Large organisational cultures can often get so wrapped up in their own operational mechanics, that they lose sight of what is changing around them and how to adapt and innovate.

A lot has changed in the NHS landscape since 1948 – and the big question is whether really the model fits with 21st century living.

Duncan Brodie, MD of Goals and Achievements and ex-Finance Director of an NHS Trust, takes a positive and pragmatic look at a culture where sticking your head above the parapet and ‘having a go’ is not the norm. With sustainability and demand vs. resource a serious current reality, how extreme do things have to get before people take notice? How do you create a supportive environment that encourages open discussion around the big (and possibly undiscussable) issues such as austerity, service structure and the ageing population?

Duncan talks about amazing commitment, tensions, sticky plasters, reality checks, human relationships and the shift from playing safe to speaking out.

Note: this interview was recorded before the release of the Francis Report.