Turning the supertanker
The NHS is often compared to a supertanker – huge and slow moving – but, in at least one regard, this analogy doesn’t work. That area is money. Whilst the sums involved in health care are huge, the fi...
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Design should start with the people we are (part 2)
There is a growing understanding that ‘human factors’ play a huge part in organisational culture, as well as in the system failures that cause harm to patients. Many of the problems that regularly...
Coming of age in the NHS
The NHS has just celebrated its 65th birthday and this month I have been working in the NHS for 21 years. Where did that time go?! I joined in 1992 straight after my degree. The Conservative party had...
Wales: A national approach to improving care
We are fortunate in Wales in that ‘national’ is achievable. We are a small country so when we say we want NHS Wales to be quality-led it feels like a realistic goal. However, up to this point we ha...
Patients, public, professionals - we’re all citizens with a stake in the system
This month marks the 25th anniversary of Piper Alpha, considered by many to be the worst offshore oil disaster of all time after an explosion left 167 people dead and destroyed its North Sea platform....
Who leads the NHS?
In a previous life as a training consultant (specialising in areas such as leadership), I used to define a ‘manager’ as someone who successfully maintained the status quo and a 'leader' as someone who...
Fresh thinking to support people with long-term conditions
Finding a new way to work with people with long-term conditions has never seemed more important. Francis’ findings about the failings in Mid Staffs – and the subsequent realisation that the problems t...
Out of hours prescriptions: is there a straightforward solution?
Last Friday afternoon I sent a tweet expressing my frustration that my GP surgery would be closed until Monday morning, meaning that I would not be able to pick up a repeat prescription over the weeke...
The Berwick report: why we mustn’t let this opportunity pass
If someone were to ask me why I am doing the job I am, I could pinpoint the reason as an evening in April 2000. At the time, I was Head of NHS Performance at the NHS Executive and was providing the se...
Learning and acting: some suggestions for ministers
Sitting listening to Don Berwick launch his report at the King's Fund yesterday, I noticed it had these words in its title: 'a promise to learn – a commitment to act'. Don was as compelling and inspir...
