Live from NHS ConfedExpo 2025 with Shaun Lintern and Victoria Macdonald

HOTL ep 79 ConfedExpo pod

Matthew Taylor: Hello and welcome to Health on the Line, coming to you from the NHS ConfedExpo 2025 in Manchester where our two-day conference is drawing to a close. You wouldn't think so? There's still a great hubbub all around me soon. However, the exhibition stands, stages, microphones will be packed away for another year.

We've had over 9,000 delegates, over 180 sessions on all manner of topics. We've had so many great speakers today. We heard from the Secretary of State Wes Streeting yesterday, Jim Mackey, who was my guest on the last episode of Health on the Line, the chief executive, NHS England. But also the great thing about these events is the networking, talking to delegates, hearing from all of you NHS leaders, conference delegates about how things feel about, uh, what it's like on the ground right now, how hopeful you are about the ten-year plan. 

So this is an opportunity to reflect on those things. Also, people are starting to say, well, it's nearly 12 months since the last election, so, what should we be thinking, how should we be thinking about the last year? What's our assessment of all of that? 

Well, to discuss all of those issues, we've got with us on Health on the Line two fantastic people to mull this over. First of all, Victoria Macdonald, health and social care editor at Channel 4 News, and who's helped to co-host this event for us and Shaun Lintern, health editor of the Sunday Times. Victoria and Shaun, welcome to Health on the Line. 

So how have you enjoyed the last couple of days?

And when you get home and your partner, your friend or whatever says to you, well, what was it like? What's the kind of one thing that you kind of want to say, well, this was really interesting. 

Victoria Macdonald: I think what I would say is that it was more upbeat than I'd expected. Actually there was a lot more positivity, there was some incredibly good, interesting, productive conversations. And I felt, and I was surprised by this because I thought, you know, there was maybe a little, people were a little bit jaundice, yet another idea of upheaval in the NHS, but actually quite the contrary. I think there has been a good enough discussion with the leaders who've been here at this conference, and it felt to me that they were really on board with a lot of the changes that are being proposed.

Matthew Taylor: Yeah, a lot of people have said that to me. Shaun, what do you think? We're all suffering from a kind of collective delusion. I mean, before I came here I was speaking to hospital leaders, a big hospital, typically having to save £2 million a week, a medium size hospital, 1 million pounds a week, all sorts of pressures and challenges. Is this just a kind of weird bubble that we come into and we all lose sight of our rationality and we're all going to go back and, and be heads down and gloomy again? Or is Victoria kind of seeing something here, which is in a way we've got to that point where there is such a collective recognition we need to do things differently, that there is a bit of energy coming out of that.

Shaun Lintern: Yeah, so I think this must be, I think my twelfth, thirteenth, possibly even fourteenth or fifteenth Confed now, and there is a bubble effect with Confed. There is a sort of slightly removed from reality, sense about Confed every year, because people come here from very difficult jobs and they're looking for space away from those challenges to think, to plan, to network, to discuss, to find solutions. 

So everyone is a little bit sort of excited to be here and I get that. But I think Victoria's right there, there has been some optimism this time around. I think partly because people feel, galvanised by a new government that whether or not the money's enough, whether or not they're doing everything right, they've got some sense of direction of travel. And the one that is stable as well. You know, we aren't expecting a new Prime Minister in 18 months’ time, which has pretty much been the pattern for the last four or five years. And we're not in a stage where, again, where we have been over the last five or six years where the discussion was all about how we slice things and save things and, and pair back whilst trying to hold the show together. 

So I think that the optimism is real, but I have to say, I think I've also detected myself talking to people. There is some cynicism, some fear I think around…the challenges are so huge. I mean, I think people have forgotten that the NHS is facing some of the biggest challenges since it was founded.

I mean, the Blair era, you know, achievements pale into comparison to what we're facing now. If we're really going to tackle the waiting list, if we're really going to sort out health inequalities, move care into the community, the neighbourhood health centres, all of that stuff we've heard before. If we're actually going to do it, it's going to be a huge climb.

