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Taskforce on Multiple Conditions

Taskforce on Multiple Conditions

The Taskforce on Multiple Conditions is an ambitious cross-sector partnership between The Richmond Group of Charities, The Royal College of General Practitioners and Impact on Urban Health.

Our overarching aim is for people with multiple long-term health problems to live as well as possible for as long as possible, because the following has been achieved:

  • The development of multiple long-term conditions is delayed or prevented
  • Where people live with multiple long-term conditions, health and care services and the voluntary sector’s offer are well aligned to manage and support them.

If you would like to find out more please get in touch with our Programme Manager, Eve Riley. You can also watch Liam O'Toole from Arthritis Research UK set out our thinking here.

  • New research report: You Only Had to Ask
  • The Multiple Conditions Guidebook - One Year On
  • Multiple Conditions & Health Equity Events Series
  • The Multiple Conditions Guidebook
  • Research report: Just One Thing After Another
  • Expert Advisory group

New research report: You Only Had to Ask

Overview of the report

Produced by Revealing Reality and commissioned by the Taskforce on Multiple Conditions the report You only had to ask: What people with multiple conditions say about health equity marks the culmination of three years of the Taskforce’s work and represent its final output.

Our starting point for this work was the recognition that the burden of multiple conditions is unevenly distributed. Evidence show that those people living in the most deprived areas are developing conditions on average 10-15 years earlier than those living in the least[1]. As leading charities, we wanted to better understand the lived experiences of some of those people who are overrepresented in the headline statistics, but routinely underrepresented in policy discussions.

To inform the report, a rapid evidence review was conducted into the literature on health inequalities and multiple long-term conditions in December 2020. The research for the report itself focused on four areas of England containing communities on low incomes, people from minority ethnic groups and people living in both urban and rural environments. It combines the insights of the professionals and services working in those places with those of the people living there. These areas are: Stockwell in South London, Manningham and Toller in Bradford, Balsall Heath East and Sparkbrook in Birmingham and North Ormesby in Middlesbrough.

At the heart of this work are the powerful and compelling stories of eight people who shared detailed insights into how they manage their own health, their own views and experiences of how well health and social care services have worked for them, and how they would really like to be supported. From ambitious data analyst Bekele, a 26-year-old man of British Somali heritage, to Vera, a 74-year-old retired cleaner, mother of eight and migrant from Portugal, the participants in this report have rich histories to share and their stories bring vividly to life the challenges they have faced before and during the pandemic.

Identifying a series of key questions and opportunities for change, this work is designed to support and shape the plans and actions of everyone responsible for the delivery of health and care services alongside others who can make a difference for people with multiple conditions.

Read The Richmond Group of Charities’ response to this report and recommendations for policymakers here

[1] Health Foundation (2018a)

The Multiple Conditions Guidebook - One Year On

The Multiple Conditions Guidebook - One Year On

The Taskforce on Multiple Conditions revisited seven of the case studies featured in The Multiple Conditions Guidebook to find out how things are progressing in the year since their original publication.  And in a year that has been extraordinary for everyone, the pandemic has presented some particular challenges for people living with multiple long term conditions.

Presented in a lively Q&A format, this report sets out candid conversations with the practitioners leading these services as well as perspectives from some of the patients accessing them. Seven case study updates are included from the Black Country, British Lung Foundation, Gateshead, Luton, Cornwall, Southwark and Yorkshire.

Given the mission of the Taskforce we hope that these findings and the case studies will be of use to the health and care sector – including local NHS bodies, councils and charities, as well as national policy makers. This work has relevance now as we navigate winter and the ongoing pandemic, but also for the longer term as we aim to maximise opportunities for new ways of thinking and working in the future that have arisen from having to do things differently during this time.

4 ways to take action now

See below for four suggested ways you can take action now to improve care for people living with multiple long-term conditions:

  1. Ask yourself: “How would someone living with multiple conditions describe our service offer?”
  2. Share this report within your own networks and with colleagues in your services leading on reducing health inequalities
  3. Share your own examples of good and emerging practice with the Taskforce
  4. Sign up to join CHAIN, the mutual support and learning network, and join the multimorbidity sub-group to keep up to date with learning in this topic area

Animation from the Taskforce on Multiple Conditions 

Why is a focus on multiple long-term conditions important? And what role do we all play in supporting those who are living with multiple conditions? Watch our new animation to find out:

Like this animation?

Please share it on social media, including the #MultipleSolutions hashtag, and with your colleagues and networks. We would like to hear from you if you have ideas or opportunities for the Taskforce to continue this conversation. Please get in touch with our Programme Manager, Eve Riley.

Take action now

See below for 5 suggested ways you can take action now to improve care for people living with multiple long-term conditions.

  1. Share 1 thing you learned from this animation with 3 other people

  2. Read The Guidebook on Multiple Conditions and ethnographic research report ‘Just one Thing After Another’: Living with Multiple Conditions.  Consider getting a group together to discuss the examples included (virtually if necessary)

  3. Pick 1 issue that you can impact and start there: medicines management; support with mobility; chronic pain; mental health; social prescribing; rehabilitation; prevention; continuity of care; personalised care and support planning; care coordination – the list goes on. Pick an area you can influence and go from there

  4. Conduct a local listening exercise with people who use your services and carers about their experiences of living with, or caring for people living with, multiple conditions. Think about how to ensure that the voices of seldom heard community members are included

  5. Get involved in conversations about system wide ‘reset’ plans on your social media accounts or online networks and the need to think about multiple conditions

Background to the Taskforce on Multiple Conditions

Why?

