Roy Lilley challenges the NMC over extraordinary hearing delays, mounting costs, failed regulatory standards and safeguarding concerns, calling for Council resignations, legislative reform and collective action by Britain's nurses.

The NHS has mountains of performance data, but improvement means more than finding failure. Find the organisations succeeding against the odds, understand why, share it and help others improve.

From lung scans in supermarket car parks to vaccination and diabetes prevention, the NHS shows how science becomes valuable when skilled people organise services that patients can actually reach and use.

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.

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.

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?

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?

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.

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.

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.

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.

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.

Political promises alone cannot reduce NHS waiting lists. Sustainable improvement depends on matching ambition with workforce, capacity, operational planning, transparent reporting and honest leadership rather than headline-grabbing announcements.

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.

Andy Burnham’s letter to Labour MPs signals a different philosophy of government, but unless power genuinely shifts from Whitehall, it risks becoming another exercise in consultation rather than meaningful reform.

Penny Dash’s latest comments on primary care estate capacity expose a fundamental contradiction at the heart of NHS policy, raising fresh questions about leadership, evidence, investment and neighbourhood healthcare delivery.

Roy Lilley explores what football leadership can teach the NHS, arguing that lasting success comes not from targets or tactics alone, but from trust, culture, relationships and permission.

Andy Burnham's route to Downing Street should begin with five practical NHS reforms: devolve power, fund patient journeys, modernise digitally, empower regions and build an NHS that anticipates problems.

Leadership is about creating an environment where talented people can thrive. Respect, professionalism and visible leadership help NHS organisations improve by enabling staff to deliver their very best.

Andy Burnham’s prevention-first vision may be right for the NHS long term, but voters experience today’s pain. The challenge remains balancing demand, capacity and workforce realities while tackling underlying causes.

Six months after implementation, significant gaps remain in chaperone compliance. CQC inspectors are finding weaknesses in training, documentation, DBS checks and the proactive offer process.

From baby checks to blank records, the implementation picture is more complicated than the guidance anticipated. Three months have passed since NHS England published its updated chaperoning guidance, the New Chaperone Guidance. In that time, The Training Network has delivered chaperone training to teams across general practice, and the conversations in those rooms have been illuminating. What GPs, nurses, receptionists and practice managers are wrestling with is not the principle of the guidance.

Something changed in December 2025. NHS England’s new chaperoning guidance raises the compliance bar significantly, introducing mandatory offers, stricter documentation, training requirements, and new expectations that CQC inspectors are already assessing.

Roy Lilley argues the NHS does not need endless transformation programmes. What it needs is competent leadership, operational discipline, consistency, and relentless focus on improving everyday frontline performance.

A first-hand account of a day-case hospital visit exposing administrative confusion, poor wayfinding, neglected estates, misplaced priorities and leadership disconnect, while highlighting the professionalism and persistence of frontline nurses.

The NHS is not collapsing or standing still. It feels stuck. Amid restructuring, uncertainty and reform fatigue, the priorities should be workforce stability, patient flow and restoring clarity at the centre.

The NHS records 403 Never Events yet the numbers barely move. The lesson is not human failure, but system design failure. Future safety gains require technology, governance and investment.

Public institutions face difficult questions about race, trust and decision-making. Evidence, transparency and data provide a better route to understanding complex failures than ideology, assumptions, blame or simplification.

Hundreds of overseas NHS England staff face uncertainty as restructuring collides with civil service rules, exposing wider concerns about redundancy protections, workforce planning, organisational trust and leadership accountability.

The foundations to this story regarding NHS outsourcing and staff pensions are to be found at the Royal United Hospitals, Bath NHS Trust. The source can be found here… and here… and in my inbox… which is why, I suspect, the story will be found to be more common than we realise. If it’s all true, there’ll be no mystery about why people who work there are asking;

Roy Lilley argues Britain keeps rediscovering NEETs, recycling old policy, while young people need real jobs, employer support and cheaper, easier routes into work.

Roy Lilley examines James Murray’s first ninety days leading the NHS, outlining five urgent priorities including workforce planning, operational listening, system flow and halting disruptive reorganisations before winter pressures intensify.

Prof Shafi Ahmed’s new book explores how AI will reshape medicine, challenging NHS leaders to rethink trust, judgement and implementation before technology simply accelerates existing organisational dysfunction.

A fictional Prime Minister’s speech becomes a reflection on leadership, austerity, honesty and political courage, questioning whether modern politics still rewards leaders prepared to tell difficult truths.

August reveals NHS fragility as reduced staffing and tightly coupled systems constrain capacity, causing waiting lists to rise despite stable demand and record levels of activity.

NHS surgical cancellations remain average internationally, but systemic inefficiencies persist. Better pre-operative preparation, coordination, and patient readiness could significantly reduce avoidable cancellations and improve costly theatre utilisation.

Leadership risks often hide in blind spots and unasked questions. Curiosity, openness, and better inquiry help uncover unknown unknowns before they become damaging organisational failures.

Roy Lilley asks whether the NHS can survive a less globalised world, arguing that workforce dependence, fragile supply chains and weak resilience planning now threaten the service’s future.

A reflection on judging books by covers, readability, and design, leading to a strong recommendation of “De-Frazzle your NHS job” as practical, engaging, and refreshingly usable.

IPPR says insurance-funded healthcare brings no clear advantage over tax funding. The NHS’s weaknesses stem from underinvestment in capital, prevention, social care and primary care, not payment mechanics or structure.

The NHS faces a strategic shift away from reliance on resident doctors, using substitution, standardisation and technology, raising risks around training, safety, workforce morale and long-term system resilience.

A sharp critique of the resident doctors’ strike, exploring political missteps and proposing five pragmatic ways to break the deadlock and stabilise NHS workforce relations.

Public health has lost its authority to influence the biggest drivers of illness, becoming reactive rather than preventative, despite retaining the expertise and capability to shape national health outcomes.

A reflective exploration of midwives in the nativity story and classical art, inspired by Jane Salvage’s richly illustrated book revealing the overlooked presence of midwives in religious history.

Roy Lilley argues social care does not need another grand review. The Care Act already provides the framework; the real barrier is Treasury funding, political nerve and implementation.

Reflecting on Iran and the NHS, Roy argues leaders announce policies without considering consequences. Cutting managers while demanding transformation ignores whiplash effects. Management means anticipating what happens next, not headlines.

A reflection on shredding policy paperwork and why frontline NHS reality overwhelms central plans. Leadership happens on wards, not in documents; money matters most, everything else is survival.

A health visitor’s doorstep encounter with an exhausted new mother frames a warning: health visitor numbers have collapsed, shifting prevention gaps into GP and A&E demand, higher costs, and risk.

A death by suicide leaves an empty desk and grieving colleagues. The piece links NHS restructuring and job cuts to rising staff suicide risk, urging leaders to pause and care.

Secondary schools report aggression from parents toward pastoral staff. Conflict management training now targets Heads of Year, welfare and safeguarding roles, emphasizing boundaries, de-escalation skills, safe escalation routes, and recording.