Complex problems and Multi-Disciplinary Teams
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2nd June 2026

Many moons ago, I was fortunate enough to observe a multi-disciplinary team (MDT) in Dudley. The team, which today would be called an ‘Integrated Neighbourhood Team’, included multiple specialist nurses, a voluntary sector link worker, a GP, a social worker, and other professionals.

They were discussing different cases. Each was complex in its own way: physical health problems blended and blurred with social and psychological needs; cases worsening, cases improving; treatment plans followed, others unravelling.

Failure demand as a route to success?
Blog post
14th May 2026

When we began looking at failure demand in the NHS, I assumed most of our time would be spent in familiar territory: productivity metrics, appointment volumes, activity data, and trends that could be graphed and compared. Failure demand is, after all, usually introduced as an efficiency concept: work created when a system fails to meet need the first time.

But what stayed with me most, from interviews and conversations across the system, was something else entirely.

Neighbourhood health should not be judged (solely) by its ability to reduce hospital activity
Blog post
29th April 2026

In 1962, President John F. Kennedy arrived at NASA headquarters for a progress update on the planned trip to the moon. He was treated to a tour of the facilities. And, midway through the tour, he met a man carrying a broom.

Kennedy asked the man what he did at NASA. Rather than saying, “I'm the caretaker”, the man replied:

“I’m helping to put a man on the moon.”