The Richmond Group of Charities are acutely aware that the millions of people that we support are often and increasingly living with two or more long-term conditions. To better understand the nature and scale of the challenge of people living with multiple conditions we commissioned a report on multimorbidity. We wanted to determine how it affects people’s lives and why the system struggles to respond.

That report showed that the extent and impact of multimorbidity is significant:

  • It is estimated that between 15%-30% of the population in England live with two or more long term conditions;
  • People with multiple conditions have poorer health outcomes, and poorer experiences of care and are more likely to report care coordination problems;
  • Multimorbidity occurs 10-15 years earlier in people living in the most deprived areas than it does in those living in the most affluent areas;
  • The perspective and lived experience of people with multiple conditions is almost entirely absent from the evidence we reviewed.

Which is why along with our partners, The Royal College of General Practitioners and Guy’s and St Thomas’ Charity, we have formed a Taskforce to focus on this challenge.

How the Taskforce works?

Our Taskforce is run by a programme team who represent The Richmond Group and The Royal College of General Practitioners and Guy’s and St Thomas’ Charity.

We have also set up an Expert Advisory Group with a wide range of backgrounds and expertise, from academia, policy and importantly those who have experience of living with multiple conditions.

Multiple Conditions & Health Equity Events Series

Event 1 - 11th May 2021: Multiple Conditions & Health Equity: Time for Primary Care Networks to act 

The first webinar in our multiple conditions and health equity events series is ready to view. 

Neil Tester, Director of the Richmond Group of Charities, is joined by panellists Josie Garrett (Health Policy Officer, Friends Families and Travellers), Natalie Creary (Programme Delivery Director, Black Thrive) and Dr Pramit Patel (Clinical Director for Care Collaborative Primary Care Network in East Surrey and Primary Care Network Leader for Surrey Heartlands Integrated Care System). 

Our panel share their thoughts and learnings on how Primary Care Networks can work with neighbourhoods and communities to help address health inequalities and improve outcomes for people living with multiple conditions.

Event 2 - 8th June 2021: Exploring solutions: Primary Care Networks, multiple conditions and health equity 

In the second event in our multiple conditions and health equity series Neil Tester, Director of the Richmond Group of Charities, chairs a workshop discussion with contributions from Dr Nav Chana (Director, National Association of Primary Care), Olivia Butterworth (Head of Public Participation, NHS England and NHS Improvement), Yasmin Ibison (Programme and Partnerships Manager, Black Thrive) and Rachel Brennan (#HealthNow Network Coordinator, Groundswell). 

Building on the panel discussion event held on 11th May, we explore how PCNs, alongside local government, NHS and third sector organisations can work together to design fairer solutions to support people living with multiple conditions.

These recorded speaker presentations were also accompanied by breakout discussions for attendees with Yasmin and Rachel. 

Read our digital events insight pack here

Take a look at our graphic recording from event 1 here

Watch individual speaker presentations from event 1 here:

Josie Garrett, Friends Families & Travellers

Natalie Creary, Black Thrive

Dr Pramit Patel, Care Collaborative Primary Care Network & Surrey Heartlands Integrated Care System

The Multiple Conditions Guidebook

Webinar – learning from the Multiple Conditions Guidebook

Our interactive learn and share webinar for frontline professionals is now available to watch online, exploring themes from the Multiple Conditions Guidebook. We encourage anyone with an interest in improving care for people living with multiple conditions to watch and shareThis webinar is geared towards practitioners working on the frontline in local services across the voluntary and community sector, health, social care, local government and public health.

Key themes explored in this webinar include an introduction to the overall messages from the Guidebook from Aimie Cole, health consultant and author of the guidebook report. Aimie is joined by Lisa Williams, Senior Project Manager at the British Lung Foundation and Becky Haines, GP and RCGP Champion for Person Centred Care to explore in more depth two of the featured case studies.

Do you have questions about the Guidebook? Want to share learning with others about work within your own setting? Or are you simply keen to engage with a network of people with a shared interest in supporting people with multiple long-term conditions? The Taskforce want to hear from you if you have examples of good practice to share or have ideas about how it can support you in the future.

The Multiple Conditions Guidebook – case studies and practical solutions to help local areas improve health and wellbeing

"They saw me as a human being – made me laugh. I have changed so much” – Mrs G, person with multiple long-term conditions

“It is really fulfilling when your patients tell you you have changed their life and they are in a different place”– Lisa Taleb, community matron

‘The Multiple Conditions Guidebook: case studies and practical solutions for local areas to improve health and wellbeing’ is part of a suite of resources published by the Taskforce on Multiple Conditions a cross-sector partnership between The Richmond Group of Charities, The Royal College of General Practitioners and Guy's and St Thomas' Charity.

This second output from the Taskforce on Multiple Conditions builds on earlier learning from people living with multiple long-term conditions across England as well as our learning from the Richmond Group’s partner programme Movement for All and the We Are Undefeatable campaign where people with multiple conditions were in the majority.

