Segment 5 represents the point at which NHS England concludes that local recovery is no longer credible and authorises direct intervention in leadership, governance and organisational structure. Recent decisions to move provider groups into this category matter not because escalation is controversial, but because it is decisive. Designing an escalation framework is one thing. Being […]
Latest articles
Leadership isn’t a destination; it’s a starting point. By Jamie Smyth, Emily Audet and Riddhi Shenoy
We’ve all been there. A medical student on their first ward round, noticing a communication gap that delays patient discharge. A newly qualified physiotherapist in a bustling outpatient clinic, thinking, “There has to be a more efficient way to manage this list.” It’s a flicker of an idea; a nascent solution born from their fresh […]
When Politeness Dilutes Risk: Why Boards Need a “Crash Call” Moment. By Vsevolod Shabad
A few months ago, watching a television drama, I noticed something that had nothing to do with healthcare — and everything to do with it. Two characters are in a life-or-death situation. One sends a clear signal. The other, operating under threat, processes the words but misses the meaning entirely. Not because the message was […]
In Conversation with Liz Darlison
To watch this interview, please follow this link Emilie Couchman: Today, I am talking with Liz Darlison MBE DL. Thank you so much for joining us. Can we start with your early life? Do you have any childhood memories that perhaps give insight into what your future career would involve? Liz Darlison: I was quite […]
It’s time to add SMA to the NHS newborn blood spot screening programme. By Kelly Silnes
Spinal Muscular Atrophy (SMA) is a rare genetic condition that causes progressive muscle weakness and atrophy. The prognosis varies depending on the type; the most common form of SMA is Type I which typically presents with symptoms before six months of age [1]. Historically the prognosis has been extremely poor, with fewer than one in […]
Transforming patient care through NMAHP led research and leadership. By Ruth Pearce
In the complex landscape of modern healthcare, leadership is not confined to boardrooms. Nurses, midwives and allied health professionals (NMAHPs) are increasingly at the forefront of transformational change, leading initiatives that improve patient outcomes, enhance operational efficiency, and strengthen clinical teams. At University Hospitals Birmingham (UHB), a structured programme of research education and clinical academic […]
NHS Funding and the Limits of “More Money”. By Vsevolod Shabad
Reading the latest House of Commons analysis of NHS spending, a familiar pattern emerges. The debate centres on funding levels — who was generous, who was austere, whether current plans represent continuity or change. For those governing NHS organisations, this framing is increasingly unhelpful. The real question is not how much money the system receives, […]
The global medical community must have all eyes on Iran. By Rammina Yassaie
Hospitals in Iran have been overwhelmed by the scale of casualties inflicted on Iranian people by Iran’s security forces, as protestors have flocked to the streets over recent weeks, demanding an end to the oppressive Islamic Republic regime.1 While the regime’s deliberate internet blackouts (engineered to mask its own violence, shielding it from global disgrace) has […]
Quality management and clinical audit: Integrating clinical audit and quality improvement to deliver impact for patients. By Iain Smith
Fit-for-the-Future, the ten-year plan for the English NHS, envisages a focus on quality and improvement driven by data.1 The plan acknowledges the wealth of data available nationally – including through clinical audits.1 Furthermore, new best practice guidance from NHS England argues for clinical audit contributing to a wider quality management approach.2 Historically, clinical audit is […]
Leadership in the Mirror: Working With Disability in Surgery When the Framework Does Not Exist. By Najeeb Aftab
Disability has been discussed in surgical training for years, yet the gap between interest and actual understanding remains wide. Commentary has questioned whether surgical training has ever meaningfully created space for surgeons with physical disabilities [1]. While others have warned that awareness alone is no longer enough and that the profession must move beyond acknowledgement […]