Steven Laitner
@SteveLaitner
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General Practitioner with Public Health background. Freelance Health Consultant interested in models and systems of healthcare. Views are my own honest ones.
Saint Albans, England
Joined November 2012
"Better, cheaper, faster: choose two" (sometimes called the project management triangle) is false in the NHS where much of the system is so far from being optimal that everything could improve:
hsj.co.uk
Debates about NHS productivity wrongly assume hard trade-offs are necessary to improve the service's performance. In fact, bottom-up analysis of clinical processes shows better, faster, cheaper care...
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Screening - don't tell me it "Saves Lives" without a statistically significant impact on all-cause mortality. Thanks.
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The money is there in the NHS Itโs just in the wrong places, often doing the wrong things or the right things inefficiently
@Kit_Yates_Maths Mismanagement, yes. But chronic underfunding is hard to argue when the NHS added nearly 25% more doctors in the last 5 years.
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The brave thing to do, which has been done, is not to bow to political and celebrity pressure but hold onto the evidence and use scarce public funds in the best way possible to maximise the nationโs health and reduce suffering. @David_Cameron @wesstreeting
I am disappointed by todayโs recommendation on prostate cancer screening from the National Committee. Targeted screening is a natural first step - but the recommendation today is far too targeted, not including black men or men with a family history, both high-risk groups.
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Surely we should only use the term โLives Savedโ if there is a statistically significant reduction in All-Cause Mortality? @CRUK_Policy
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Meaningful engagement with people with lived experience: challenging, messy, and more vital than ever. Healthcare leaders at every level must urgently implement @WHO framework on engagement, writes @maiacaryn
https://t.co/7rXl4E4VTh
bmj.com
Health and care leaders and policy makers at every level should urgently implement WHOโs recent framework on engagement, write Maia Olsen, Katia de Pinho Campos, and Guy Fones Recognition that people...
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Have you signed up to our lunchtime webinar with the PCNs and Federations delivering thriving services in their area? Chaired by @SteveLaitner, with panelists from NICS, BSOL ICS and Unity PCN, make sure to secure your spot today:
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@SteveLaitner @DSWorkFit What a lovely photo of Charlotte - Happy World Down Syndrome Day to you both from everyone at the DSA. #WorldDownSyndromeDay #LotsOfSocks #ImproveOurSupportSystems #WDSD2025
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Stereotypes are there to be broken See the person, not the disability Could not be prouder of my wonderful daughter Charlotte @DSAInfo @DSWorkFit
#WorldDownSyndromeDay
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I had hoped the Polypill was by now an ex-parrot, ceased to beโฆ
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Using AI to โtakeโ a good โhistoryโ from a patient and present it to a clinician in a summary single paragraph of important clinical information would be a game changer @murrayellender
One huge problem with using AI in the NHS is that there is no relationship at all between problems suitable for AI solutions and the big problems the NHS has. So many AI "solutions" are solving non-problems.
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5 books with critical ideas that should improve how the NHS is managed: https://t.co/247JGLzTwR (but are mostly ignored).
hsj.co.uk
Steve Black recommends his top five books on policy and strategy for healthcare leaders
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@SteveLaitner Agree. Seems quite a reductionist approach. Feeds the supplements industry and gives folk an easy win.
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Not convinced that continuing loads of research that increasing single dietary factor x leads to a reduction in disease y is that useful for overall public health (Today - calcium & bowel cancer; morning (not afternoon) coffee and heart disease) Holistic approaches more useful?
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Aide is now registered as a UK Class I Medical Device. This means the platform is trusted, clinically validated, and more capable than ever of supporting long-term condition management. Read more about our impact here https://t.co/YJglJFbv3j
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@VincentGnanapr3 @alex_freeman @pash22 @SteveLaitner @hstovring @KariTikkinen @rwittmer3 @LondonProstate1 @PredictProstate I've 12% risk of prostate cancer. To decide if it's worth looking for it. I need to know: 1) likely characteristics of the hypothetical prostate cancer 2) probabilities of different outcomes with & without treatment 3) to apply my own health state valuations to the probabilities
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@VincentGnanapr3 @alex_freeman @pash22 @SteveLaitner @hstovring @KariTikkinen @rwittmer3 @LondonProstate1 This tool calculates my risk (predicted incidence) of prostate cancer. It tells me nothing about: a) the prognosis of the cancer (effect on life expectancy) b) the likely change QALY gain with treatment c) how QALY gain is influenced by my personal valuations of health states
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Itโs so hard to push back against the โearly diagnosis must always be betterโ narrative weโve been fed since we were young Screening is just a logical extension of that thinking Maybe we need to be open and honest about why the former isnโt always true first ? @pash22
Screening: do strong a priori beliefs outweigh facts? In a survey, 83% of women aged 40-49 would take part in a hypothetical mammography screening programme. This is despite being told there were no benefits & potential harms. Many disbelieved the information provided
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