Dr Ross Dunne and Chris Larkin: Reimagining dementia diagnosis

Dementia is the UK's biggest killer. Yet around a third of people living with it don't have a diagnosis.And we're still largely using services designed for a time when there was much less we could do about the condition.That's beginning to change.The new Manchester Brain Health Centre is bringing together earlier diagnosis, advanced testing, prevention and personalised support in a very different model of care.And one of the most interesting things is how even changing the language can make a difference.Ask people whether they think they can reduce their risk of dementia, and many will say no. Ask whether they can improve their brain health, and they're much more likely to say yes.In this episode I speak to Dr Ross Dunne, one of the clinicians behind the Manchester centre, and Chris Larkin from Alzheimer's Society, which is helping lead the initiative.We explored what's wrong with dementia diagnosis today, how the Manchester team is redesigning the experience, and what it would take to bring this approach to the wider NHS.The science is changing. The challenge now is to redesign services to make the most of what's becoming possible.Problems Worth Solving is brought to you by Healthia, the collaborative service design consultancy for transformation in health, care and public services. Find out more about our work at healthia.services.

Dr Neil Churchill OBE is Director for People and Communities at NHS England. He has spent much of his career working across the boundary between the NHS and voluntary sector. His argument is simple: the health service depends on charities far more than it often acknowledges - but those relationships are still too fragmented and transactional. In this conversation, Neil introduces Diagnosis Connect - an initiative designed to connect people with specialist charities at the point of diagnosis, rather than leaving them to find support by chance. It raises a bigger question: as the NHS becomes increasingly digital, how do we make sure its real-world relationships with the voluntary sector exist in the digital world too?  We also explore what the shift towards neighbourhood health means for charities and communities - and why care closer to home can’t be delivered by the NHS alone.Problems Worth Solving is brought to you by Healthia, the collaborative service design consultancy for transformation in health, care and public services. Find out more about our work at healthia.services.

Tero Väänänen, Head of Design at NHS England, has spent nearly thirty years watching the same pattern repeat across finance, telecoms, and now one of the world's most complex health systems. Organisations optimise the capabilities they own. People fall through the gaps between them.In this conversation, Tero introduces a framework that reframes the whole problem. Healthcare is an infinite game — there's no winning, no endpoint, no final whistle. But we keep designing it with finite rules that were never meant to join up.We also explore a risk that isn't getting enough attention: how agentic AI could widen health inequality rather than close it — and what we'd need to do right now to prevent that.Problems Worth Solving is brought to you by Healthia, the collaborative service design consultancy for transformation in health, care and public services. Find out more about our work at healthia.services.

At a radiology AI conference, a clinician described a simple interface choice: an agree/disagree button for feeding back on AI diagnoses. It looked clean and efficient. But it assumed something fundamentally untrue: that clinicians experience a binary internal state when reviewing AI outputs. In reality, what they experience is uncertainty, context, fatigue and gut instinct. And when you force all of that into a binary choice, you don't just create a poor experience. You distort the data training the model.In this episode, consultant psychiatrist Dr Lia Ali argues that behaviour isn't a surface layer in health technology — it's infrastructure. Drawing on experimental psychology and her work at NHS England, she makes the case that most health AI is built for a version of human cognition that doesn't exist. She calls this the fictional binary human, and she thinks it's one of the biggest unspoken risks in health technology today.Problems Worth Solving is brought to you by Healthia, the collaborative service design consultancy for transformation in health, care and public services. Find out more about our work at healthia.services.

Last year, GP teams in England delivered over 380 million appointments — and the pressure is on to deliver even more. But maybe the bigger opportunity isn't making each consultation faster? What if it's rethinking the relationship between a person and their GP?Dr Shanker Vijayadeva is a practising GP and lead for digital transformation in London at NHS England. He lives on both sides of the system - in clinic seeing patients and leading change across the capital.In this episode, we explore what he calls "the wider consultation" - the idea that care should start before a patient walks in and continue long after they leave. We talk honestly about what AI is and isn't doing in general practice, why COVID proved the NHS can move fast when it has to, and what happens when you get Age UK to train GP practices on their own technology.Problems Worth Solving is brought to you by Healthia, the collaborative service design consultancy for transformation in health, care and public services. Find out more about our work at healthia.services.

In this episode, Helen Thomas, Chief Executive of Digital Health and Care Wales, shares a rare and honest perspective on the human side of transformation.Drawing on more than 36 years in the NHS, including leading Wales’ digital response during covid, Helen reflects on what leadership really feels like at the sharp end of health and care – making difficult decisions, carrying responsibility, navigating uncertainty and still showing up for others.We explore why digital transformation is fundamentally a care model challenge, not a technology one, and how getting this wrong quietly undermines adoption, trust and outcomes. Helen also reflects on what the pandemic revealed about the system’s ability to move at pace, why so little of that has stuck, and what leaders can learn from it.This is a conversation about judgement, compassion and inclusion as leadership disciplines – and what it takes to lead change in complex systems today.Problems Worth Solving is brought to you by Healthia, the collaborative service design consultancy for transformation in health, care and public services. Find out more about our work at healthia.services.

