The NHS and social care workforce crisis is often described as a vacancy problem. But at neighbourhood level, it’s something more fundamental: the loss of experience, relationships and judgement as people quietly leave, while…
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After yet another stint with Radio 4, I found myself grumbling about GIRFT and marvelling at the genius of those who repackage 1970s quality control as ground-breaking in the public…
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Mike Gill is Director at At Scale Limited and author of “How to Survive Austerity: A Field Guide for Public Sector Managers” Every generation thinks they’re living through the apocalypse.…
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Across England, systems working on neighbourhood models, population health and out-of-hospital redesign are experiencing a familiar frustration. National momentum has slowed, guidance has yet to land, and key contractual frameworks…
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We're now in 2026, and NHS leaders responsible for network transformation still lack clear national direction on neighbourhood working. Pioneer sites were meant to be implementing integrated neighbourhood teams, yet…
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"How to Survive Austerity" was Mike Gill's field guide for public sector managers who suddenly found the ground shifting under their feet. Written in the aftermath of the 2008 financial crisis,…
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Let’s start with the good news. Despite everything you hear, primary care isn’t in decline. It is busy, yes, and stretched, certainly, but it is also full of ambition and creativity. Across…
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The evolving ambition for neighbourhood working seeks to bring services closer to home and within communities, foster collaboration, and promote wider health and wellbeing. These interventions support key health ambitions;…
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In the evolving landscape of health and social care, the need for cohesive, patient-centred approaches has never been more pressing. We find ourselves at a pivotal moment where integrated care…
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In today’s rapidly evolving public sector landscape, particularly within health and social care, the need for effective leadership has never been more critical. Organisations face complex challenges that demand not…
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