Anita

Four classical musicians performing a string quartet in a nineteenth-century rehearsal room, illustrating Baumol’s cost disease and the limits of NHS productivity. NHS productivity and patient pathways

NHS productivity isn’t simply about working harder or treating more patients. Roy Lilley explores how shorter patient journeys, fewer interfaces and smarter pathways could transform healthcare efficiency without compromising care.

14/09/202614/09/2026Healthcare

Horizon

AI has arrived before the NHS is ready. Regulation, infrastructure, accountability and digital foundations remain unfinished, leaving healthcare racing to complete yesterday’s modernisation while tomorrow’s transformation accelerates beyond it.

07/09/202607/09/2026Healthcare

Responsibilities

Overhead view of a senior management meeting room after a meeting, with a long table covered in briefing papers, notebooks, laptops, water glasses and coffee cups. Empty chairs surround the table while two officials leave the room in the background. NHS England abolition feasibility

Abolishing NHS England was supposed to simplify management and save billions. Instead, workforce, legal and financial complications raise an awkward question: who decided this enormous reorganisation was actually feasible?

02/09/202602/09/2026Healthcare

Spreadsheet

Britain may be run less by ministers than Treasury spreadsheets. NHS pension assumptions could release £5.4bn, raising a bigger question: will the NHS benefit, or will Treasury take it back?

27/08/202627/08/2026Healthcare

Power

Moving NHS managers and ministers from London to Leeds is not devolution. Real reform means transferring power, budgets and authority to regions, not simply relocating command-and-control bureaucracy further north again.

20/08/202620/08/2026Healthcare

Plug

Busy NHS community health centre waiting area with patients seated while nurses and clinical staff move between reception and consulting rooms. NHS Neighbourhood Health

Neighbourhood Health is the NHS’s eighth attempt to shift care from hospitals into communities. Without proven targets, extra capacity, workforce and double-running money, history looks likely to repeat itself again.

17/08/202617/08/2026Healthcare

Newspaper

Female GP prepares for the working day in a GP consultation room, with a computer, examination couch and blood sample tubes visible. NHS prostate cancer PSA testing policy

A quiet change to NHS prostate cancer testing shifts power from informed patients towards GP judgement, raising serious questions about transparency, inequality, evidence, cost and the future of PSA testing.

27/07/202627/07/2026Healthcare

Answers

A working mother sits in her parked car outside a UK care home, overcome with emotion after visiting her mother with dementia while balancing work and family responsibilities. Andy Burnham social care reform

Andy Burnham’s social care reforms promise fairness for families, but funding alone cannot solve workforce shortages, capacity constraints or NHS integration. After seventeen years, voters deserve detailed answers, not aspirations.

23/07/202623/07/2026Healthcare

The Missing Middle

Modern NHS regional health authority headquarters with staff entering the main reception, illustrating regional NHS leadership and healthcare system management. NHS missing middle

Roy Lilley argues the NHS needs to restore a powerful regional tier, creating a functional middle between Whitehall and local providers to improve planning, accountability, delivery and long-term resilience.

22/07/202622/07/2026Healthcare

Paid for

Care worker assisting an elderly resident using a walking frame in a residential care home corridor in England. social care funding reform

Louise Casey’s call for another national conversation on social care echoes Andy Burnham’s 2009 consultation. The evidence already exists; what remains absent is political courage to decide funding.