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I hope the VM experiment works. Why would anyone hope for anything else. I am skeptical, because experience has demonstrated that quite aside from leadership commitment, discipline, appropriate use of tools etc. there is another obstacle to overcome "Not invented here syndrome".

Having worked with Trusts to develop their own "Ways" the key to sustainability is the transfer of knowledge and skills to enable people to meet the challenges they face. The time VM are planning to spend at each location, on the face of it doesn't seem to be enough to achieve what is hoped.

As Umesh will attest, whilst the commitment from leadership to sail a different course may have existed at WWL in 2010, the skills across the wider organisation and indeed the WWL Way itself were learned from another.

Oh, one other thing. Steve Burnell - LEAN thinking starts with the customer, and understanding what they value. In a healthcare setting this means patients, therefore your argument makes no sense, in any, by any metric.