And I think a lot of people. Realise how tough that could be. And bear in mind, 50 per cent cut in ICB management costs. Wes Streeting said today we're not doing a top down reorganisation. Well, I'm not sure many people in the conference would agree with that. It feels like that. So there's a lot that people are dealing with.

So it's sort of, there's a, it's a conference of two sides, I think, for me. 

Matthew Taylor: But then Victoria, speaking into that, Jim Mackey, yesterday, I mean, Jim's got a particular style. He's got that kind of roll up your sleeves, get down to it. Jim, on the phone kind of way of thinking about leadership. I said in my speech, and I said this with due deference to the previous leadership of NHS England, that there was a bit of a jarring quality to the NHSE message in the past, which was on the one hand everything, aren't we doing well? Here's a great list of wonderful things we're doing. And then a kind of helplessness. 

And what you get with Jim, it feels to me is slightly the reverse of that, which is he wants to say, no, things really, really aren't great and I want to talk to you about how things aren't great and we need to recognise that. But then a kind of, but in the end folks, it really is primarily up to us. 

And I think that's part of what energises people a bit. What did you think of Jim's speech? And how do you think Jim's doing a couple of months in? 

Victoria Macdonald: I was actually impressed by it because it was straight talking and I think we haven't seen enough of that out of NHS England's.

I think he said these are difficult times. He didn't go quite as far as you did and saying, this is the last chance saloon. Sorry to steal your headline, Shaun, but he was very upfront and honest about what is confronting the NHS and what needs to be done.

And I think people found that, I certainly found that refreshing, there was no sort of NHS speak in it and it's very difficult for journalists when people - I had to ask Shaun today what, um, what is it? Left… left… left… shift, left shift, meant right? which I kept hearing. 

At the same time he was also not letting people off the hook. I mean, he was saying, you have to go and do this and we will give you that freedom. We will decentralise where we can, but we won't stop watching and we will be here. 

And I think he also told delegates too, if you need our help, you can ask us. Which again was quite refreshing because too often you have felt, especially when I'm going around and I'm filming in hospitals or in GP surgeries or whatever, there is such a huge disconnect between NHS England and what's happening on the ground where I can see to my left hair GP who surgery I've, I've filmed and what he, what he would do in his GP surgery and what NHS England is requiring or expecting all of it.

It, it just didn't always match up. 

Matthew Taylor: So I wonder we might get into pattern here, Victoria being really positive and you being slightly the voice of realism. But I, [Victoria]…whilst I can be negative if you want… [Matthew Taylor] I'll give you an opportunity. 

Shaun Lintern: Well, Matthew, they don't, they don't call me ‘Misery Corner’ in the Sunday times for no reason.

Matthew Taylor: Do you think Jim has brought a welcome kind of clarity and a kind of new voice? 

Shaun Lintern: He has, I think people appreciate, Jim is quite an authentic speaker. Sometimes that's got him into trouble in the past and it's one of the reasons journalists love him because he, he will say something and it's great.

Matthew Taylor: Yeah. Everyone was rushing around yesterday saying, he'd said something a bit unpolitical about, about social care. 

Shaun Lintern: Well, exactly. So he is great in that sense. But from the delegates here, from the NHS leaders, I think they see in Jim someone who's talking their language and he's not trying to be something that he's not. He's not, you know, he doesn't have, I don't think any bigger ambitions beyond the job that he's doing now. He's got a mission and he's, and he's mission driven, and I think he speaks to that. 

Matthew Taylor: I'm reliably informed that he thinks the Newcastle job is bigger than the NHSE job, you know, but… 

Shaun Lintern: Well, exactly. I wouldn't be surprised if he does think that, and he comes with a lot of experience. He knows what he's talking about, you know, he's walked the walk. So in that sense, I think people are backing him at the moment and want him to succeed. 

I think some of the things, if I was to go through what he said, I think there is a little bit of Jim that sort of seems to suggest that every single one of NHS's leaders are good and they're all trying to do the right thing, and they're all working hard and everybody's doing what they should. And you know, I'm sorry to say though that that's not the case. 

