First, let us be absolutely clear that End Game is a profound supporter of NHS Change Day, and applauds both its aims and the outcomes of thousands of tiny improvements to make NHS services more considerate, caring and patient centred.

But however committed our cheerleading, we will always be outclassed by Helen Bevan when it comes to inspirational rhetoric. Of late, she has been more encouraging about NHS Change Day than anyone has ever previously managed to be, about anything.

See her latest soundbite, “Change is changing”. It suggests an endless virtuous cycle of improvement and innovation, and patients, and change, and kindness, and presumably eventual enlightenment. It first emerged in September (we think) but got a more high profile airing at the NHS Innovation Expo last week.

So the winds of change are in fact subject to a secondary set of meta-winds. Or perhaps the wheel of change is actually a sort of mad gyroscope, like a circle within a spiral, like a wheel within a wheel, neither ending nor beginning, on an ever-spinning reel, like in that nightmarish easy listening acid trip of a song The Windmills of Your Mind.


But who is inside Helen Bevan’s crazy windmill of change?

Why, Certificated Change Agents, of course. Realising that improving the care of patients was not enough of an incentive for many NHS staff to take part in NHS Change Day, Ms Bevan devised a badge and certificate for them to print out if they promised to do their jobs better.

We checked, and “certificated” actually is a word. Possibly Ms Bevan’s School for Health and Care Radicals was conscious of potential negative connotations if it started “certifying” its most ardent students.