Imagine starting every day with a calculation: what you eat, how you move, whether an unexpected walk or a stressful meeting will tip your blood sugars out of range. That daily mental load sets the stage for our conversation with Dr David Cheney of Diabetes UK, where we unpack the hidden frictions in diabetes care and the bright spots that are changing outcomes.One in five people in the UK are living with diabetes, prediabetes, or undiagnosed type 2, yet only around sixty percent receive their annual care processes. Stigma pushes people away from appointments, and access to treatments still depends too much on geography. David explains why the first year after diagnosis matters so much, and how a single empathic consultation can build confidence that lasts—while careless words can do the opposite. David shares how Diabetes UK backs professionals through Clinical Champions, bite-sized CPD, and paired learning that equips both sides of the consultation. Co-design has created Cornwall’s clinics where out-of-hours, one-stop checks boosted attendance and cut waits. We also address AI’s promise and pitfalls: helpful algorithms and reminders on one side, misinformation and disintermediation on the other.We close with Diagnosis Connect, a simple but powerful idea: automatic signposts from GP systems to trusted charities at the moment of diagnosis. That timely link can open doors to remission, prevention, mental health support, and practical tools—right when people feel most overwhelmed. If you care about better diabetes outcomes, less stigma, and services built around real lives, this conversation offers a grounded blueprint and a dose of hope.Problems Worth Solving is brought to you by Healthia, the collaborative service design consultancy for transformation in health, care and public services. Find out more about our work at healthia.services.

Professor Jim McManus: Zooming out on preventionIn this episode, we explore prevention in its widest sense — across systems, communities and everyday life.Professor Jim McManus, National Director of Health and Wellbeing at Public Health Wales, explains why prevention remains one of the toughest challenges in health and care. He shares how poverty, place and inequality still shape life expectancy in Wales, and why we must shift prevention from a “side programme” to the organising principle of the whole system.Jim argues that prevention isn’t just about saving lives — it’s about economic productivity, community resilience and human connection. As he puts it: “You can’t compete with China if you can’t get off the sofa.” He highlights what needs to change — from the way we educate children and design services, to how we empower voluntary organisations and digital tools to make healthy choices easier.This conversation builds on our recent episode with Rachel Hope from NHS England, zooming out from digital prevention to the broader human and economic cycle that keeps people well. Prevention, Jim reminds us, is possible — but only if we design systems around people, not programmes.Problems Worth Solving is brought to you by Healthia, the collaborative service design consultancy for transformation in health, care and public services. Find out more about our work at healthia.services.

The way we design health apps is shaping who stays healthy and who gets left behind.In this conversation, Amber Vodegel, founder of the world’s largest pregnancy app, Pregnancy Plus, and now CEO of 28x, challenges how women’s health technology is built, funded, and trusted.Amber argues that health knowledge shouldn’t sit behind a paywall or be traded for personal data. With around 800 million people menstruating every day, access and trust matter.She’s designing a different path: on-device AI that keeps data on your phone, content at multiple reading levels so information is understandable without dumbing it down, and interfaces women feel comfortable opening anywhere—ditching traffic-light cues that confuse and stigmatise.We explore how 28x aims to sit between the NHS and TikTok—combining clinically validated content with formats people actually use. Amber opens up her playbook: a year of research-before-build, user research with teenagers and low-literacy groups, and a product strategy where cycle tracking earns attention for evidence-based education. She also explains a circular business model: free at the point of use, ethical sponsorships and pay-it-forward contributions, and reinvesting profits into period products, education, and female founders globally.If you are interested in designing for trust, who should own health data, or how tiny on-device AI could reshape digital health, this episode offers a practical, provocative blueprint. It’s a story about turning design from surface polish into system change—and building technology that serves people first.Problems Worth Solving is brought to you by Healthia, the collaborative service design consultancy for transformation in health, care and public services. Find out more about our work at healthia.services.

What if the word "solution" is generating more problems than it solves? In this revealing conversation, Rachel Hope, Director of Digital Prevention Services for the NHS, challenges our fundamental thinking about technology and transformation in healthcare.Rachel is building the architecture for a new kind of health service - one that's digital-first and prevention-focused. With stark statistics showing a 19-year gap in healthy life expectancy between the most and least deprived areas, and 40% of the NHS budget spent treating preventable conditions, the need for radical change is clear.The conversation digs into the role of human-centred design in creating effective services. Rachel explains how research has transformed their understanding of user needs, revealing unexpected insights like the importance of enabling couples to book vaccination appointments together. By embedding digital specialists alongside policy and operational teams, they're breaking down traditional silos and creating more responsive, intuitive services.Rachel envisions a future where digital services are so intuitive that "you don't even notice how great they are, unless you remember how bad it was before" - making healthcare as accessible as online banking while freeing up clinicians to focus on care rather than administration.Whether you're working in healthcare, interested in digital transformation, or simply care about creating more effective public services, this conversation offers fresh insights into how we can rethink our approach to complex problems. Problems Worth Solving is brought to you by Healthia, the collaborative service design consultancy for transformation in health, care and public services. Find out more about our work at healthia.services.