During its first year the Taskforce gathered extensive evidence about people’s experiences and outcomes but found that no-one was shining a spotlight on what people were doing to improve support, where, how and why. Believing that others might face similar difficulties in tackling the challenge, the Taskforce commissioned a targeted review of practical approaches that work for people with multiple conditions. Working with the generous support of local and national experts, we have written up all this learning and insight into a new guidebook for other local leaders faced with similar challenges.

This work showcases 10 examples of how local areas and frontline professionals across health, social care, the VCS, local government and beyond are responding to the challenge of how to provide better care to the 15 million people in England living with multiple long-term conditions. The intention of these resources is to provide local practitioners with practical insight and to create conversations to bring about change at scale.

This guidebook is part of a suite of resources that can be used in different ways and for different purposes. Resources include a summary slide deck, shareable graphics, an infographic, standalone summaries of key text and the case studies, as well as practical materials from the case studies.

Key themes of the work

In this review we find that good practice for people with multiple conditions exists, and there is much we can learn from existing practice. Each case study is unique to the place, setting and people involved. Yet there are themes, or ingredients, shared across many. Many of these themes are familiar and are recognised by national policy makers in the NHS Long Term Plan:

  1. People like me – involving peers and co-production
  2. Taking the long view – focusing on prevention and sustainability
  3. Looking at my whole life – taking the right personal and practical steps
  4. Rooted in place – learning from local data and people in communities
  5. All for one – working in partnership and fostering collaboration
  6. One for all – coordinating to navigate complexity
  7. Time to talk – sharing conversations and aspirations
  8. Minds matter – improving mood and wellbeing

How to use these resources

The aim is for these materials to encourage more cross-disciplinary conversations between professionals with a shared interest in improving care for people with multiple conditions. The case study sites have generously offered to be available for questions and to help us to build a network of professionals. We would also love to hear from others about their own experiences in improving care for this group. We were unable to feature all of the inspiring examples submitted, so we have also made available the longlist of approaches we reviewed as part of this work. We want to build our evidence base and spotlight other interesting approaches. Please help us to share this learning by:

  • Convening a forum or group to review and discuss the guidebook on multiple long term conditions with colleagues inside your own organisation.
  • Sharing your own examples of best practice with the Taskforce or tweet @Richmondgroup14 @RCGP @GSTT using #MultipleSolutions.
  • Contacting the case study leads to ask questions and find out more.
  • Cascading this work to others within your network who may find it of interest.
  • Requesting a presentation of the work within your own setting.

Webinar

We are keen to engage with regional teams and frontline professionals about this issue. We are planning a a ‘learn and share’ webinar showcasing learning from the case study sites and project team and providing an opportunity for Q&A in January 2020. Please email RichmondGroup@macmillan.org.uk if you would like to receive an invitation to sign up to this webinar.

How can people get in contact with the Taskforce?

Please contact Eve Riley, Programme Manager, Taskforce on Multiple Conditions via everiley@macmillan.org.uk. Limited numbers of the guidebook are available in hard copy on request.

Resources hub

Resources hub

Click to download an easy-to-print verson of The Multiple Conditions Guidebook in single pages.

Click image below to download poster infographic

To access individual PDFs of the case studies please click on the titles below:

Total Wellbeing Luton: The benefits of an integrated health and wellbeing service

In Luton multiple wellbeing services are integrated through a shared front door with access to things like talking therapies, smoking cessation, weight loss programmes, swimming and more.  

Southwark: Using navigators to organise social prescriptions

A voluntary sector-led social prescribing scheme that works in partnership with the local council, GPs and communities through a single referral checklist. 

Cornwall: Moving towards self-management

Public health led approach to kick start culture change, working with local partners in GP surgeries, the voluntary sector and people with multiple conditions, to co-design a range of services that encourage self-management. 

British Lung Foundation: Setting up expert patient peer support groups

Sustainable and professionally supported volunteer-led peer support groups, with links to health and care services, are increasing self-management, reducing isolation and addressing health inequalities. 

South West: Helping people with Learning Disabilities

Collaborative approach to keep people with learning disabilities as healthy as possible with the promotion of prevention and training and education for carers and families. 

Gloucestershire: Creating a specialist multi-disciplinary community team

A multi-disciplinary community team led by community matrons including physios, dieticians, occupational therapists and wellbeing coordinators support people to stay as independent as possible.

Yorkshire: Minimising the risks of multiple medications

Training for GPs to provide the confidence, tools and skills to reduce the risks from multiple medications, or polypharmacy, through de-prescribing where appropriate. 

Year of Care Gateshead: GP practices combining health reviews using care and support planning

Combined annual health reviews in general practice with care and support planning driven by what matters to the person involved, their concerns and questions. 

Black Country: Helping people into work

A charity-led programme to support people into work with around 20 partners involved. 

South Somerset: Creating an enhanced team around GPs

An integrated care model involving an acute hospital, GPs, adult social care, and the voluntary and community sector with activity driven by analysis of a linked dataset. 