Matthew Taylor: …he talks a lot about performance variation, which implicitly suggests that he is recognising that isn't the case 

Shaun Lintern: Performance, yes. But, but he gave people a very clear kind of sense that you'll get the freedom to do what you need to do. And, you know, I hate to say this, but given who I am and the job I have, you know, I wouldn't be in the job I am if I hadn't written about an awful lot of examples I'm afraid of NHS leaders not doing the right things.

And we know that that happens. We know there are coverups where there are crimes committed, there are mistakes made. Sometimes these are genuine human error mistakes, et cetera. Sometimes they're not. Sometimes they're a bit worse. 

And I find it, and I'd say the same to Wes Streeting as well. I think they're both rushing a bit too quickly to give freedom without necessarily the regulation of managers that Wes Streeting's talked about, but not delivered, and I'm not talking here about striking managers often going down the punitive section. I think I would take people back to the Clark review, which talked about professionalising NHS management. Giving them the training, the standards, the education, et cetera, and a little bit of a stick at the end for those who really went beyond the pale. I think we need to see some of that being actually brought forward some proposals on that. We haven't seen that at the moment, so I'm a bit concerned about that.

Matthew Taylor: So Victoria, the Secretary of State speech today, I mean, he did have a bit of that. I think Jim as well, puts a lot of emphasis on transparency. If we can really open up performance and you know, I hear what you say, Shaun, but you know, I'm a leader. No leader wants to be at the bottom of a league table and to be known to be there, so they do put quite a lot of emphasis on that, 

I thought what lot was interesting about Wes, his speech, you know, I enjoyed it because it was, as he said at the beginning, a bit nerdy. He was speaking to the audience. There wasn't a headline grabbing thing. There's been a characteristic of where his speeches over the last couple of years, which is it's reasonable, and then the last 5 per cent he says something about, I'm going to force league tables or sack people, or whatever.

There wasn't that kind of sting in the tail. It felt like a genuine attempt to engage the service. What did you, what did you make of it? 

Victoria Macdonald: I thought it was fine. Yes. As a journalist I was thinking, I can't quite find the headline in this, but unfortunately… 

Matthew Taylor: He did play that at the beginning.

Victoria Macdonald: Yes, exactly. I, you know, it was him in a way. He's very good at speaking to the audience he has in front of him. I would've liked more detail out of him in some ways about why NHS England was abolished without a plan in place. I think that the people in this conference hall would've quite liked to have known that as well. I would think there should have been more of an acknowledgement from him that there are about to be an awful lot of redundancies. And I've spoken to a lot of people here who are genuinely worried, particularly women. And I did a session this morning where that was a very big topic of conversation about, you know, who's going to lose their jobs, where the impact assessment is.

So there was none of that, but he talked about. Realism and honesty, and I think people want to hear those words whether we get that realism and honesty. I don't know. I thought he was quite motivating at the end when he was talking about the staff and who makes up the staff of the NHS and the Wind Rush generation and the children and the grandchildren.

And it actually felt like a little bit of a dig, to me at the Prime Minister for some of his discussions about immigrants and so on. I thought it was quite pointed. I don’t know if you thought that, Shaun, but I actually found it very, very refreshing and I think it hit the room very well.

Matthew Taylor: He did seem, I felt very relaxed. Shaun? 

Shaun: Yeah, yeah, I'd agree. 

Matthew Taylor: I think often, you know, I've not been coming here as many years as you, but often when politicians come, it's a bit brittle. They kind of get in and get out and try to avoid a row or adverse reaction. He is someone who feels, seems to be at home in this setting.

To Victoria's point, he gave us quite a lot of insight into the ten-year plan. Nothing that would surprise those of us to be watching the process. But the detail is yet to come. What did you make of both him and what he said? 

Shaun Lintern: So I think you're right. He seemed quite relaxed.

He seems to almost be enjoying it, but he would, wouldn't he? After a spending review where he is just been given an extra 50 billion in cash. So I suppose he's got a few things to smile about. 

He did say some things that really made me sit up and take note. I think the one that particularly stuck in my craw is he said foundation trust initiative was one of the best, uh, initiatives in the last 25 years. I'm going to have to remind the Streeting team to read the Francis Report and the effect that that policy had on mid staffs and the hundreds of patients who suffered admist that. 

