In The Loop: the BIG Questions

IHSCM
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In this podcast series, Roy and Niall leverage their extensive experience in health and social care to engage in insightful conversations with influential figures. They explore the sector's critical issues and challenges, cutting through political rhetoric and hype. Each episode offers a deep dive into the realities of healthcare, providing listeners with a clear understanding of the complexities involved. Who is Niall? Niall Dickson CBE is a prominent health and social care figure. He has held several key positions, including Chief Executive of the NHS Confederation, Chief Executive and Registrar of the General Medical Council, and Chief Executive of The King’s Fund. He has also worked as a journalist for the BBC and was awarded a CBE for his services to patient safety Who is Roy? Roy Lilley is a health policy analyst, writer, broadcaster, and commentator on the National Health Service (NHS) and social issues. He has held various influential roles, including vice-chairman of West Surrey and North East Hampshire Health Authority and chairman of the Homewood NHS Trust. Roy is also known for his popular eLetter, which reaches around 300,000 health and care managers, and for founding the Academy of Fabulous Stuff, a repository of best practices in the NHS.

Episodes

  1. 3D AGO

    Paul Farmer CBE.

    Have older people got it too easy? In their latest ‘In the Loop’ podcast, Niall and Roy have a fascinating exchange with Paul Farmer CBE, the leader of Age UK, Britian’s largest charity campaigning and providing services for older people.   Little more than a generation ago, pensioners were seen as among the poorest and most vulnerable groups; today the vast majority have never had it so good. Yet Paul argues that is a dangerous narrative which ignores the two million or so older people who either experience poor health, financial insecurity or loneliness. And he rejects the idea that this is just about deprivation, suggesting we have not faced up to the enormous challenge of living in an ageing society.  When challenged on the cost of the triple lock for pensioners, Paul says he  welcomes the debate about the future of the state pension, including the possibility of means testing. But he warns that successive governments’ record on means testing has been extremely poor.     On social care another warning - because of chronic and persistent underfunding he suggests something terribly bad could easily happen and that solutions offered in the past will need to be revised given the parlous state of services today. Paul argues not only that social care needs significant extra funding but also a long-term view; the question is who is going to play for these reforms?       As for the NHS, he points to fact that in the last year more than fifty thousand patients in their 80s ended up hospital corridors, and that we need to start looking at the health service through the lens of older people. He is challenged on how much of Age UK’s income actually goes to local branches that provide direct services, as opposed to lobbying and other national activities. Paul responds by saying they have begun to give more to local branches and have plans to do more.  Listen too to Niall and Roy’s reflections on this absorbing exchange with one of the most influential leaders advocating for older people in the UK.

    38 min

  2. FEB 20

    Nicola Ranger, General Secretary of the RCN.

    Niall and Roy in conversation with Nicola Ranger, the General Secretary of the Royal College of Nursing In the latest podcast, Niall and Roy delve into the besieged world of nursing with the leader of the world's largest nursing union, Nicola Ranger. In a frank exchange, Nicola reflects on the recruitment and retention crisis, the fact that nurses spend too much time on pointless tasks, the unprecedented levels of low morale, and the possibility of strike action. And she says there is an urgent need to reform nurse education, including, in her personal view,  a national exam for every nurse wanting to join the register.  This is a clarion call for reform within and beyond the profession, and a warning of an existential threat to the NHS if the government does not invest and start valuing nurses.  This is an open, honest and thought‑provoking exchange — one well worth listening to.

    43 min

  3. FEB 4

    Tom Dolphin chair of the BMA council.

    The British Medical Association are never far away from the headlines but what is their real game? In their latest In the Loop podcast, Niall and Roy have an in depth discussion with Dr Tom Dolphin the BMA chair who leads one of the most powerful trade unions in the country, if not the most powerful. In a revealing exchange Tom reflects on the growing militancy of doctors and their willingness to strike, as well as the changes affecting General Practice which for some GPs is making their lives less satisfying and more transactional. But he insists the partnership model, in which GPs run their own businesses, can survive if it is properly supported, in spite of many younger doctors choosing to take on salaried roles.  Tom also doubts the value of revalidation, the system that requires doctors to show they are competent and up to date and he blames the NHS for making doctors undergo pointless statutory training as part of that process.  And he is deeply concerned at so called ‘doctor substitution’, whereby tasks once performed by doctors are being carried out by professionals with new roles such as Physician Assistants, and he reveals talks are underway with the Royal College of Nursing about the expanding roles of Clinical Nurse Specialists.   As the seemingly existential duel with the UK government goes on, this is a chance to hear the leader of Britain’s doctors as he reflects on the battles ahead for the BMA, but also to hear his take on the wider and fundamental challenges facing the medical profession. Tom insists the BMA and the UK government are aligned in their ambition for the NHS, but there is little sign in this exchange that the union will back down. Indeed he issues a warning that if things don’t go their way, further strikes are possible from other doctors including consultants, the most senior doctors on the front line.

    41 min

  4. JAN 4

    David Gregson, Founder of BeeWell.

    In the Loop – the BIG Questions  Niall Dickson CBE and Roy Lilley with their latest guest David Gregson founder of BeeWell   To start 2026 Niall and Roy make a departure from their usual management and political interviews and explore the worrying state of our young people.  The awful reality that youngsters in the UK appear to be unhappier than nearly all their European counterparts.    Their first guest of the New Year is David Gregson an entrepreneur and philanthropist has embarked on an ambitious and innovative programme called Beewell. Its aim is to improve the wellbeing of young people throughout the country, starting in Greater Manchester and a few other areas of England. Working with the Mayor Andy Burnham along with schools, local authorise and the NHS, the Beewell approach s already claiming to have made a significant impact, affecting the lives of thousands of school children.    But can this programme, which demands action and a mind-shift from statutory and voluntary services, really be the catalyst to change the prospects of the next, generation? The current position is dire. In a fascinating exchange, David Gregson points to weaker family relationships, restrictions on child freedom, and the fact that adults often no longer understand the world in which their youngsters live. He applauds moves by the UK government to raise the profile of youngsters’ wellbeing and its support for idea of conducting surveys in every school but wants them to go further and faster.

    41 min
  • 4 Episodes

About

In this podcast series, Roy and Niall leverage their extensive experience in health and social care to engage in insightful conversations with influential figures. They explore the sector's critical issues and challenges, cutting through political rhetoric and hype. Each episode offers a deep dive into the realities of healthcare, providing listeners with a clear understanding of the complexities involved. Who is Niall? Niall Dickson CBE is a prominent health and social care figure. He has held several key positions, including Chief Executive of the NHS Confederation, Chief Executive and Registrar of the General Medical Council, and Chief Executive of The King’s Fund. He has also worked as a journalist for the BBC and was awarded a CBE for his services to patient safety Who is Roy? Roy Lilley is a health policy analyst, writer, broadcaster, and commentator on the National Health Service (NHS) and social issues. He has held various influential roles, including vice-chairman of West Surrey and North East Hampshire Health Authority and chairman of the Homewood NHS Trust. Roy is also known for his popular eLetter, which reaches around 300,000 health and care managers, and for founding the Academy of Fabulous Stuff, a repository of best practices in the NHS.

Information

  • Creator
    IHSCM
  • Years Active
    2025 - 2026
  • Episodes
    4
  • Rating
    Clean
  • Copyright
    © 2026 In The Loop: the BIG Questions

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