


If you want to push the boat out, there are subscription boxes for a year's supply of coffee from the upper Ganges armpit. 


Gourmet food? Toasted Cumquat seeds maybe, and the good old standby of smelly candles that always remind me of my granny’s wardrobe.  


If you’re feeling a bit flush, a bit of Tech might do the job? One of the those new ring-things that tells you if you’re still breathing. 


I came across Gaiatop Avocado, Rechargeable Hand-warmers… don’t ask…they’re on Amazon. 


How about a;


beautiful necklace studded with crystals that mirror the constellation that corresponds with their astrological sign’


... Amazon, again.


You’ve probably still got time to book Xmas at the Carlton Hotel, St. Moritz.


How about a pair of Fluffy-Cuff, fingerless gloves made in an Alpaca wool-blend, so you can still message on yer iPhone, or…


… a Louis Vuitton, Rosalie Coin Purse, priced at a bargain £305…


... who has coins these days? The buskers in London play guitar wearing fingerless gloves but they all have a PayPal touch thing. You can swipe them a quid as you pass-by.


I was going to suggest a Montblanc, gold plated, fountain pen. At £1,500 they’ve proven to be a hit. Harrods has sold out.


If you are really stuck you could use your creative side and print up your own voucher with a promise to give someone an exclusive hour of your time every day. 


It’s not the price… it’s the cost that counts.


How about reading your favourite book aloud. Use voice-memo on your iPhone and send them a chapter a week, as a talking-book… ‘I loved book this so much, I wanted to enjoy it with you’.... thoughtful and cheap.


If all else fails there are actual books!  


The numbers are interesting; 40% of Britons hadn't read a book in the last year.


Waterstones reports a 5% revenue rise, which they say is fuelled by an increased interest in fiction by younger readers


A mixed picture. What does it mean... dunno.


Travel books, recipe books, thrillers, historical, fact, fiction? What to chose?


If you are thinking of a book for someone who has an interest in matters NHS, plus all the other imperatives; travel, food, love, historical facts and fiction…


I can highly recommend; Nick Black’s, Bare Knuckle Surgeon.


A meticulously researched history book, woven into a life of intrigue and passion. 


Fact and fiction, side-by-side in a powerful combination. History and expertly crafted story telling, bringing a choking, dangerous London, of the 1800's to life.  


Written of a time when incompetent surgeons, corrupt royal colleges, nepotism and quackery… the medical establishment… a small coterie of self serving doctors…


... went unchallenged… 


… until 1823, when a young surgeon, son of a farmer, who'd survived being at sea, mastered bare-knuckle fighting (Black takes you into the ring with all its gore and consequences) and escaped assassination, did what no doctor had dared.


Risking ruin, Thomas Wakley, took on the establishment by publishing The Lancet... the global publication so revered, today.


Wakley scandalised the establishment and laid the groundwork for modern health care, transparency and sharing best practice.


As much as it is brutal, for the times Wakley lived in were brutal, it is also a tender love story and remains a message for the NHS and healthcare today.  


Nick Black’s Bare Knuckle Surgeon, is ingenious. Innovative in its story telling of a London that was filthy and corrupt. People who were impoverished and exploited and where, in the summer; the rich moved out to higher ground and cleaner air.


This book is a Phd in public health and town planning. In parts, as brutal as any airport thriller. It’s a history the medical profession cannot be proud of. There are passages that Jane Austen would approve of. 


It’s a great read, where you bump into facts and insights and wonder why you didn’t know them already.


It's a cookbook of broths and pies, the diet of old London. It's an exposé of insurance company cheating. It's a book about fellowship and love. About poverty. The impact of ill judged legislation, greed and power.


It’s the perfect present for anyone, who has everything...


____________


... and available from Amazon who'll get it to you in time for Xmas, to wrap it up with a big bow, step back and take the credit for being a present genius.

NEW-NEW-NEW-NEW-NEW

Dr Charlotte Refsum 


In their latest In The Loop podcast

Niall and Roy debate with

Dr Charlotte Refsum

Director of Health Policy at the

Tony Blair Institute.


In a frank discussion Charlotte a former GP reveals how the former Prime Minister is still closely involved in policy development and she lays out the stark choices facing the NHS if it is to survive in the face of the enormous challenges it currently faces. 


Charlotte is a former GP, has been involved in supporting change in 25 countries, contributed to the government’s NHS plan and has worked with Sir Patrick Vallance and Sir John Bell on technology and how the arrival of the AI era will transform health and care.


This podcast is her frank assessment of HMG's strategy. Hard questions about what will be needed to implement the changes needed and whether the absolute priority, which concentrates so much of its resources on older people with long term conditions, is justified. 


Charlotte suggests the current budget may be all we can afford, and in her view the NHS needs to find ways of living within its means...


... that will involve thinking like an insurer, assessing future risks and taking prevention much more seriously.



Download the podcast here...


... and to listen again and access the whole series follow the link below. 

For all the previous

In the Loop

podcasts with

Rob Webster

ICB CHEx

Sarah Woolnough

CEO of the King's Fund

Sir Jim Mackey

Dame Jennifer Dixon

Lord Darzi

Professor Tas Qureshi

Dr Penny Dash, chair NHSE

Richard Meddings,

former chair NHSE,

Sir Jeremy Hunt,

Sir Andrew Dilnot,

Paul Johnson IFS

CLICK HERE


-oOo-


Probably, the most listened to

Podcast in the NHS!

FREE!

Want to contact Roy Lilley?

Please use this e-address

roy.lilley@nhsmanagers.net 

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Dr Paul Lambden


Reindeer Aren’t Just For Christmas


'... we need to turn to what is probably the best known verse of an American, “A visit from St Nicholas”, written by Clement Clarke Moore in 1822 for his children, and first published anonymously in the Troy New York Sentinel the following year.'


News and Other Stuff

---

>> ICB restricts autism, ADHD and - weight loss services.

>> HMG making significant changes to the dental contract - to ensure dentists receive fairer payment.

>> The NHS’s annual December stress test - reveals a fundamental flaw.

FREE BOOK - CLICK TO DOWNLOAD


... from Ed Smith, former chair of NHSImprovement and Roy Lilley.


If you work in the NHS you may not have a stethoscope and you may not stand at the bedside but you are part of the invisible army of people who keep the lights on, makes sure the place is clean and properly maintained, and all the other things...


If you are the one... it's OK to be proud of what you do and...


... this book is for you."


Click here for a free download.

The ME Association to fund Imperial College London scientists in £1.1m ground-breaking research study









This is what I'm hearing, unless you know different. In which case, tell me, in confidence

__________


>> I'm hearing - Andy Heeps has been appointed CEO of University Hospitals Sussex FT. He's been the interim since last summer.

>> I'm hearing - Professor Jonathan Benger CBE will become NICE's next chief executive. He starts the role on the 19th December. Tricky time....

>> I'm hearing - GP magazine is reporting; At least two thirds of ICBs - and possibly as many as 80% - have been notified by GP practices about concerns over workload or patient safety since changes to online consultation requirements took effect.

More News

----

>> Rosie Cooper stands down as Mersey Care FT chair- due to health issues.

>> Nearly 1 in 4 Americans believe US healthcare is in ‘crisis’ - Gallup.

>> Aquablation therapy using a robotic approach for prostate cancer - trials.

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