And again, following on your point about transparency, they are very big on this and publishing this stuff and, and there is an unintended consequence of that.

Now, as a journalist, I love transparency. I love league tables. Of course we do. But I'm also very aware that if you are at the bottom of a league table, you might then be encouraged to do things that maybe you shouldn't. 

Matthew Taylor: Yes. 

Shaun Lintern: And they should be aware of that. The government needs to be cognisant of that. So does Jim, in this new world that they're building. 

The other comment that he made was GPS running hospitals, which I thought was quite interesting. I think that that's going to get some attention. And I'm looking forward to the first acute hospital that's run by GPs. If they shut it on Wednesday for training, that'll be interesting.

Matthew Taylor: Let’s go from that, Shaun, straight into the ten-year plan. What for you is the - you know, I've heard various concerns about the ten-year plan. I've heard that it'll be too aspirational and not concrete enough. I've heard that it will feel like ten different plans in one document, but not a single core strategy, et cetera, et cetera. What's your one big hope for the ten-year plan, and what's the one thing that you think would really undermine it? 

Shaun Lintern: So I think from what Wes was saying - he seemed to be suggesting that it, there would be some quite tough things in there. And I think, you know, I hope that's the case. I think I sort of feel like the system is addicted to these plans.

They’ve  rarely survived contact with reality, and I'm not really sure they have much value actually. But maybe with a government like this, in place for four years, this one might just be important and what I want to see as a plan. But specific mechanisms of delivery that are going to achieve it. 

If we just get a hundred pages of grand ambition and then there's another technical document that comes out later that will be a real disappointment. I think this plan's got to spell out how we go from A to B. If it fails to do that, I think it will join the many other plans that are propping up, you know, monitors around the NHS.

Matthew Taylor: I quite enjoyed his gag about here I am saying that I want to let go of control, and then I'm talking about a ten-year plan, which is the classic instrument of Soviet regimes. 

What would be, Victoria, the one scene that you most want to see in it? And, and what would be your biggest concern? The thing that will kind of make people go, oh.. 

Victoria Macdonald: I most want to see that shift from hospitals to community. I really believe that. That is long overdue. We've seen it tried before, but never with any great enthusiasm. But we've been sold this; we've been told right from the beginning of this government that that is one of the three shifts that they want to see. And I really hope that that is big.

I've been told that it is very big, that it is very much there in the plan. I've also been told that there is a lot of stuff there on things like personalised medicines, the use of genomics, better use of data, and I would be very disappointed if that doesn't come through, if they don't grab that and say you cannot have an NHS now that doesn't share patient records, that isn't using the best of the technologies that have often been invented in this country. And I'm slightly worried that it will fudge that because of course that does come with a cost. 

And then the other thing that could equally be fudged is grabbing the money from the acute sector in order to put it into the community because it's going to have to see a shift of that money. And I can see some power games playing out over that.

The trust chief executives I've talked to and I’ve asked them outright, what would you say if they took part of your budget and put it in the community? They'd say, great, because it would help us with our A&Es or whatever. Saying it is one thing and actually allowing it to happen is quite another. 

Matthew Taylor: And holding primary to account, you know, so if you move the money, primary is going to have to demonstrate it's actually reducing the number of people turning up at A&E and it's reducing the number of outpatient support, et cetera. So, that's quite challenging with the primary sector because it's a sector still made up primarily of small businesses. If there's one thing GPS value more than anything else, it's their autonomy. But this isn't going to work unless primary care is willing to take on some risk and to work.  

Shaun Lintern: I wonder if moving the money is the wrong approach. What we need, perhaps need to do is move the staff. And the money will flow…

Matthew Taylor: Yes, yes. 

Shaun Lintern: … where the staff are being paid. And I do wonder do we need staff working in hospitals? Their employer just needs to shift. Become the new look ICBs.

Victoria Macdonald: The way I've read it, that is what is…

Shaun Lintern: If you wanted to shift the results, that's how you would do it.

Matthew Taylor: And that's one of the arguments for acutes being the leading agency in this change. Because they've got to be incentivised to do it themselves. It's not to feel like a loss of empire, but a different kind of empire. But there are different. There are different models as well. 

