Steve Black
I'm a data scientist who has been supporting the NHS to make better use of data for a decade and a half. I'm an expert in A&E data and performance, having more experience of the datasets than most of the people still working on them in the civil service.
I'm @sib313 on Twitter and blog at https://policyskeptic.blogspot.co.uk
matt_black is a pseudonym I needed to use when working for big consulting and the NHS so I didn't have to get permission before commenting. I now work independently.
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
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
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.
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
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
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
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
Daily InsightThe mythbuster: It’s the management, stupid
A timely report draws attention to the importance of strong, well-supported management
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
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
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
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”.
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.
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
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
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
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
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
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.
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