Click image below to download long list of case studies

Longlist of case studies

Click below for editable slide deck of this learning

Click image below for longlist of cases studies

Click post-it note below for a list of further practical resources

Research report: Just One Thing After Another

'Just One Thing After Another': Living with Multiple Conditions

Its increasingly common that people affected by long term conditions will be living with more than just one, yet as highlighted by The Richmond Group report ‘Multimorbidity’ earlier this year, people’s lived experiences often go unheard. Systems and services, across the public and voluntary sector, are often geared up around single conditions. For this reason, the Taskforce on Multiple Conditions has chosen as its first priority to focus on better understanding this lived experience, taking an ethnographic approach.

We are pleased to publish our first report, “Just one thing after another” – Living with multiple conditions. Conducted by Revealing Reality, this research study explores the day to day impacts for ten people in England living with multiple conditions. The people featured in the report range from 24-year-old HR professional Anna in Somerset, to 71-year-old Godfrey, a retired factory worker who lives in Lambeth. Combined, they represent a total of 37 different conditions, including diabetes, depression and HIV.

Sharing the learning from longform interviews conducted with people across a broad demographic range, the report showcases their everyday experiences and perceptions of their quality of life. This work builds on recent research by Guy’s and St Thomas’ Charity which explores stories of people with multiple long-term conditions living in inner-cities, illustrating that people’s progression from one to many health conditions varies significantly and is influenced by wider social factors.

Findings reveal a clear and overarching theme of how those living with multiple conditions tend to describe their experiences not in terms of single diseases but rather in terms of loss. There is a compound impact of (1) loss of mobility, which contributes to (2) diminished social connections which in turn can contribute to (3) a loss of mental wellbeing.

Addressing multiple conditions requires a profound shift for how we think about and organise care services. This research offers a chance to pause and listen to people’s stories, reflecting an essential perspective and often unheard voice in this important national debate.

Contact us if you would like us to present these research findings within your own organisation.

In addition to our ethnographic research we've published a series of blogs from Experts by Experience on our Expert Advisory Group, where they share their experiences of living with multiple conditions:

- Navigating the system without a map by Wendy Broderick

- Notes from the front line: Living with multiple conditions by Jane Taylor

- Health and Care services can't make me "better", but they can be better for people like me by Kim Ryley

Watch our series of short films to see key themes explored in our participants own words:

Loss of Mobility

Diminished Social Connections

Loss of Mental Wellbeing

Relationships with Healthcare Professionals

A number of articles and blogs were published to accompany the report, which explore particular themes:

“Just one thing after another”: Living with multiple conditions By Eve Riley, Programme Manager, Taskforce on Multiple Conditions, featured article via Social Care Institute for Excellence, April 2019

 “Living well with multiple conditions” By Ruth ten Hove, who represents physiotherapy on the Expert Advisory Group to the Taskforce on Multiple Conditions, published in Frontline Magazine, Chartered Society of Physiotherapy, April 2019

‘Multimorbidity’: an acceptable term for patients or time for a rebrand? Editorial by Carolyn Chew Graham, Jane Taylor, Liam O’Toole and Chris Salisbury published in the British Journal of General Practice, August 2019

Learning from our Taskforce partners

Taskforce partners, Guy’s and St Thomas’ Charity, produced a report: From one to many: exploring people’s progression to multiple long term conditions in an urban environment and went on to conduct some work with IPSOS MORI on the use of language around multiple conditions and you can see their findings collated on this slide deck.

Royal College of General Practitioners
Effective Multimorbidity Management programme

Expert Advisory group

  • Caroline Abrahams
    Co-chair, Care and Support Alliance & Charity Director, Age UK

    Caroline Abrahams is Charity Director at Age UK where she oversees all the charity’s influencing and charity marketing/Brand activities. She is also the charity’s lead spokesperson.

    She has been at Age UK for 5 years having previously worked in the voluntary sector, for the Local Government Association, as a senior civil servant and adviser in Government and Opposition. 

  • Dr Farooq Ahmad
    GP, Colliers wood Surgery & Director, Merton Health Federation & Clinical Lead, Healthy Ageing theme, Health Innovation Network

    Dr Farooq Ahmad received his bachelor’s degree in Medicine from University of Manchester Medical School and after early years training in ENT joined General Practice in 1999.

    For the past 18 years Farooq has been a GP in Colliers Wood, South London. He has also been the Clinical Director for Diabetes and Dementia for NHS Merton CCG till October 2016.

    He is a Clinical lead in Healthy Ageing theme at Health Innovation Network, South London.

    He has been involved with commissioning work since its very inception and has been leading transformational change in care of patients with Long term conditions. He is also one of the federation directors for Merton Healthcare.

    Farooq is part of Clinical Champion Alumni for Diabetes UK. In 2014, he jointly led the development of a new Dementia facility, Merton Dementia Hub in Mitcham, Surrey which was nominated for innovation award.​

  • Dr Mark Ashworth
    Reader in Primary Care, King’s College London

    Dr Mark Ashworth has been an inner-city GP and GP Trainer for 30 years. He is Reader in Primary Care at King’s College London and leads on the research development of Lambeth DataNet, a database of all patients registered at GP practices in Lambeth and an ideal source of anonymised data for studying patterns of multi-morbidity. His team have also developed PSYCHLOPS (‘Psychological Outcomes Profiles’), a patient-generated mental health outcome measure which is used to provide insight into what patients say is most important to them; since 2015, PSYCHLOPS has been used by WHO in their work in developing countries. Since 2017, he has chaired the NHSE ‘Technical Working Group’, which is responsible for producing options for the future of QOF (the Quality and Outcomes Framework) in primary care. 

