All articles by Steve Black
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Daily InsightThe mythbuster: Stop counting, start thinking
The NHS traditionally measures capacity by counting staff and beds, but post-covid evidence shows better operational management is even more important than simply increasing resources
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Daily InsightThe mythbuster: The dishonest metric that disguises the true extent of long A&E waits
Measuring ’trolley waits’ tells us little about the true and deeply worrying scale of delays in emergency care, argues Steve Black
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Daily InsightThe mythbuster: Simple, plausible and wrong
20 per cent of A&E patients end up being cared for in corridors, and delayed discharges cost at least £2.7bn annually, yet ministers ignore the best solution to these problems.
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Daily InsightThe mythbuster: NHS care can be faster, better AND cheaper
Debates about NHS productivity wrongly assume hard trade-offs are necessary to improve the service’s performance. In fact, bottom-up analysis of clinical processes shows better, faster, cheaper care is achievable now
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Daily InsightThe mythbuster: Simple solutions are bad solutions
The NHS can benefit from insights from the theory and practice of operational research, writes Steve Black
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Daily InsightThe mythbuster: It might be Christmas, but let’s not rely on miracles
Too many NHS strategies skip crucial operational detail, relying on miracle thinking instead of confronting today’s problems and sequencing real, workable steps to achieve their goals, writes Steve Black
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Daily InsightThe mythbuster: Why NHS improvement programmes don’t work
Billions spent on NHS elective recovery has failed to cut waits because of a failure to tackle the real bottleneck, outpatient services
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Daily InsightThe mythbuster: It’s the management, stupid
A timely report draws attention to the importance of strong, well-supported management
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Daily InsightThe mythbuster: What Wales can teach us about value
A new book on value-based healthcare offers worthwhile lessons on measuring outcomes that matter to patients, engaging frontline teams, and making difficult trade-offs
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Daily InsightThe mythbuster: Much better, but still room for improvement
The Health Foundation’s full productivity report provides an effective analysis of NHS challenges, but still misses the critical role of management in driving system-wide improvements, argues Steve Black
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Daily InsightThe mythbuster: Shallow and naive thinking will not fix NHS productivity
A panel of experts, convened by the Health Foundation to examine NHS productivity, is guilty of failing to move beyond government clichés to identify the real barriers to improvement
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Daily InsightThe mythbuster: This year’s planning guidance is better but still deeply flawed
Steve Black assesses the NHS planning guidance for 2026-27 to 2028-29 – aka the “medium term planning framework”.
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Daily InsightThe mythbuster: A classic tale of NHS process failure
Taking the time to find out how the NHS really works reveals huge opportunities for improvement, but too few leaders and policymakers bother to do so.
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Daily InsightThe mythbuster: It does not matter that Streeting’s new adviser has no health experience
A new NHS delivery unit is to be led by an education expert, but despite the criticism this news sparked, it may yet be successful
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Daily InsightThe mythbuster: Just say ‘no’ to demands for higher drug prices
The NHS faces pressure to pay more for drugs, but evidence shows higher prices rarely lead to better patient outcomes
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Daily InsightThe mythbuster: The government and BMA are both wrong about online GP access
Both the government and BMA misunderstand online GP access. Properly implemented triage improves patient care, efficiency, and reduces clinical risks
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Daily InsightThe Mythbuster: NHS data is in a mess and AI can’t fix it
England’s fragmented approach to publishing A&E performance data creates barriers to analysis, contrasting sharply with Scotland’s accessible single-file datasets. It also raises questions about AI’s promised productivity gains
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Daily InsightThe mythbuster: A better way for the NHS to improve
The NHS crisis stems from poor system design – real solutions require understanding and improving the flow of work, not more resources
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Daily InsightThe mythbuster: Doctors can’t manage care by themselves
Administrative overload in the NHS is often blamed on managers, yet evidence suggests the real issue is a lack of effective management capacity, says Steve Black.
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Daily InsightThe mythbuster: What Nietzsche teaches us about long A&E waits
Long A&E waits cost lives, yet NHS leadership avoids the evidence – echoing Nietzsche’s warning about institutional denial of truth