Roy Lilley’s recent reflection on NHS leadership published on 12th March hits uncomfortably close to home. He describes a system where intelligent, experienced leaders quietly comply with decisions they privately believe are “chaotic, destabilising and corrosive to morale.” They go along with upheaval, job losses, and directionless restructuring — not because they agree, but because speaking up feels unsafe. It’s easy to label this as Groupthink, the Abilene Paradox, or bure

Across the health and care system, evaluation has never been more important. Rising demand, persistent inequalities and the pressure to innovate responsibly mean that commissioners and providers need credible, context‑rich evidence to make decisions that genuinely improve lives. Real‑world evaluation is now central to that mission. The Health Innovation Network (HIN) South London captures this clearly in their first newsletter of 2026, with an article from Dr Andrew Walker, I

NHS organisations are awash with feedback. Staff share their experiences through pulse surveys, annual surveys and consultation. Patients share theirs through the Friends and Family Test, complaints, compliments and interviews. Health and Social Care Regulators, the CQC, assess services through the five domains: safe, effective, caring, responsive and well‑led . Each dataset is valuable on its own. But when they sit in silos, they hide as much as they reveal. Triangulating th

In this 3 part discussion Paul and Elouise delve into the subject of the impact of organisational change on the people involved. As always if you are interested in talking with us in more detail about this topic we would love to talk more. Email Eross@akumen.co.uk to arrange a meeting.