  • Andy Bell
    Director, Centre for Mental Health

    Andy Bell has been with the Centre for Metal Health since 2002. Previously working for the King's Fund, he began as Director of Communications, becoming Deputy Chief Executive in 2009.

    He is a member of the Mental Health Policy Group and was chair of the Mental Health Alliance between 2006 and 2008. Andy has carried out research on the implementation of national mental health policies and on local mental health needs assessments. He writes a regular blog on mental health policy for the Huffington Post.

  • Sue Boran
    The Queen's Nursing Institute

    Sue joined the Queen’s Nursing Institute in April 2018 as Director of Nursing Programmes. She has had a clinical background as a District Nurse and Practice Teacher in Hackney and the City of London and for the past 18 years has been a Senior Lecturer and Course Director for the District Nursing Specialist Practice programme at London South Bank University.

    Sue became a Queen’s Nurse in 2015 and has worked with the QNI on the Transition to Adult Services project.

    Sue is very passionate about community nursing and district nursing in particular. She is an advocate for care being close to people’s homes and in supporting people to self-care and regain independence where possible. She is also interested in dementia, frailty, loneliness and social isolation.

  • Juliet Bouverie
    CEO, Stroke Association

    Juliet has been Chief Executive of the Stroke Association since June 2016. The Stroke Association is the UK’s leading stroke charity promoting life after stroke. With a turnover of £37m per year and a staff team of 800, the organisation’s activities extend from funding stroke research, to providing services to stroke survivors and their families, influencing and campaigning for change, and educating and working to prevent strokes. There are 1.2 million stroke survivors in the UK, yet stroke still remains the fourth single largest cause of death in the UK and second in the world.

    Prior to joining the Stroke Association, Juliet was at Macmillan Cancer Support for 16 years in roles ranging from Head of Planning and Policy, Director of Corporate Development, and from 2011 – 2015 Executive Director of Services and Influencing. In this role she led a staff team of over 800 people and a budget of £150m, oversaw a programme of award-winning innovations and service design across the UK, and secured important government commitments to improve patient experience and post-treatment support through the 2015 Cancer Strategy for England.

    Prior to Macmillan, Juliet worked at the British Red Cross in strategy and service evaluation, the Community Development Foundation in fundraising, and a political consultancy. She was a trustee of the Long-Term Conditions Alliance and chaired the Cancer Patient Experience Board for University College London Hospital (UCLH) from 2011 – 2014.

    Juliet has a degree in Modern Languages in Oxford and a postgraduate diploma in management. Juliet lives partly in London and partly in the Forest of Dean.

  • Wendy Broderick
    Expert by Experience, Arthritis UK

    Wendy retired from working in the NHS five years ago following experience in primary and secondary care, her most recent role was Hospital Chief Pharmacist.

    Wendy was diagnosed with two forms of arthritis; ankylosing spondylitis in her early 20s and then later on with Adult Stills disease. This has led to five joint replacements and long term use of steroids has resulted in steroid induced diabetes, which is treated with daily insulin injections.

    Wendy is enjoying retired life in the North East of England near Newcastle and volunteers for Arthritis Research UK, first as a patient on their USER committee and more recently as a Patient Insight Partner on the Health Subcommittee.

  • David Buck
    Senior Fellow, Public Health Inequalities, The Kings Fund

    [David Buck] David works in the policy team at The King’s Fund. Before joining the Fund, David worked at the Department of Health as deputy director for health inequalities. He managed the Labour government's PSA target on health inequalities and the independent Marmot Review of inequalities in health. While in the Department he worked on many policy areas – including on diabetes, long-term conditions, dental health, waiting times, the pharmaceutical industry, childhood obesity and choice and competition – as an economic and strategy adviser. He has also worked at Guy's Hospital, King’s College London and the Centre for Health Economics in York where his focus was on the economics of public health and behaviours and incentives. 

  • Sally Burlington
    Head of Policy, Local Government Association

    Sally has had a wide ranging career in policy and strategy development in the Civil Service and local government, particularly focusing on policies to tackle poverty and disadvantage. After starting her career in HM Treasury, she joined the Office of the Deputy Prime Minister’s Social Exclusion Unit in 2002. From 2004-07 She led the secretariat for Sir Michael Lyons’ Inquiry examining local government and how it is funded. She worked at the Department for Education on children in care and early intervention policy from 2007-2012, before joining LGA in 2012. As Head of Policy she leads the LGA’s work on social policy issues including health and adult social care.

  • Carolyn Chew-Graham
    Royal College of General Practitioners

    Carolyn is a GP Principal in Central Manchester, Professor of General Practice Research at Keele University, Honorary Professor of Primary Care Mental Health at South Staffs and Shropshire Foundation Trust and Honorary Professor of Primary Care, University of Manchester.

    Carolyn’s main areas of interest and expertise include the primary care management of patients with depression, multimorbidity and unexplained symptoms. She has qualitative research methods expertise, drawing on theories from both social sciences and psychology, but always with a focus on clinical practice.

