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NHS-style hospital corridor representing operational pressure and system flow. James Murray NHS first 90 days

Matters

Roy Lilley examines James Murray’s first ninety days leading the NHS, outlining five urgent priorities including workforce planning, operational listening,...
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Book cover of INTELLIGENT: The Evolution of AI Transforming Healthcare by Shafi Ahmed, featuring bold white typography on a black background with a bright central light effect.

Properly

Prof Shafi Ahmed’s new book explores how AI will reshape medicine, challenging NHS leaders to rethink trust, judgement and implementation...
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Prime Minister delivering a televised speech about economic reform, public spending and political leadership.

Playbook

A fictional Prime Minister’s speech becomes a reflection on leadership, austerity, honesty and political courage, questioning whether modern politics still...
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Empty hospital corridor with clean floors, handrails, and patient room doors on both sides, brightly lit with ceiling lights

Toothbrush

August reveals NHS fragility as reduced staffing and tightly coupled systems constrain capacity, causing waiting lists to rise despite stable...
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odern hospital operating theatre prepared for surgery

The post

NHS surgical cancellations remain average internationally, but systemic inefficiencies persist. Better pre-operative preparation, coordination, and patient readiness could significantly reduce...
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Dimly lit office with an open wooden cupboard and a broom handle protruding outward, suggesting an unexpected hazard

Ignorance

Leadership risks often hide in blind spots and unasked questions. Curiosity, openness, and better inquiry help uncover unknown unknowns before...
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Two NHS nurses walk down a hospital corridor past signage promoting resilience, supply security and workforce planning, with a digital dashboard showing medicine stock levels and regional risk.

Prepared

Roy Lilley asks whether the NHS can survive a less globalised world, arguing that workforce dependence, fragile supply chains and...
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A self-help book titled “De-Frazzle Your NHS Job” on a wooden table with a coffee mug, notepad, and plant in a sunlit room.

Grabbed me

A reflection on judging books by covers, readability, and design, leading to a strong recommendation of “De-Frazzle your NHS job”...
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A busy NHS hospital corridor with nurses and doctors moving between wards, while a small number of patients sit waiting on chairs along the wall under bright clinical lighting.

Better

IPPR says insurance-funded healthcare brings no clear advantage over tax funding. The NHS’s weaknesses stem from underinvestment in capital, prevention,...
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Senior consultant observing junior doctors treating a patient in a hospital ward

Relations

The NHS faces a strategic shift away from reliance on resident doctors, using substitution, standardisation and technology, raising risks around...
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A group of NHS doctors stand on a picket line outside a modern hospital, wearing scrubs under winter coats and holding protest signs calling for fair pay and safe staffing, under a grey overcast sky.

Worse

A sharp critique of the resident doctors’ strike, exploring political missteps and proposing five pragmatic ways to break the deadlock...
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A lone public health official in a white coat stands under a single spotlight on a dark, empty stage, facing looming shadowy images of obesity, social media icons, and scales symbolising inequality.

Script

Public health has lost its authority to influence the biggest drivers of illness, becoming reactive rather than preventative, despite retaining...
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Care Quality Commission branding alongside a large red warning triangle containing a compliance checklist icon, highlighting new chaperone guidance requirements for healthcare providers. New Chaperone Guidance

Three Months In: What GPs Are Really Saying About the New Chaperone Guidance

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Book cover of The Midwife’s Book of Hours by Jane Salvage, featuring a medieval Nativity-style painting of Mary holding the infant Jesus, with animals and attendants, set against a deep blue background.

For you

A reflective exploration of midwives in the nativity story and classical art, inspired by Jane Salvage’s richly illustrated book revealing...
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A photo-realistic editorial image showing a weathered “Social Care Review” folder and supporting papers left in tall, overgrown grass beside a rustic wooden sign reading “LONG GRASS,” lit by warm late-afternoon sunlight in a quiet countryside field. The scene symbolises delayed social care reform, policy drift and the repeated deferral of urgent government action.

Grass

Roy Lilley argues social care does not need another grand review. The Care Act already provides the framework; the real...
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A hand writes “WHAT NEXT?” on a whiteboard showing an NHS pathway flowchart linking General Practice, community services and Accident and Emergency, surrounded by sticky notes about wait times, access and staff shortages.

Disappointment

Reflecting on Iran and the NHS, Roy argues leaders announce policies without considering consequences. Cutting managers while demanding transformation ignores...
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Vector illustration of a paper shredder destroying documents.

Differently

A reflection on shredding policy paperwork and why frontline NHS reality overwhelms central plans. Leadership happens on wards, not in...
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A health visitor wearing a lanyard and carrying a tote bag stands outside a red brick house speaking reassuringly to a tired new mother holding a swaddled newborn at the front door in soft early morning light.

Front door

A health visitor’s doorstep encounter with an exhausted new mother frames a warning: health visitor numbers have collapsed, shifting prevention...
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