Care by Design understands the fundamentals of organisational development, service management and leadership for the 21st century public sector organisation and communities.


Establish SEPSIS as a medical emergency and a clinical priority for the NHS
Sepsis is under-appreciated and under-recognized. It is a disease process which can affect people of any age, including people who are normally well. It claims more lives than lung cancer, and more lives than breast cancer, bowel cancer and prostate... Read on
Launch of Patients First
Wednesday December 14th 2012 saw the launch of Patients First. Angie Nisbet from Care by Design was privileged to be invited to the launch event. The purpose of Patients First is ‘to reduce death and harm in the NHS by campaigning for th... Read on
Everything Changes Yet Everything Stays The Same
What was the famous Petronius quote? “We trained hard, but it seemed that every time we were beginning to form up into teams we would be reorganised. … I was to learn later in life that we tend to meet any new situation by reorganising; and a wo... Read on
Patient Experience Now a Key Performance Measure for Acute Hospitals
The NHS Performance Framework now places great emphasis on measuring patient experience. The measure of patient experience sadly only applies to Acute Trusts and Mental Health Trusts. If one of these Trusts is failing on patient experience... Read on
Water, water everywhere but not a drop to drink...
Especially it seems for the people in our hospitals and even worse our older people at home. I have worried for some time that we are not hydrating people properly in hospital and not making the connection between recurring Urinary Tract Infections ... Read on
The Rising Need for Social Care Support for Older People
The Rising Need for Social Care Support for Older People and the decline in funding for Social Care will mean that more and more people will have to look to fund their own care and if they own savings and a property; they need to be better informed ... Read on
Post Francis Enquiry and Report can we now lead the NHS to the Future of Positive Patient Partnership?
I haven’t read the full Francis report in all its volumes. For me the fact that so much harm was done to so many and the impact not only for them but for their loved ones left with the memories of what happened is enough for me to know things have... Read on
Next Stage Review
The recent unveiling of the Next Stage Review and launch of the NHS constitution consultation marks a significant point in the history of the NHS. We must applaude Lord Darzi for the sterling work that he has led over the past 12 mont... Read on
Credit Crunch in the NHS
McKinsey’s report on saving money in the NHS may make some people think that the action required by NHS staff is one of bottom line cost reduction. This will only make matters worse not better. Also, we have known for years tha... Read on
Report of Findings from Visit to Worthing Hospital to see Dr Gordon Caldwell’s Post Take Ward Round Process Delivering Safer Care Friday May 14th 2010
Doctor Gordon Caldwell has been studying the reliability of clinical and administrative processes that enable timely, effective, safe and productive treatment of patients admitted to medical beds at Worthing Hospital and how these processes support ... Read on
All Change for the new NHS
I feel like saying – ‘oh no; here we go again! Rearranging the deck chairs’. What is it that Petronius famously said? “We trained hard, but it seemed that every time we were beginning to form up into teams, we would be reorganised. I was to ... Read on
Nurse Present During Consultant Led Ward Rounds Only 59% of the Time
Gordon Caldwell; Consultant Physician’s team has published an article in Nursing Management showing that in the last 2 years during 1921 patient reviews on 146 Consultant led ward rounds, a nurse was present at the bedside on only 59% of case revi... Read on
Dear colleagues
Over the next few weeks I will start to write my observations on the current climate surrounding and impacting on public services particularly since the recent political party conferences. One thing that saddens me is how much both sides continue t... Read on