    Carolyn is Chair of RCGP Scientific Foundation Board and RCGP ‘Curriculum Advisor, Mental Health’. She is also currently a member of the NICE Clinical Guideline Development Group Depression (update) - work which directly impacts on commissioning decisions and patient care. Carolyn is Section Editor of BMC Family Practice and Editor-in-Chief of Health Expectations.

  • Nichola Duane
    Expert by Experience, Asthma UK

    Nichola was diagnosed with Asthma twenty years ago but more recently Broncotrachamalsia, Ulcerative Colitis, severe esophillic asthma, and Vocal chord dysfunction this had led to further ailments such as diabetes and high blood pressure caused by medication. Unfortunately due to her illness she had to give up both full and part time work. This provided her with the opportunity to pursue in engaging with the health sector in a numerous of positive exciting roles. Including advisory member for the department of health, member of the asthma quality standards expert topic group, guest speaker at conferences and media contributions, a judge for the National Patient Experience Awards (penna), patient expert for NICE, as well as a speak up and policy volunteer for Asthma UK.

    Nichola is from a small village based in Lancashire.

  • Sarah Duncan
    Head of Clinical Policy, NHS England

    Sarah is a qualified physiotherapist with 20 years of clinical NHS experience in neurological and stroke rehabilitation, subsequently working in an advanced clinical stroke practitioner role.  

    Sarah’s national roles began in 2009  as a  national improvement lead  for stroke to support implementation of the National Stroke Strategy. She joined NHS England at its inception in 2013 into a clinical policy role with a remit for long term conditions and end of life care policy.

    In 2014, Sarah moved into the seven day services improvement team in NHS Improving Quality, leading and driving the implementation of seven day services. in 2017, she led the development of the STP delivery Unit for NHS England.

    Sarah is now the Head of Clinical Policy for NHS England, based in the medical directorate. The Clinical Policy Unit is responsible for the development of new clinical policy, for providing reactive and proactive clinical policy advice and support to the rest of NHS England.

  • Peter Goldblatt
    Senior Advisor, UCL Institute of Health Equity

    Peter Goldblatt is a senior advisor at the University College London Institute of Health Equity.

    His main activities concern measurement and monitoring and contributing to reviews of action on the social determinants of health.

    Peter is currently working on the review of equity and health inequalities in the Americas.

  • Jeremy Hughes
    CEO, Alzheimer's Society

    Jeremy Hughes joined Alzheimer’s Society in November 2010. He is leading the charity in its five year strategy ‘Delivering on Dementia 2012-17’ managing an annual budget in excess of £90m. Jeremy co-chairs the Dementia Friendly Communities Champions Group with top broadcaster Angela Rippon for the UK Prime Minister, David Cameron.

    Jeremy was previously Chief Executive of Breakthrough Breast Cancer where he was instrumental in providing visionary leadership, galvanising the charity's research platform and its authority on campaigning and policy. Before that Jeremy was Head of External Affairs at the International Federation of Red Cross and Red Crescent Societies.

    His career in health and social care charities includes leadership posts at the British Red Cross, Leonard Cheshire, Muscular Dystrophy and NCH Action for Children.

    Jeremy was the chair of National Voices 2009-14. He is currently the Co-chair of the UK Dementia Action Alliance and chair of the Global Alzheimers and Dementias Action Alliance

    Jeremy was awarded the CBE, for services to older people, in the Queen's Birthday Honours 2015.

  • Professor Khalida Ismail
    Professor of Psychiatry & Medicine, King's College London

    Khalida Ismail qualified in medicine from the University of Oxford, and is Professor of Psychiatry and Medicine at the Institute of Psychiatry, Psychology and Neurosciences, King's College London and Consultant Liaison Psychiatrist at King's College Hospital NHS Foundation Trust. Her research interests are:

    a) understanding the epidemiology and underlying mechanisms of psychiatric disorders, especially depression and eating disorders, in diabetes and

    b) developing and evaluating innovations in psychological treatments to support self management and improve diabetes related outcomes.

    At King’s Health Partners, she leads the largest Diabetes and Mental Health Research Group in the UK with funding of over £10 million over the past 10 years. She has also been leading the Diabetes, Psychiatry and Psychology service at King’s College Hospital NHS Foundation Trust for nearly 20 years. She also is the lead palliative care psychiatrist at Trinity Hospice, London. Her research was translated into the innovative 3 Dimensions of Care for Diabetes service (3DFD) which won 3 Quality in Care Awards 2011, the BMJ Best Diabetes Team 2014, NHS Innovations First Prize, 2015 and the Mary MacKinnon Lecture, Diabetes UK 2015 and is being scaled up to 3 Dimensions for Long Term conditions supported by a Health Foundation Award (£0.5m). She is currently completing an NIHR (£2.4m) randomized controlled trial of the effectiveness of a face-to-face intensive lifestyle intervention based on behaviour change techniques to increase physical activity and reduce weight in 1750 people at high risk of cardiovascular disease. She is also the senior psychiatrist involved in STEADY which is developing the first complex intervention in the UK for type 1 diabetes and eating disorders, led by NIHR Clinical Scientist Marietta Stadler (£1.4m).

  • Dr Mona Johnson
    Clinical Director, Self-Care & Prevention, NHS Digital

    Mona Johnson is the senior responsible clinician across the self-care programmes in NHS Digital: A portfolio that covers health and service information on NHS.UK, the NHS Apps Library and its underpinning assessment service, Care Identity, Personal Health Records and NHS WiFi. These programmes seek to enable people to have access to the tools or information that they need, in order to be better empowered in collaborating with clinicians in their own care.

