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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 Guy's and St Thomas' Charity.

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 Head of Programmes Beth Capper, bcapper@macmillan.org.uk. You can also watch Liam O'Toole from Arthritis Research UK set out our thinking here.

  • The story so far
  • Next Steps
  • Expert Advisory group

The story so far

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.

We held an online learning event launching the Taskforce which you can watch here.

There's also a short highlights video here.

Next Steps

Next Steps

Based on the findings from the Multimorbidity report, we have identified the following priorities for the first year:

  1. Better understanding the lived experience of people with multiple conditions

One of the key findings from the report was that the perspective and lived experience of people with multiple conditions is almost entirely absent from the evidence we reviewed. We have already commissioned ethnographic research with people living with multiple conditions, so watch this space for the findings, which will be shared in the summer. We will review our priorities and further develop our workplan in light of these insights. 

  2. Co-ordinating information and support offers of the Richmond Group charities

We know coordination is critical for the whole health and care system, but we believe looking closer to home will be a powerful way to start. We are committed to looking across the information and support offer of the 14 Richmond Group charities to better join up support provided by condition specific charities to people living with multiple conditions. We also hope to make it easier for GPs and patients to use our offer when facing multiple conditions.

  3. Building our insight on health and deprivation

Our report found evidence that 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; this is unacceptable. Our partners Guy’s and St Thomas’ Charity are already doing exciting work to understand the links between multimorbidity and deprivation, so we hope to build on their work and collectively address this. We will share further information on this in the coming months.

  4. Prevention

The Richmond Group of Charities is committed to preventative care; it can reduce the risk of developing an illness in the first place or help manage an ongoing condition and minimise risks of exacerbation or reoccurrence.  Prevention underpins so much of our member charities work.  Currently, this priority for the Taskforce on Multiple Conditions will be taken forward within our key prevention work through our physical activity programme - Movement for All.

Expert Advisory group

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

    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).

  • 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.

  • 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.

  • Jon Siddall
    Director of Funding, Guy's & St Thomas' Charity

    Jon Siddall is Director of Funding 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 areas.  

    Jon leads the Charity’s funding programmes. Over the next decade, the Charity plans to invest £250 million into improving health and healthcare in the London boroughs of Lambeth and Southwark and sharing insights with anyone facing similar challenges elsewhere.  The Charity’s first two programmes are on childhood obesity and multiple long-term conditions.

    Prior to joining the Charity, Jon worked across the healthcare and foundation sectors, most recently helping to establish the South West Academic Health Science Network (SW AHSN) as Director of Innovation. Jon has worked with funders and impact investors in the UK, Ireland and New Zealand on a range of complex social issues and held advisory Board roles at the SBRI Healthcare (NHS England) and Transform Ageing (Design Council).

    [Juliet photo] Jon holds an MBA with distinction gained during a IBM-funded scholarship and BA (Hons) in Human Geography from the University of Southampton. 

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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. 

  • 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.

  • David Bramley
    Deputy Head, Clinical Policy Unit, NHS England

    David is Deputy Head of NHS England’s Clinical Policy Unit. The Unit is responsible for designing and developing clinical policy to support the Five Year Forward View which sets out the vision for the NHS. David’s main focus is on the identification and management of frailty as a long-term condition and promoting improved prevention.

  • 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. 

  • 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. 

  • 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.

  • 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.​

  • 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 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. 

  • 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. 

  • Moira McGrath
    Director of Integrated Commissioning, Lambeth Council and Lambeth Clinical Commissioning Group

    Moira is currently Director of Integrated Commissioning for Lambeth Council & Lambeth Clinical Commissioning Group (CCG) leading on commissioning areas including working with people with long term conditions, mental health and support for older people.  She has led work on developing and implementing innovative alliance contracting for integrated mental health services which has improved outcomes for people with mental illness, reduced use of hospital care and reduced costs.  She was a founding member of Southwark & Lambeth Integrated Care – a 5 year partnership supported by Guy’s & St Thomas’ Charity to improve and innovate in care for older people which reduced growth in use of emergency care, reduced falls and increased community support. 

    She is a partner in Black Thrive, a collaboration between members of the African Caribbean community and statutory organisations in Lambeth to improve black health & wellbeing in Lambeth.  In prior roles in Hertfordshire PCT she worked on the redesign of diabetes and respiratory services and wheelchair services.  She has a background in working in primary and community care commissioning.  Other experience includes working for the national Health & Social Care Change Agent Team providing advice and support to health & care systems across England on preventing delayed transfers of care.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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. 

  • 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.

  • 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.

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