From Prescott’s speechwriter to the NHS 2 August 2017 Jeremy Marlow had planned to join the NHS as a doctor. Twenty-five years later he finally works for the health service as executive director of operational productivity at NHS Improvement. “I always wanted to read medicine – I had places [to study it at university],” he says. “But my adolescence struck a bit late and when I left school I just didn’t want to do it. I didn’t want to be locked in – so you wonder why on earth I joined the civil service.” But the pull of science still proved strong, and after a year out he took a degree in environmental science followed by a PhD at Newcastle University in paleo-oceanography – “reconstructing the oceans and climate of the past” – which provides insights into climate change. He had been exploring postdoctoral opportunities, but chanced upon a booklet at a careers fair on the civil service Fast Stream. “I looked at some of the career descriptions of people who had gone in and thought ‘I like the look of that’,” Marlow says. After securing a place he told the civil service he was interested in working in the Department for Environment, Food and Rural Affairs, the Home Office or the Ministry of Defence. He was posted to Defra shortly before a major climate change conference in Johannesburg – and was mortified to find himself assigned to the litter and dog fouling team, part of an interdepartmental group looking at liveability and quality of life. Read the full article at Civil Service World ____________________________________________________________________ NHS links with councils are fracturing 31 July 2017 The financial crisis engulfing health and social care risks driving the NHS and local government apart. Local Government Chronicle has revealed that ministers have instructed 47 of the 152 councils running social care to reduce delayed transfers of care from hospitals attributable to social services by 60% or more, based on their performance in February. The accompanying letter from the Department of Health and Department for Communities and Local Government made clear that councils that fail to hit their target risk being penalised in the allocation of the £2bn of additional social care funding announced in the budget. The Local Government Association has already withdrawn support for the Better Care Fund planning guidance (pdf) for this year, which compels councils to focus on reducing pressure on the NHS irrespective of their local priorities. There are two issues: whether this is a sensible way to tackle delays in transfers of care, and what this increasingly fractious debate says about relations between health and local government. According to the official statistics, there were 178,400 days lost through delays in May. Around 55% were attributable to the NHS, 37% to social care and the remainder had shared responsibility. Read the full article at the Guardian Healthcare Network ____________________________________________________________________ Ambulance overhaul shows way forward 14 July 2017 NHS England’s gutsy move to overhaul the ambulance response system exemplifies how the NHS can push through controversial changes, and the perils of trying to do it. At first glance the new system appears counterintuitive – allowing 999 call handlers more time to decide the appropriate action, and classifying significantly fewer calls as needing the fastest response. But, crucially, the changes are based on an all-but-bulletproof body of evidence. NHS England claims the Ambulance Response Programme, commissioned in 2015, has been the world’s largest clinical ambulance trial, involving independent analysis of 14m emergency calls over 18 months. It says emphatically that no safety issues were identified with the new approach, and estimates that 250 lives will be saved across England annually. For the public launch, a small army of senior clinicians and other prominent figures was assembled covering everything from acute care to strokes, heart attacks, ambulance services and paramedics. Each explained why the new approach was best for their patients and the wider system. The ambulance improvements are central to the national drive to treat heart attacks and strokes quickly in specialist centres. Instead of the current fiasco of multiple ambulances being sent to the same call, and paramedics on motorbikes being dispatched when an ambulance is needed, the focus is shifting to the outcome for the patient. Read the full article at the Guardian Healthcare Network ____________________________________________________________________