    Mona comes from a background in General Practice and is still a practising GP in Greater Manchester. She is a member of the Royal College of General Practitioners and an honorary member of the Faculty of Public Health. Mona is interested in how technology can enable people to better understand and co-manage their conditions with clinicians, and how technology can free clinician time and change the clinician-patient interaction.

  • Dr Tom Margham
    Clinical Lead, EQUIP Programme, Tower Hamlets Clinical Commissioning Group

    Tom lives and practices as a GP at the Jubilee Street Practice in Tower Hamlets. Between 2010 and 2015 he worked as Lead for Primary Care at Arthritis Research UK, where he developed an interest in training of healthcare professionals, health policy and service development. Over recent years, Tom has developed his skills in Quality Improvement and service redevelopment with roles at NHS Improving Quality and latterly the NHS Sustainable Improvement Team. Supporting national projects including CCG development, the GP Access Fund and GP Development Programme. Since 2016 he has been Clinical Director of the Tower Hamlets EQUIP programme. The EQUIP programme uses Quality Improvement methodology, team coaching and live operational data to support general practice teams in unpicking day-to-day problems, getting joy back in their working day, and by doing so delivering great care to their patients.

  • Phil McCarvill
    Deputy Director of Policy, NHS Confederation

    Dr Phil McCarvill is chief advisor to the chief executive of the NHS Confederation . He joined the NHS Confederation as deputy director of policy in April 2015. Prior to joining the charity he was head of policy and public affairs for the charity, Marie Curie. He has previously worked for the Commission for Racial Equality, Equality and Human Rights Commission, Institute for Public Policy Research (IPPR), as well as a range of roles in local government and the NHS.

    Phil has written extensively on a range of issues including dementia, end of life care, health inequalities, NHS reform, housing and race equality. He is an experienced media spokesperson, with experience of both television and radio.

    Phil has a PhD in ethnic relations from the University of Warwick.

  • Professor David Oliver
    Consultant Geriatrics and Acute General Medicine, Royal Berkshire NHS Foundation Trust

    David has been an NHS doctor since 1989 and consultant Physician since 1998. He is the current elected clinical vice-president of the Royal College of Physicians, leading the Care Quality Improvement Directorate.

    David is a visiting fellow at The King's Fund and visiting Professor at City University, London, alongside his clinical job as an NHS consultant in geriatrics and general internal medicine at the Royal Berkshire NHS Foundation Trust where he led and developed services for several years. He was formerly a consultant and clinical director in south London.  He was president of the British Geriatrics Society until 2016 and Department of Health National Clinical Director for Older People until 2013.

    David writes professionally for medical and general publications, including since 2015 his weekly “acute perspective” column in the BMJ and blogs regularly for the King’s Fund.   Academically, he has published more than 120 research papers, reviews book chapters and editorials. 

  • Liam O'Toole
    Chair of Expert Advisory Group & CEO, Versus Arthritis

    Liam became chief executive officer at Arthritis Research UK in November 2009 and is responsible for leading our dynamic and committed workforce in our fight against arthritis.

    Liam has played a leading role in many of the major changes that have taken place in the UK’s health and medical research landscape over the last decade. Between January 2007 and November 2009 he was head of the Office for Strategic Coordination of Health Research (OSCHR), a joint office funded by the Department of Health and the Department for Business Innovation and Skills, set up to develop a more coherent strategic approach to publicly funded health research.

    Before his role with OSCHR Liam spent three years as chief executive of the UK Clinical Research Collaboration and was the first administrative director of the National Cancer Research Institute following 16 years’ experience of research management at the Medical Research Council and the British Diabetic Association (now Diabetes UK).

  • Don Redding
    Director or Policy and Partnerships, National Voices

    Don Redding is Director of Policy and Partnerships for National Voices, the coalition of charities that stands for people being in control of their health and care. He is a recognised subject expert and thought leader on person centred care, the approaches that can achieve it, and the role of the VCSE sector in supporting, developing and promoting it. Don joined National Voices in 2011, having previously been Head of Policy and Communications for Picker Institute Europe.

    In the last 11 years he has led the organisation’s national policy work, including on integrated care. He was a key contributor to the Realising the Value programme and authored the paper on New Approaches to Value which looked at the value people and communities contribute, and what they value in relation to their lives and health outcomes. Don led National Voices’ contribution to the development of NICE Guideline NG 56 on managing multimorbidities in primary care; and most recently contributed to the development of a new national definition of quality in general practice, which includes responsibility for meeting the multimorbidity challenge.

  • Kim Ryley
    Expert by Experience, Macmillan

    Kim is a recently retired local authority chief executive, who worked closely with health and social care services and voluntary and community sector organisations for a number of years. Kim currently works part-time, as a freelance Leadership consultant, coach and mentor to give greater priority to his health and wellbeing. He currently resides Shrewbury, Shropshire.

