iiinova — where your digital self keeps evolving

Alf Collins @alfcollins.bsky.social · 09/10/2026

Of course it will be pay for view. They are barbarians. Mark my words…

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Alf Collins @alfcollins.bsky.social · 08/10/2026

Thanks Neil. Erk it’s paywalled but I’m sure it’s a fab article as Phil W knows his onions. How’s stuff Neil?

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Alf Collins @alfcollins.bsky.social · 08/10/2026

No, I don’t want to download your bloody App thank you very much.

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Alf Collins @alfcollins.bsky.social · 06/10/2026

My wife waiting for an op next Monday. Not life threatening but we’ve both significantly shifted our lives around for the next 3-4 weeks. She’s just had a text: ‘your operation next week is cancelled’. That’s it. No reason, no apology, no sense of how to rebook. Thank God she hasn’t got cancer

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Craig Nikolic @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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Alf Collins @alfcollins.bsky.social · 29/09/2026

In this case, I wonder how invaluable the planning actually was. I’m guessing that (as per..) there was much magical thinking/bulls**t.

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Craig Nikolic @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 Nikolic @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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Alf Collins @alfcollins.bsky.social · 24/09/2026

Ask them is they have any health policies Sebastian 😂

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Sebastian Rees @sebrees1.bsky.social · 24/09/2026

It’s the most wonderful time of year…

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Alf Collins @alfcollins.bsky.social · 23/09/2026

Couldn’t agree more. And good to hear from you too. Btw, has Alan Cribb been in touch re: his new book?

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Alf Collins @alfcollins.bsky.social · 23/09/2026

Ah but Charlie if you want people to change their behaviour you just keep going with the same message and say it louder and LOUDER.

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Alf Collins @alfcollins.bsky.social · 22/09/2026

And national leadership for the work has dissolved over the last few months. Wonder why?

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Alf Collins @alfcollins.bsky.social · 22/09/2026

Our 11 year old Labrador did the same about 6 months ago. We felt quite pushed towards surgery- though I understand the results are excellent. On balance, and considering her age we decided not to proceed. Within 3-4 weeks she was fully mobile and now seems to have fully recovered.

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Craig Nikolic @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 · 09/09/2026

Pedants corner response. The population in the SAS is a random sample of the general public, not of current NHS users (though of course many will be). And…satisfaction is a volatile concept with ill determined psychometrics. Bottom line- Not sure we should attach much credence to it.

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Alf Collins @alfcollins.bsky.social · 09/09/2026

At 18 secs there’s an interesting slip of the tongue ‘I have *every* doubt that what Trump is conveying is…his experience’ 😂😂

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Alf Collins @alfcollins.bsky.social · 09/09/2026

Hear hear. Maternity teams should not just be listening to concerns, but proactively eliciting and acting on preferences and concerns across the maternity and neonatal pathway. A single ‘rule’ is not going to fix this.

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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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Alf Collins @alfcollins.bsky.social · 06/09/2026

Exactly as Sir John Oldham said when he launched the LTCQIPP programme: ‘a tsunami of need is coming our way’. Oh wait, when was that? (checks notes)….2010.

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Alf Collins @alfcollins.bsky.social · 06/09/2026

I was a member of the DHSC/NHSE National Overprescribing Review that reported in 2021. It had a broad scope, *but*, senior leaders in NHSE and DHSC moved on, new ideas came in and the national drive became anaemic. It should have been a 10 year programme of work but seems to have been forgotten.

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Alf Collins @alfcollins.bsky.social · 03/09/2026

A friend was phoned to offer a slot for surgery the next day. She declined as she was on holiday in Spain. She was phoned a few days later with the same offer and declined again as she was still in Spain. She’s been advised that she is now not on the WL.

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Alf Collins @alfcollins.bsky.social · 02/09/2026

The people that design these policies and do this work should be ashamed of themselves. That said, a significant proportion of people on WLs don’t know what they are waiting for, and an even bigger proportion would opt for alternative treatments if they had shared a decision earlier in the pathway

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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 · 28/08/2026

Only Dick Emery missing from that list.

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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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Alf Collins @alfcollins.bsky.social · 24/08/2026

👍. I’d be up for something….maybe an initial meeting of like minded people, with a fluid agenda?

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Alf Collins @alfcollins.bsky.social · 24/08/2026

I think there has been a shift towards more recognition of the need for ‘whole person healthcare’. And the medico-industrial complex is pulling just as hard in the opposite direction. Clinicians should bring about a social movement. We tried with ‘Rethinking Medicine’ but the time wasn’t right..

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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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Alf Collins @alfcollins.bsky.social · 24/08/2026

Ah yes of course…wonderful work. So many good people have attempted to broaden our appreciation of the philosophy of healthcare, yet the medical model is remarkably resilient.

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Alf Collins @alfcollins.bsky.social · 24/08/2026

We’ve spoken about this Charlie. A couple of decades ago, a handful of us were calling for ‘psychologically informed’ care and support for people with LTCs. It never really took off.

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Alf Collins @alfcollins.bsky.social · 21/08/2026

Totally. We are in such a privileged position, at least we can go some way towards making the ‘system’ work for us.

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Alf Collins @alfcollins.bsky.social · 21/08/2026

As far as I’m concerned the whole NHS digital first agenda can **** itself. I find navigating any aspect of the digital world increasingly challenging and frustrating and plan a significant digital detox when I finally retire.

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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

Lovely. And there is something important that comes to mind here about empathetic leadership—-lots of people talk about it, but it remains an aspiration for most leaders/clinical leaders, such are the demands of the work.

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