Interview with Sir John Oldham OBE
National Clinical Lead for Quality and Productivity at the Department of Health, UK.
Member of the National Quality Board

Could you briefly describe the work you’ve been involved with and the difference it’s making to patients?

What we’ve been looking to do is to seek greater integration and less fragmentation in what you might term the conventional healthcare system -that is between the bits of healthcare and social care which make a huge difference to what is the biggest driver of healthcare in certainly all developed countries and in parts of developing countries which are people with multiples long term conditions and complex needs.

Yes, we’ve been talking a lot about the needs of people with long term conditions and there has been much discussion around the need for a paradigm shift. Do you think that’s happening?

I think people are beginning to discuss the paradigm shift. I think the debate has shifted in the last 3 years from one of denial to acceptance of the problem. I think what there isn’t a consensus around is what people intend to do about it. But time is not on peoples side, the mathematics are horrific and no healthcare system I know of in any developed world is sustainable if they continue to do what they do now.

What do you feel needs to shift to make the situation more sustainable?

I think the important thing is to refocus on seeing people as whole people, not as body parts. That means looking to various elements of their existence, not just their physical health but their functional need and focusing on what people themselves want.

I mentioned in my talk about starting with a conversation. that conversation being what would you wish to be your future. it isn’t things like what the blood pressure control is, it is I want to be able to go shopping, I want to be able to walk my dog on the beach and then orienting all the elements of the care system, both in terms of their functional need and their physical health around those objectives.

I think its really important and certainly my take away from here is a reminder to me that changing peoples lifestyles makes a huge difference and like many who’ve had conversations with people for 20 odd years and not been able to do it, what this conference has given to me is perhaps another angle, what is a really important thing, so that we truly see people as whole people. This includes what happens in the other parts of their lives, not just what happens during the short time that they’re with whichever professional they happen to be with.