Let's just turn away to from, from the ten-year plan, because of course, as we all know, in the end, the biggest problem of politics is events.

What do you think might be the thing that's going to come along that's going to knock Wes off course in the next few months? Because you know, when he is back here next year when you are both back on this podcast next year, it'll be not a new government, but a midterm government. And that feels very different.

So, are there things which I wish you think might come along, and then in a year's time we talk about the ten-year plan. We're going to be talking about this scandal or that strike, or this or that. What would you be worried about if you were him? 

Victoria Macdonald: He doesn't look like a man who gets easily knocked off course to be frank.

But, you know, I don't know. We will see some strikes. The nurses are not happy. We know the resident doctors are already and… 

Matthew Taylor: You think they'll be strike because I'm not sure the public is going to be as sympathetic as they were last time 

Victoria Macdonald: I asked somebody this question and it was more in hope that there aren't going to be strikes because actually they're quite difficult to report on because there's only sort of one line and one picket line and that's it. But that's a purely selfish… 

Matthew Taylor: You know, I had to do 150 interviews where I say I understand the position of both sides, and I call them both to talk to each other and there's only so many times you can make that bias for argument.

Victoria Macdonald: Exactly. But I suspect the resident doctors might go out on strike again. I don’t know about the nurses. They're always a bit harder to read. I don't think that would knock him off course either, actually. I think he would, he would probably take that one in his stride. 

Matthew Taylor: And how do you think he'd handle it? Is he going to be resolute? 

Cabinet colleagues are going to be pretty, I mean, if he goes to cabinet and says I've got to kind of give way to this and I need more money. I don't think he's going to get a good hearing. 

Victoria Macdonald: No, he wouldn't. And I mean he was very gracious about his cabinet colleagues today, about not sort of stabbing him in the back or the front even, because he got so much money and they didn't. But there is no room for manoeuvre. And I think that is going to be a problem for him. But will it knock him off? Of course. No, I think he will deal with it.  

Matthew Taylor: Do you think there are going to be strikes and do you think that is the biggest thing that might end up consuming where his energy is rather than where he wants to focus, which is reform and recovery. 

Shaun Lintern: I'd love to see the Secretary of State's risk register, I must admit. But on strike specifically, I think the jury is out. None of us know which way they're going to vote clearly based on the last ballot when they got 98 per cent support for a strike, the risk has to be that resident doctors are going to go out on strike.

To your point about public support, frankly, I don't think they care about public support. They’ve pretty much said this to me at various points that's not their primary concern.

Matthew Taylor: When you say ‘they’, do you mean the BMA, do you mean the union leaders or do you mean the actual staff. 

Shaun Lintern: People within the BMA have said to me, we are not concerned about public support.

Matthew Taylor: But you think that's true of people out in the field? 

Shaun Lintern: It gets interesting when you are a consultant covering for a junior doctor then it becomes quite interesting discussion within the ward. So I think we'll see how that plays out. 

But that could really throw the elective waiting list ambitions to the wall. And of course it's helpful to have someone to blame them. And it could play to Wes Streeting’s strengths if he wants to go down that road, I'm not sure the public would really buy that one, they would see it as his fault. 

But you asked about other things that might blow us off course. I mean, any number of scandals can emerge at any point. 

Matthew Taylor: He says with a glint in his eye. 

Shaun Lintern: Yeah… we've got huge problems in maternity. We've got huge problems in departments. And let's remember none of us were talking about issues with infectious diseases in October 2019. And within six months everything had changed. 

Matthew Taylor: You are on such a ray of sunshine, really. 

Victoria Mcdonald: But you are right. And I didn't bring it up, but I mean, the thing that is most on my radar and that I've been doing them a lot of reading around is bird flu.

I just feel like at this time I need to be slightly more prepared. And it's not out of the question. And as we know, the NHS is running hot again. So it's in exactly the same position it was. 

So just to make me more pessimistic than you are.

Matthew Taylor: And the worst thing is if that happens, people will say, oh, it looks like after the pandemic we pulled away from the pandemic preparedness. You just thought, you know, Yes, that's a different conversation. 

