If operational decisions shape patient outcomes as much as clinical decisions, why doesn't the NHS support them with the same evidence infrastructure?

Simple, intuitive ideas don’t draw critical attention. They stroll about the policy world, untested and unscathed. And they can survive, unaltered, for decades.

One such idea is that increasing the supply of community-based services will reduce hospital-based activity. In differing guises, and to varying degrees, this has been a mainstay of policy for decades.

The 10 Year Plan, for example, says that:

New NHS patient experience minimum standards aim to improve how people experience waiting for elective care

Reducing elective care waiting lists remains one of the most pressing challenges facing the NHS. With more than seven million people currently waiting for treatment in England, there is growing recognition that addressing the backlog requires more than additional capacity alone. It demands better use of data, new ways of working, and stronger collaboration across organisations and disciplines.

Understanding what it takes to deliver culturally responsive dementia care.

Why are operations still being cancelled on the day of surgery, despite long waiting lists and high demand? The answer often lies not in a single point of failure, but in how the perioperative pathway functions as a whole.

Failure demand is described as the additional work created when services fail to meet people’s needs effectively the first time – and is rife across the NHS.  

Guest blog by Jacob Lant, Chief Executive, National Voices