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Alf Collins

@alfcollins.bsky.social
1.7K followers 754 following 831 posts

Doctor, patient advocate, Trustee Patients Association, Picker Institute. Person centred, high value care, shared decision making, support for self management. Ex Health Foundation, NHS England. Rugby, family, good food. Personal views

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Reposted by Alf Collins
Craig @craig.nikolic.co.uk · 29/09/2026
Much of the problem is the lack of challenge. Ideas are put out and then become fawningly adopted without any challenge from those who really do know better.
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Craig @craig.nikolic.co.uk · 29/09/2026
But… the old saying is very true, plans often don’t survive first contact with the enemy, but the planning itself is invaluable.
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Craig @craig.nikolic.co.uk · 29/09/2026
The NHS’s long term plans are usually as successful as Gosplan’s were for the Soviet Union.
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Alf Collins @alfcollins.bsky.social · 29/09/2026
Here’s a thought for all you NHS nerds: How’s the 10 year plan going?
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Alf Collins @alfcollins.bsky.social · 26/09/2026
Staying at a hotel with wife this weekend. Welcome pack tells me that the owners ‘fundamentally believe in balance’ and that the hotel is designed around my whole self. Other than that utter b*****ks it seems quite nice.
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Sebastian Rees @sebrees1.bsky.social · 24/09/2026
It’s the most wonderful time of year…
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Craig @craig.nikolic.co.uk · 21/09/2026
One of the most telling things about NHSE for me is the attrition of senior people in the top 2-3 layers. I wouldn't take a job there now if you added an extra zero to the salary.
hsj.co.uk
Exclusive: National director to leave next month
The national lead for neighbourhood health, and former national medical director, has resigned, HSJ has learned.
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Alf Collins @alfcollins.bsky.social · 20/09/2026
I was today years old when I learned you don’t have to smile at the camera to make Apple Pay work.
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THIS Institute (The Healthcare Improvement Studies Institute) @thisinstitute.cam.ac.uk · 14/09/2026
Successful innovation depends on the people as much as the technology. Our latest Explain THIS resource explores clinician engagement and why it matters for introducing and sustaining healthcare innovations. Read the latest resource: buff.ly/HmX7V5r
Infographic titled “Top tips for engaging clinicians in adopting new technologies and innovations.” Using illustrated healthcare-themed panels connected by arrows, the graphic presents seven recommendations for successful technology adoption: (1) Involve clinicians from start to finish, (2) Provide training on new technologies, (3) Use peer-to-peer influence to help drive engagement, (4) Create clear communication channels and feedback loops, (5) Bring discussions about new technologies into natural workflow moments, (6) Recognise the time and effort clinicians contribute, (7) Share real-world impacts and progress.
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Alf Collins @alfcollins.bsky.social · 10/09/2026
A single item PREM measuring empathy. @pickereurope.bsky.social
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Alf Collins @alfcollins.bsky.social · 07/09/2026
Want to make sense of your patient experience data? Thinking of using an AI programme to help? Read this report first.
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Charlie Jones @charliepsych.bsky.social · 29/08/2026
Leaves you feeling stupid but it's tech not fit for purpose I tried to buy tickets & got an email full of links. Asked to speak to a person "you need to go via the portal". I said it's not accessible. Bloke took my order by phone & said I couldnt have bought those tickets through the portal anyway😆
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Pete Moore @paintoolkit.bsky.social · 28/08/2026
Digital is on a massive dose steroids Alf and leaving us of certain age (and way younger) way behind.
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Alf Collins @alfcollins.bsky.social · 28/08/2026
My wife (she 68 and CEO of a medium sized company, me 66) and I having parallel conversations with 2 public services right now, each of them pushing us hard to go ‘digital first’. All too complex and confusing for both of us, and we have declined. We are becoming digitally illiterate.
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David Oliver @mancunianmedic.bsky.social · 28/08/2026
In his "Oh you are awful! But i like it!" character
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Alf Collins @alfcollins.bsky.social · 26/08/2026
I spent a couple of hours on ChatGPT today, looking at shared decision making in England. Lots of great work going on but a huge pity that there’s no leadership in DHSC.
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Dr Liza Morton @drlizamorton.bsky.social · 24/08/2026
Please keep shouting, however futile it seems. Even small changes make a real difference, thank you for all you’re doing to bring enlightenment & real change.