Last question, because you're both political observers as well as health experts. I said in my speech, Wes referred to it in his speech that we could, at the next election, see reform the conservatives, maybe a conservative reform combination, who knows, for the first time in the face of those public satisfaction figures saying, look, this doesn't work anymore. 

And I don't think that what they would say is, we're going to smash the NHS. What they would simply say is what Margaret Thatcher said all those years ago. It is actually a good thing that people are opting out and providing for themselves. Let's incentivise that, and if we do that, the NHS will have fewer people to serve. This is good for the NHS, even if it breaks up the kind of notional universalism of it.

Is that scaremongering or do you think it's possible, Shaun? 

Shaun Lintern: I think it's a real possibility, but I'm not too worried about it because first of all, people are already making their own choices to go private and that's been going on… 

Matthew Taylor: Two million people having buying weight loss drugs directly. 

Victoria Macdonald: Well, that's a slightly different issue, 

Matthew Taylor: Yeah. But nevertheless, you know.

Shaun Lintern: It's true, yeah, it's a true issue, but people are already opting out in their own way and that will continue. But I think why I'm an optimist to chase the tone on this, you know, I hear this all the time about the NHS. It's broken, the funding model doesn't work, let's move to social insurance. It goes around all the time, and it's an easy debate to have. It's a bit unthinking of people when they trot this out, because actually, okay, let's sit down and talk about that and how, how to explain to me how that model delivers me more MRI scanners more doctors, more beds, new hospitals without me paying any more money.

And usually the answer is, well, you, we'll have to pay more money. Well, why don't we try that first before we throw the whole thing out? And I just think the public, when confronted with a real, genuine offer to change the model and they have to get into the facts of what that would look like. I think the British people who are, you know, in every survey going very proud of the NHS and what it is and what it stands for, I think they will turn away from that offer.

So if Reform wants to go down that road, I think they'll end up making a political error. 

Matthew Taylor: So that, as I say, Shaun is not, and I'm going to give you the last word Victoria, that isn't my concern. I don't think it will be, let's move from one funding model to another. I think it will be, the majority of young people are accessing primary care services through commercial apps, 2 million people are buying weight loss drugs online… we're seeing more and more people opting to pay for elective procedures. Let's not see this as a problem. Let's see this as a good thing. Let's incentivise it. And then, as I said, sorry, I'm quoting myself, where thing that old men do a lot, as I be said, a service for poor people soon becomes a poor service. That's my worry again. 

Do you think if that is a real concern, do you think you might be reporting at the next election that the NHS is a huge issue because some parties are saying universalism is no longer the way forward.

Victoria Mcdonald: I've just actually had a mini documentary made about me, about my observations of the NHS over 35 years. Actually, I haven't told the producer that it's actually 40 years, but we'll just leave it at that. And so I've been thinking a lot about where it was when I first started reporting on it, where we are now, and what we see for the future.

And I think the conclusion that I've reached, and you and I have talked about this before. I've seen it way worse way, way worse in the past than it is now. But it is at a pivotal moment and I think that everybody is right to be looking at the, at the, um, at the public surveys because they are really depressing.

I am going back to being optimistic and I think that the public are saying we are fed up with the NHS, we're fed up with not getting to see our GPs. We're fed up with having to be on a waiting list, but we're not fed up with the NHS as a concept as an overall structure and I think it will survive. But, and this is, this was sort of what I've finally reached for the end of the, the documentary was, was it is now actually up to the public.

And I think there needs to be a better conversation with the public, not us here, because we know all this. We need to go to the public. You need to go to the public. Then politicians need to go to the public and say this is the moment where you have to stand up and fight for it, because if you don't fight for it, it will disappear and it will be a thousand cuts. It won't be overnight, it won't be disbanded like that. It will be more and more people taking out private health insurance. More and more people opting to pay for their, for their hip surgery. As we can see, it's the highest level of private health insurance at the moment that there's ever been.

And that is a worry.  I had to pay privately for an MRI scan. Oh. I did say, don't you know who I am? [Laughs]

Matthew Taylor: Shaun, Victoria, we will have you both back next year. When's the documentary going to be out on our screen? 

