How The NHS Works

Hi, my name is Callum Birch.

I've worked in the NHS for 14 years as a radiographer, researcher, project manager, and now as an analyst.

In clinical practice, I was able to improve care by focussing on what was best for the patient.

But when I tried to improve services, pathways, and systems, it was another story altogether.

It was like being on a massive, anchored ship that refused to move an inch.

I wanted to understand why.

And then I experienced the NHS as a patient when my 3-year-old son suffered from a perforated ulcer wrapped around his duodenal artery.

I’m deeply grateful to everyone who saved him.

But I also realised that the same systems I’d struggled against as an employee had delayed the specialist referral he desperately needed.

Suddenly, I wasn’t just observing the immovable ship from the deck - I was trapped in the hull.

But this time, I had the analytical tools to understand what was happening.

Since then, I've started taking my pursuit to understand the NHS - through the lens of an employee, patient, and parent - more seriously.

Even after 14 years, the NHS is still a mystery to me, so I'm writing to understand, and will share what I find, with you, on this website.

If you want to read the first analysis, share your email address, and I'll send it to you personally.