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Charlie Jones @charliepsych.bsky.social · 24/08/2026
Hi Alf, yes definitely. With LTCs being such a big part of NHS work it frustrates me that this remains such an uphill struggle. There’s no lack of evidence. NHS remains better at trauma/single episodes of care, but worse at care for LTCs where theres a need for continuity & relational approach...
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Charlie Jones @charliepsych.bsky.social · 24/08/2026
Some hospital inpatients get referred for Psychology input, & I'm open to this. We see a tiny fraction of inpatients. But ALL patients have psychological needs. 'Seeing a psychologist' is the wrong approach (& expensive). Psychological care should just be an integral part of normal, holistic care.
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call634-5789 @call634-5789.bsky.social · 20/08/2026
Enough.
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Lesley Smith @lesleysmith.bsky.social · 20/08/2026
Totally agree Alf. NHSE has specified to Cancer Alliances that they should in 26/27 “complete delivery of improvements plans for behaviour change for physical activity” but somehow the BC words don’t often land, despite the great training through movingmedicine.ac.uk
movingmedicine.ac.uk
Moving Medicine - The ultimate resource for healthcare professionals
The ultimate resource to help healthcare professionals integrate physical activity conversations into routine clinical care.
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Alf Collins @alfcollins.bsky.social · 20/08/2026
It continues to amaze me how much of healthcare relies on patients changing their behaviour, yet how little time is spent training healthcare professionals in behaviour change techniques. There is a pervasive sense of ‘if clinicians tell patients to……, they’ll just do it’
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Simon Christmas @simonxmas.bsky.social · 18/08/2026
And if you’d decided NOT to buy the ticket, you’d have received five emails asking you if you were still going, whether you’d forgotten to press buy, etc.
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Alf Collins @alfcollins.bsky.social · 18/08/2026
Routine cross country train today. On the positive side, I paid for and downloaded my tickets in 3-4 mins On the negative side, I received 5 emails and 3 texts overnight and this morning to ‘remind me’ of my trip Enshittification is driving me out of the digital world.
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Nigel Edwards @nigel-edwards.bsky.social · 18/08/2026
This makes me mad. I met him when he was appointed as Perm Sec at DHSC and was profoundly underwhelmed. Eveything he subsequently did suggested that I had hugely overestimated him.
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Charlie Jones @charliepsych.bsky.social · 15/08/2026
I always start a clinical appt by taking my lanyard off & putting it down on the table. It's a habit formed over years. It's a tiny gesture, & prob more a reminder to myself to notice symbols of power & to set out for something more like a conversation than a consultation...
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Charlie Jones @charliepsych.bsky.social · 15/08/2026
Hi Alf nice to hear from you. Epistemic injustice in healthcare very interesting to me. I've only come across the term last few years, but I see it everywhere & good to have a descriptor for it. Power- who has more power, who has less, & how is power used?
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Alf Collins @alfcollins.bsky.social · 13/08/2026
Fascinating report on self management of insulin by people with learning disabilities. Sadly, no mention of communication techniques such as ‘chunk and check’ and ‘teach back’. I recently trained 90 community nurses in commskills to support self management. None had had previous training.
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Simon Christmas @simonxmas.bsky.social · 12/08/2026
At last, an anti-science campaign we can all get behind.
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tpchealth.bsky.social @tpchealth.bsky.social · 12/08/2026
Community-facing roles are carrying more complexity. Our Community Health and Wellbeing Worker apprenticeship provides structured development in confidence, boundaries, and reflective practice. Next cohort: 23 September tpchealth.com/level-3-comm... @alfcollins.bsky.social
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Alf Collins @alfcollins.bsky.social · 11/08/2026
Fabulous hip OA evidence summary from @bmj.com. Wonderful to see shared decision making given such prominence. And as someone living with pain from hip OA- it’s useful for patients as well!
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Alf Collins @alfcollins.bsky.social · 11/08/2026
Reminded again today that, like patient safety, personalised (cf person centred) care isn’t something that healthcare teams instinctively ‘just do’. It needs a supportive policy context and national leadership. And we don’t have that right now…
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Alf Collins @alfcollins.bsky.social · 11/08/2026
No. I do not want to use your f***ing portal.
