Let’s have a look at ‘complexity’. The NHS don’t have monopoly on complexity; what about space travel, nuclear submarines, power stations, missile systems, AI, IT, MRI scanners, etc. These are all examples of complexity – in specification, design, realisation, operation, and very importantly Quality Management. But guess what? They all have sophisticated Quality Management and Safety Management Systems other than the NHS. In each of theses industries it takes many years of training for Quality Professional to design and manage these Quality and Safety Management systems, all except for the NHS who haven’t started yet.