Sweden has a self-declared hospital bed crisis, linked to higher levels of mortality and premature discharge (which often leads to higher rates of readmission) (see for instance: pmc.ncbi.nlm.nih.gov/articles/PMC...)

Commentators often hold up Sweden (with lower beds per head) as an example of how bed numbers can be reduced with investment in primary and community care.

Most of those commentators don't really ask any critical questions about Sweden...

When we look at international evidence on bed numbers, it is clear that total and level of occupancy in England are currently not safe. There are few 'transformational' approaches to delivery that would fix this problem.

FWIW I find it very implausible that the NHS will need less G&A beds over time - even with shift to more digitally provided care and options closer to home.

Increasing bed numbers is not a 'good' thing in itself but it certainly would do a lot to help with flow.

Public finances are a state, demographic trends are awful, public expectations on healthcare are unrealistic but… ambient scribes!

Too hard…seek magic tech/ai solution instead.

Please leave party conferences alone. 😢

HEART OF THE MATTER: There are significant differences in both the risk factors for, and the prevalence of, heart and circulatory conditions between different areas of Scotland.

Read the analysis by @jamie-ohalloran.bsky.social and @sebrees1.bsky.social ⤵️

www.ippr.org/articles/tak...

No disagreement there. I think the cost savings on prevention tend to be overstated - we should see this as being more about value of investment and resource allocation then shifting costs!

On that measure, this plan is a real success 💪

Hats off to @cthomashealth.bsky.social, @sallywarren.bsky.social and many many more! Enjoy some well deserved rest!

Ends/

Lots of questions (rightly) about implementation – Government should be clear on 'what happens when' questions in planning guidance.

But the purpose of this plan is not to micromanage change from the centre but to provide the right framework for transformation going forward.

8/

Transforming the app, which 35 million people use is especially welcome.

Making the app a fully integrated front-door will put more power in the hands of patients, and I'm particularly pleased to see a focus on improving channels for patient communication and feedback.

7/

Others will be much better placed to comment on genomics and cutting-edge clinical innovation, but it’s great to see focus placed in the plan on using tech to free up staff time and get the basics right for patients.

That's where the biggest digital opportunities are!

6/

The development of integrated neighbourhood health centres will reduce the need for hospital visits and improve quality.

Prioritising areas with the lowest healthy life expectancy in rollout is a welcome sign that this government is serious about tackling inequalities.

5/

The strategy on shifting care from hospital to communities draws very heavily on
@ippr.org work: tinyurl.com/344czv9v

Of course, this shift will take time, but the focus on changing workforce model, approach to contracting, and payment mechanisms is the right place to start.

4/

Central to that vision is bringing about a prevention revolution.

The plan’s focus on tackling obesity, a Beveridge-sized challenge is esp. welcome. In the long-run a similar level of ambition should be applied to other risk factors but this is the right place to start!

3/

There’s a huge amount to like in the plan and it’s great to see how much of it has drawn on thinking from my
@IPPR colleagues (past and present!)

The plan sets out the right vision to shift our entire health system from reactive, sickness care to health creation.

2/