Victoria Mcdonald: I’ll let you know. 

Matthew Taylor: Okay, well, we'll all look forward to that.

We're delighted, Shaun, that you ended up on a slightly more positive note. Thank you so much for joining me on Health on the Line. 

Now we're all heading off from Manchester for another year. It just leaves me to introduce our Leader in Six feature, which this time is with Matthew Coates, chief executive at West Hertfordshire Teaching Hospital NHS Trust, where I undertook a really brilliant visit just a couple of weeks ago.

Goodbye. 

Matthew Taylor: So first question, Matthew, what's top of your in-tray right now? 

Matthew Coats: Top of my in-tray is what’s always top of my in-tray, which is making sure that we provide the best possible patient care that we can, and we do that by keeping in balance patient safety, quality of service, financial sustainability and the timeliness with which we treat patients.

Matthew Taylor: Tell me about an innovation in your trust that you are particularly proud of or enthusiastic about. 

Matthew Coats: I'm particularly proud, if I had to single it down from one, two would be surgical, robotics and virtual hospital. But if I was, if you're asking me just to say one, I'd say virtue of hospital.

There's been a groundbreaking piece of work here, which is to make sure that we can remotely monitor patients in their homes and elsewhere. That helps us prevent admission, but also creates the conditions early discharge and that itself takes several wards worth of patients out of the main patient flow, which has enabled us to make, amongst those other things the improvements in patient flow and A&E performance that we have.

But it's also improved patient experience. It's not just made sure that we can de-normalise corridor care, but the satisfaction scores for virtual hospital are much higher - nine point something per cent, 9.5 per cent, in terms of patients who feel satisfied with that service and that's what we're here for. 

Matthew Taylor: Brilliant. Tell us about leader that you've come across in your career that you really admired.

Matthew Coats: I'd have to say Jeremy Haywood. I've been privileged to meet some absolutely brilliant people and some really bright people. And then there's Jeremy. And Jeremy was the brightest person by a street. 

Matthew Taylor: And this is when he was cabinet secretary. 

Matthew Coats: Right. I think Jeremy's defining characteristics were combining the ability to hold an entire system in his head at one time. And for him, that was our country, and then its place in the world, but at the same time to give it a human dimension and care for people. 

Matthew Taylor: The only problem with Jeremy, because I worked with him as well, was inadvertently, he'd infantalise people because everybody knew that whatever you sent to Jeremy, he'd make it better. So you in the end didn't need to worry too much because you don't need to worry. 

Matthew Coats: No. He was inspirational to me. And, and it's this trying to, and his, this ability to both humanise but also keep this entire piece and all of its moving parts and those dimensions in, in his head at one time. 

Matthew Taylor: If you were king of the NHS for one day, Matthew, what would you do? 

Matthew Coats: I'd try and help you all write the best possible ten-year plan for the rest of us. Everyone's really waiting in anticipation for what comes, is going to create the framework for the next generation for the NHS. And the single biggest thing I would like to see get done really well is that 

Matthew Taylor: Absolutely. Tell us something about yourself that's interesting and nothing to do with your job. 

Matthew Coats: I think I'd probably say that I've got the second most stressful job in our family. My wife directs TV drama and so I get an insight into a completely different world and I'm in awe of the work that she does. 

Matthew Taylor: And she ever done a hospital drama?

Matthew Coats: She did do Casualty once. 

Matthew Taylor: Right. And did you watch it? And so you got this wrong and you got that wrong? 

Matthew Coats: Someone said at our wedding that Jill runs a pretend hospital. Matthew pretends to run…

Matthew Taylor: But he is on topic though because my last question is, tell us a bit of content you've consumed recently. Might be a book, a podcast, a film that you really enjoyed, you'd recommend to other people. And it can be as trivial as you like.

Matthew Coats: We watch Scandal the other evening, the Profumo scandal. 

Matthew Taylor: Oh right, the old one?

Matthew Coats: Yeah. And that was really interesting. A reminder that in politics, some things never a change.

Matthew Taylor: Matthew, thank you.