    Kim has four long-term, potentially life-threatening health conditions, some of which he has been managing for 15 years, becoming an expert in those conditions and self-managing them more effectively. Kim is at risk of developing more long term conditions but recognises how fortunate he is that his current medical conditions were diagnosed early and have been well treated and medicated by dedicated and caring health care professionals. However there are times where he has had to be assertive in being allowed to do more to manage my own health, to improve my quality of life. This has been essential, as his experience of health care has been one of dealing with fragmented, specialised services, which do not always take a holistic view of patients and their needs. Kim has also been struck by how little focus or support there has been in dealing with the psychological effects of multiple conditions, which can be a burden and a constant reminder of one's own mortality.

  • Professor Chris Salisbury
    Professor in Primary Health Care, University of Bristol

    Chris is a GP, Professor of Primary Health Care at the University of Bristol, and an NIHR Senior Investigator. He has published 5 books and over 200 research papers on the broad topic of how to improve provision of primary care. He has conducted several high-profile evaluations of new models of care, such as changes in out-of-hours arrangements, NHS walk-in centres, GPs with Special Interests, telehealth for chronic disease management, and the potential role of new forms of consultation such as e-consultations. In recent years Chris has focused on how health care should address the challenge of the growing number of people with multimorbidity.

    Professor Salisbury is a board member for the NIHR Health Services & Delivery Research programme, was past chair of the RCGP Scientific Foundation Board and RCGP Research Paper of the Year Panel, and has been a member of several other national and international boards and advisory bodies.

  • Professor Naveed Sattar
    Honorary Consultant (Cardiovascular & Medical Sciences), University of Bristol

    Naveed Sattar is a clinically active academic experienced in biomarker studies and trials investigating the causes, prevention and management of diabetes, obesity and heart disease. He has authored or co-authored over 700 published papers, has received several national and international prizes for his research, and is in the top 1% of cited clinical academics in the world according to the Clarivate Analytics 2017 Highly Cited Researcher list.

    He has been on several national and international guideline committees, including: European Society of Cardiology (ESC) Task Force to develop 2019 Guidelines on diabetes, pre-diabetes, and cardiovascular diseases; Joint British Societies 3 CVD prevention recommendations; SIGN obesity and CVD prevention guidelines (as Chair); and European CVD prevention guidelines. He is currently involved in several lifestyle and drug trials in diabetes and CVD and leads on biomarker initiatives in other trials. He is also on editorial or international advisory boards for Diabetologia, Lancet Diabetes and Endocrinology, BMC Medicine and UK Biobank, and is an Associate Editor for Circulation.

  • Barbara Reichwein
    Programme Director, Multiple Long-Term Conditions, Guy's & St Thomas' Charity

    Barbara leads the multiple long-term conditions programme at Guy’s and St Thomas’ Charity, an independent, place-based foundation working to tackle the major health challenges affecting people in urban, diverse and deprived communities. 

  • Jane Taylor
    Expert by Experience, Arthritis UK

    Jane spent most of her working life in education and until taking ill health retirement 10 years ago, was a Senior lecturer in English at Manchester Metropolitan University. She now works part time for the Open University.

    Jane has experience of living with several long term conditions. She has lived with rheumatoid arthritis for over 30 years, having been diagnosed at the age of 26. In her 30s she was diagnosed with antiphospholipid syndrome which caused a number of miscarriages throughout her 20s and 30s.  Over the intervening years she has also developed osteoporosis and osteoarthritis and has at times been treated for depression.

    As well as her experience of living with a number of conditions, Jane supports a sibling with schizophrenia and diabetes and her youngest child has a number of health problems.

    Jane is currently the Chair of Arthritis Research UK’s Patient Insight Partner group and has worked with the charity in a voluntary capacity for 8 years bringing patient insight to various research activities including review and evaluation of funding applications.

    Jane feels passionately about the way the single disease model that exists in the healthcare system impacts negatively on patients with multimorbidity particularly where there is co-existence of both a physical condition and a mental health condition.

    Although originally from Dundee Jane now lives in Manchester with her partner and youngest child who is 14 and two older children study in London.

  • Ruth ten Hove
    professional Advisor, Chartered Society of Physiotherapy

    Ruth ten Hove is head of Research and Development at the Chartered Society of Physiotherapy. Ruth has worked for many years for improvements in the access to and quality of rehabilitation for the population who have multiple conditions. She has most recently led, on behalf of the CSP with the RCP, a national audit of physiotherapy and hip fracture (Hipsprint). This highlighted variation across the whole rehabilitation pathway  - from acute care, to transition and rehabilitation outside of hospital. A better understanding of the reasons for this variation as well as implementing a programme of improvement are the next steps to providing more consistent high quality care.

    Ruth has also led work with NHSE which will result in a significant proportion of physiotherapists who currently manage people with Musculoskeletal conditions in hospital outpatient services move into General Practice. 

  • Mike Wilson
    Director, Pembroke House

    Mike is Executive Director of Pembroke House — a multi-use community space and centre for social action in Walworth, South London. The work of “settlements” such as a Pembroke House inspired the architects of the modern welfare state. Mike and the team are now exploring how the same place-based focus can inspire new thinking and ways of working today. He is leading a range of initiatives with local partners that touch on multimorbidity, including developing neighbourhood models of care that engage individuals and groups beyond the traditional health sector and that focus on the creation of strong and vibrant communities.

    Prior to his work at Pembroke house Mike has been a teacher, a civil servant and he studied and worked in Chicago on a Fulbright scholarship. 

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