Alyson McGregor: Healthcare is unsustainable in its current form

McGregor has been director of Altogether Better, an NHS hosted National Network organisation, for eight years

10th January, 2017
Alyson McGregor of Altogether Better

What are your day to day responsibilities?

I am the Director of Altogether Better, a role which on paper brings all of the usual responsibilities of a chief executive. What that means in reality is that I spend my days working with an amazing and diverse team of people on the things that matter most. I work with clinicians, managers, academics, evaluators and citizens who care enough to step forward to take action. Our role is to bring citizens and staff from different settings and services together in new and productive conversations that make a real difference to peoples lives. We have worked with over 24,000 citizens who work alongside NHS and social care staff and every day brings something new to humble us, teach us something we didn’t know or just make us proud to be part of this work. Our evidence based work has taught us that we do the best work when it is both meaningful and fun so in a nutshell my role is to work to create the conditions for that to happen.

What is your professional background?

I started my career in the NHS in public health and health improvement working on reducing health inequalities, moving into the voluntary and private sector for a while as a consultant working on a broad portfolio of work including coaching, management and service design. I worked at board level in a number of PCTs for over 9 years in non- executive roles.

Tell us something very few people know about you?

I am a bit of an open book, probably because I talk too much! People may not know that I have 3 grown up sons and know more about Premier League football than I could ever have imagined!

You are speaking at the 2017 Health Summit. What is your talk about?

Altogether Better has developed a robustly evaluated evidenced based approach called Collaborative Practice which brings citizens and GP Practices together which delivers:

- A vast range of new offers that promote wellbeing and resilience, prevent ill health and treat people who struggle to live well with LTCs, isolation and loneliness

- Reduction in consultation in primary and secondary care and a shift in the way patients use services – moving towards social rather than medical solutions

- Failure demand one of the biggest costs in the NHS is reduced

- A financially sustainable business model for General Practice emerge

- Patients, carers and citizens become a valued part of an ‘extended health and care team’

- Reduction in workload pressure

- Staff morale improves

- This approach has also been successfully used in a number of different settings including A&E, specialist hospital services and mental health trust. We are currently prototyping in Care Home settings.

What challenges do you see for the healthcare sector in Ireland?

Healthcare is unsustainable in its current form as it struggles to adapt to the growing burden of long term conditions, lifestyle related health issues and the demand generated by social factors such as social isolation. None of these can be ‘cured’ by a clinical consultation. The way forward is system transformation, widely prescribed but often poorly understood and implemented.

The NHS Five Year Forward View asks us work together to deliver new sustainable models of care “where fully engaged patients, carers and citizens play a greater role in their health and health care.” These new models of care will harness the assets and energies of clinicians, patients, citizens, and community partners. Along with many others, Altogether Better care passionately about the sustainability and survival of the NHS. Working closely with citizens and over 90 GP practices has given us a deep understanding and extensive expertise in how to support these changes to happen.

Where would you like to see the health service in 10 years time?

I would like to see a health service which offers is a future for patients, carers and citizens where they are recognised as a part of the solution and not the problem -- as an asset not a burden; where they gift their time, energy, interest and enthusiasm to work as equal partners in making a real difference to the lives of others; where a vast range of new offers emerge that promote wellbeing and resilience, prevent ill health and treat people who struggle to live well with their long term conditions, isolation and loneliness; where the mental health and wellbeing of patients improves significantly

And [a health service] which offers a new model of general practice: where consultations in primary and secondary care reduce significantly; which tackles failure demand; where there is a reduction in the pressures on staff in General Practice and staff morale improves; where a new sustainable business model for General Practice emerges; which makes prevention the norm – an integrated part of the system; where having champions (citizens) as part of the practice family changes the nature of the family and both coevolve to do things differently, and; where patients get what they really need and not only what clinicians and professionals can offer.

Alyson McGregor, Director of Altogether Better, will be speaking at The 13th National Health Summit at Croke Park on February 7. For more information or to book tickets visit

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