I’ve been giving a lot of thought to Lean and Standard Work in the NHS. Engineering and manufacturing organisations have been implementing Lean and Standard Work for many years but because of the background of these organisations they have been able to adapt their design and implementation of these techniques to suit the nature and needs of their individual organisations. With my background in engineering and manufacturing I assumed that the NHS would be able to do the same. I was wrong. I can envisage the design of a Lean and Standard work design that would be suitable for the NHS but People working in the NHS find the differences between what that do and what organisations like Toyota do, that is where most of the case studies come from, to be so different that they regard it as not right for the NHS. I have therefore decided to change the terminology to differentiate the difference between manufacturing and healthcare. From now on I will refer to ‘Lean’ as ‘NHS Lean’ and Standard Work’ as NHS Standard Process’. I hope that this change in terminology will help the NHS to move forward with NHS Process Management and Quality Management. The next stage in this is to write some definitions for these systems in the NHS. I’m hoping that the Q Community will help with this.