In The Loop: the BIG Questions

IHSCM

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. 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

  2. 12/03/2025

    Dr Charlotte Refsum, Director of Health Policy at the Tony Blair Institute.

    In their latest In The Loop podcast Niall and Roy lock horns with Dr Charlotte Refsum Director of Health Policy at the Tony Blair Institute. In a frank discussion Chalotte a former GP  reveals how the former Prime Minister is still closely involved in policy development and she lays out the stark choices facing the NHS if it is to survive in the face of the enormous challenges it currently faces.      Charlotte is a former GP who has specialised in health policy. She worked for the consultancy firm KMPG and has been involved in supporting change in 25 countries.  She contributed to the government’s NHS plan and has worked with Sir Patrick Vallance and Sir John Bell on technology and how the arrival of the AI era will transform health and care. In the podcast Charlotte defends the Institute’s links with big tech companies and non- democratic governments and insists she and her colleagues have editorial independence and have never felt under any pressure to write anything or hold a view because of those relationships or funding.  What follows is a frank assessment of the current government’s strategy but hard questions about what will be needed to implement the changes needed and whether the absolute priority, which concentrates so much of its resources on older people with long term conditions, is justified.  Charlotte suggests the current budget may be all we can afford, and in her view the NHS needs to find ways of living within its means. That will involve thinking like an insurer, assessing future risks and taking prevention much more seriously. And there is also  talk of copayments for some new treatments for those who can afford it and the need for the NHS to start decommissioning some services if it is to embrace the technological revolution that is underway.  And she suggests we need a revolution in primary care.  As for the professions, she suggests the impact on doctors and others is uncertain but will be profound.  One of the changes she identifies is how new technology will continue to undermine the asymmetry of information that underpins the professions and how it will become easier and cheaper for people to seek advice from elsewhere. But she adds, that does not mean a dystopian future where we send out someone with an NVQ and an iPad to get and manage complex cases!

    36 min

  3. 11/12/2025

    Rob Webster CBE.

    In the Loop – the BIG Questions  Niall Dickson CBE and Roy Lilley with their latest guest Rob Webster CBE   For this next edition of In The Loop podcast Niall and Roy come together with Rob Webster one of the most prominent NHS managers and a huge advocate of integration. Rob heads up the West Yorkshire and Harrogate Health and Care Partnership an integrated care system.  And like every other system in the country he is grappling with a huge financial challenge, a big reorganisation, redundancies and staff threatening industrial action. So how is he managing as he faces a 45% reduction is his workforce and key staff in an angry mood?  Rob reveals this is the most frustrating period in his 36 year career with enormous pressure on everyone and he admits it is causing harm to his staff.  But he insists it will not distract from the work. While he acknowledges the difficult financial position, he says the transition is incredibly difficult, supports the aims of the reorganisation and believes that close working relationships between health, local authorities and the third sector can and will deliver meaningful change.   He says the NHS must put its people first and argues that staff have quite rightly become dissatisfied and that the job of NHS leaders is to do something about this. He notes how painful it has been to see the attrition of standards over the past fifteen years but suggests this can be a period where the NHS has to recover and transform services. Niall and Roy remain concerned about what can be achieved given all the headwinds but here again is a leader who says they can make progress.     N.B. This podcast was recorded before the government announced the go-ahead for widespread redundancies in ICBs and NHSE.  Speaking at a Providers conference on 12th November the Secretary of State said;   ‘...Funding arrangements [for voluntary redundancies] have been agreed with HM Treasury and will be from within the existing funding settlement. We will not be cutting any investment to the NHS frontline. Further detail will come forward in the coming weeks.’   It is widely anticipated that NHS organisations will be permitted to overspend budgets in the current year and the amounts reclaimed over subsequent years through efficiency savings.

    41 min

  4. 11/03/2025

    Sarah Woolnough, CEO of the King’s Fund.

    In The Loop: the BIG Questions

    46 min

  5. 10/14/2025

    Sir Jim Mackey.

    In their latest In The Loop podcast Niall and Roy have a revealing exchange with NHS England Chief Executive Sir Jim Mackey. In a wide ranging discussion  Jim admits just how challenging it will be to meet the government’s ambitions for the NHS. If they deliver, he thinks books will be written about it and that it could be the greatest public sector turnaround of all time.  “We are trying to do a lot in one go, we are trying to do major change on pretty much every front,  very quickly and what feels like in a rush, and at times it feels a bit overwhelming.”   But he remains optimistic and argues that they have no alternative but to address a whole series of fundamental challenges.    Sir Jim makes clear he did not know NHS England was going to be abolished when he took on the role. He supports the plan but says it would have been reasonable to assume that when the announcement of job losses was announced everything about the redundancy programme would have been ‘boxed off’ and ‘lined up’. But it  wasn’t. And he says that matters have  become more complicated as the year’s gone on and as other things have changed politically and  economically.   He insists that redundancies at NHS England and for staff at Integrated Care Boards (ICBs) should be achieved through voluntary deals, but admits they are still negotiating with the Treasury and that it has taken too long, with lots of argument and this issue becoming tied to other negotiations.  According to Sir Jim “The delays on the redundancy costs have added complexity and drift and we do feel we are trying to do too many things at once. The big problem we’ve got is we do not have the time because the public aren’t as patient with us as we’d like them to be, because of the mess we had go into.” “I am as irritated and annoyed as anyone else is about how long it has dragged. It’s no way to be treating people but it is complex and it is not about compulsory redundancies.  We are going hammer and tongs to get things resolved as quickly as we can. It has gone on too long.” On ICBs he says he always thought 42 was too many with too much difference in their sizes, and that they were given too much to do and had to  work with a very expensive and incredibly  complicated operating model    In future ICBs will concentrate on commissioning rather than performance management – Sir Jim admits he did not love commissioning but feels the absence of it in recent years has been a problem and that they need to restore its value,  with performance management largely sitting  with regions  On resident doctors “We are in bad way, where there is significant dislocation between them and what they need and what they want, versus what we as employers want and need, versus what the population want.”  Sir Jim says they need to fix some of the stuff that is causing irritation but also take a fundamental look at how the training and rotation works ‘as they clearly don’t like it’

    45 min
  • 5 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
    5
  • Rating
    Clean
  • Copyright
    © 2026 In The Loop: the BIG Questions

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