...this royal throne of kings, this sceptered isle… this precious stone, set in the silver sea, this blessed plot, this earth, this realm...
I’ll miss out the bit about;
‘a fortress built by Nature… against infection and the hand of war’.
Shakespeare didn’t know about Covid and the Ukraine.
With me, are a hundred or so, more souls.
To my right, a lady, trying to manage a boisterous curly-haired toddler. In front, a man. He needs a hair cut. Next to him, a woman who needs a better conditioner.
I just need more hair.
People watching. Everyone’s the same, yet we’re all different. I’d bet they’ll have one thing in common, they’ll want to be healthy…
.... and that’s where the problems begin.
They won’t be. Allergies, anxieties, disasters and diseases. Accidents, happenstance… the passage of time. The deck is stacked against them.
It’s likely that: 17% will be on anti-depressants;13% opioid pain medicine; and the over 50’s… three quarters are likely to be taking ‘something’.
You know yer old when you know the pharmacist by their first name.
The WHO says, 60% of calls on health services are life-style related. We own our diseases. Home-made. With the help of what we eat, drink, do and don’t do.
Aboard this plane, an entire NHS cost centre.
A plane full of people who, sooner or later, will need an appointment, a diagnosis, a prescription, an operation. Maybe an ambulance or a phone call.
If only we knew when, where and what with.
It’s a population. Not a salami-slice of Blighty but a population none-the-less. It would be interesting to put them all, in a petri-dish… watch their lives unfold.
What could we predict?
If we could foretell the future, not necessarily to whisper messages of caution, the public's health is a private matter and life-style, a choice…
… but to fathom demand and direction.
By taking national data and dividing it by the number of people of a particular age, with reasonable certainty, in the next ten years a plane load might need; six thousand prescriptions, 500 GP appointments, a thousand operations, fifty ambulances…
… but when they get to the airport and go their separate ways… their data, in the aggregate is dispersed…
… meaningless.
If they went home and there was a local health index: what makes them sick and why; how health has improved or declined over time; how this varies by area and why; even where ambulance call-outs come from and why….
… that’s meaningful.
If they live in Northumbria, there is a huge variation in health scores from Whitley Sands to Darras Hall and Blyth. Healthy people, healthy lives, healthy places and a 24-point difference between the most and least healthy areas for health outcomes.
Generating data about the health of a population, in very small areas, as a health index, was recommended, in 2018, by the, then, CMO, Dame Sally Davies.
Now, the work of Jonny Pearson Stuttard and the ONS, have made it a reality; using 56 indicators across three domains.
This demonstrates the art of the possible, as a data framework, to track and address small area population health and inequalities.
This makes prevention and improvement visible, accessible and doable.
National frameworks and initiatives are all very well but they pose mobilisation problems and measuring outcomes, with the inevitable time lag, often don't fulfil their potential.
A local health index is a breakthrough… to be able to slice and dice the data, enabling a community, multi-agency response.
Data is important but it can be overwhelming.
Packaged so that it is visible, meaningful and connected with communities creates a new window for integrated care boards and the opportunity for the gold-standard; see, plan and do.
Without data the NHS is flying blind. With too much data it’s flying in a blizzard.
With local data, integrating diverse datasets from across the health system into a population health framework, creates a new focus on resource management and...
>> I'm hearing - Julian Hartley CEO at Leeds Teaching Hospitals is to be next boss of NHS Providers. Another old white guy. I thought Saffron Cordery was doing a great job after Captain Mainwaring left.
>> I'm hearing - Shazad Sarwar a management consultant and by the looks of it, a professional NED, is to chair to East Lancashire Hospitals Trust from December.
>> I'm hearing - The Home Office is to look at umbrella bodies becoming sponsors for newly-qualified international medical graduate GPs to address the visa issues that threaten to drive them out of the NHS.