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Helen Hughes @helenh49.bsky.social · 11/08/2026
AI clearly has a huge opportunity to improve efficiency. But what about effectiveness, productivity and most importantly, safety? In this blog, @cflashman.bsky.social expands on issues and the risks that we must address. A must read! www.pslhub.org/learn/digita...
pslhub.org
AI is now the top risk to patient safety—what can organisations and patients do to protect themselves?
Clive Flashman considers questions posed by participants at a recent panel discussion exploring the patient safety risks associated with the application of AI technologies in healthcare
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Andrew Longhurst 🇨🇦 🍉 @alonghurst.bsky.social · 10/08/2026
Authoritarian necropolitics
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Nigel Edwards @nigel-edwards.bsky.social · 29/07/2026
Repeated reviews in maternity (and other areas) have not really go to the bottom of the issues - often because they are genuinely hard to understand. And so the pattern repeats. bmj.com/cgi/content/...
bmj.com
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Alf Collins @alfcollins.bsky.social · 28/07/2026
Wouldn’t it be fab if the 22 NhSE patient decision support tools (www.england.nhs.uk/personalised...) were on the NHS App? It would be a significant step forward for ‘patient power’ but no one at the centre seems to even know about them.
england.nhs.uk
NHS England » Decision support tools
NHS England » Decision support tools
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James Titcombe @jamestitcombe.bsky.social · 25/07/2026
There is much to be welcomed about the Amos report - but its conclusions on the influence of ‘normal birth’ ideology on maternity safety are not supported by wider evidence, offer dangerous false assurance and must not be relied upon. www.hsj.co.uk/patient-safe...
hsj.co.uk
The Amos review’s conclusions on ‘normal birth ideology’ are not credible
The Amos review's conclusions on maternity safety contradict four previous major investigations, raising serious questions about the evidence underpinning national policy
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Mike Chitty @mikechitty.bsky.social · 19/07/2026
We call it ‘deeming leadership’ In a close field it is the worst type of leadership. We deem compassion and candour and quality. We get poor care, burnout and privatisation. Cock up or conspiracy?
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Simon Christmas @simonxmas.bsky.social · 18/07/2026
I’ve always thought of national policies as having the same status as the Egyptian Book of the Dead. Detailed priestly prescriptions for how to control something that doesn’t happen and, even if it does, can’t be controlled.
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Alf Collins @alfcollins.bsky.social · 18/07/2026
Wife about to undergo bilateral cataract surgery. Basic lenses available on NHS, more sophisticated lenses only available privately. Having looked at NICE and evidence, it does seem that the core argument is population value. But…seems like a good case for copayments. Tell me I’m wrong 😊
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Alf Collins @alfcollins.bsky.social · 14/07/2026
Complex system theory right there.
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Alf Collins @alfcollins.bsky.social · 10/07/2026
I still don’t know which button to press to end a call on my iPhone. I rely on the person I’m speaking with to cancel the call
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Jason @nickmotown.bsky.social · 10/07/2026
With Penelope Keith’s passing, I got to thinking about Paul Eddington, in his final days, facing the camera that one last time, despite the shitty hand life had dealt him, and the courage it must have taken to do so. Given the chance to spin some grandstanding bullshit, he chose to say this instead:
“A journalist once asked me what I would like my epitaph to be and I said I think I would like it to be ‘he did very little harm’. And that’s not easy. Most people seem to me to do a great deal of harm. If I could be remembered as having done very little, that would suit me”.
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Alf Collins @alfcollins.bsky.social · 08/07/2026
Ahh that’s leadership. Right there.
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Helen Haskell @hhask.bsky.social · 05/07/2026
Martha’s Rule study to boost NHS patient safety www.uclh.nhs.uk/news/uclh-le...
uclh.nhs.uk
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General Boles @generalboles.bsky.social · 05/07/2026
"I know it's not the sort of thing you usually do Mr Havelange but speaking as a nuclear power we'd appreciate Gascoigne's yellow being overturned and the match result annulled"
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Alf Collins @alfcollins.bsky.social · 03/07/2026
My wife has just been phoned to ask on what date she wants her cataract surgery. How lovely to be given the choice. But she didn’t even know she’d been referred…
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Neal Maskrey @stokemacca.bsky.social · 30/06/2026
The Probate Division of the High Court admin was very impressive. Other than that, I agree; nothing works as it should.
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