In 1999 D J Brown left his job as a doctor in the NHS, frustrated by a system that seemed intent on breaking him. He developed a career as a business consultant, helping companies to improve the way they worked. But his vocation eventually drew him back to healthcare and he returned to the NHS, only to find that it was still hampered by inadequate leadership, inefficient processes, unbalanced targets and a lack of collaboration. He found institutions full of caring and committed healthcare staff unable to do the jobs for which they were trained.

And then the local hospital nearly...