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Inequalities in English schools stem from numerous factors be they educational, social or economic. Thatcherite policies reshaped the education agenda in the 1980s and inequalities were ignored by successive governments until 1997 when New Labour included social objectives in its approach with measures, such as Education Action Zones and Excellence in Cities. The following Conservative-Liberal Democrat coalition and Conservative governments of David Cameron maintained such objectives through the Pupil Premium and the Universal Infant Free School Meals scheme. Theresa May’s government seems to have adopted a different policy since July 2016, focusing on meritocracy. Methodological obstacles are inherent to studies on the evolution of inequalities at school level and it may be argued that successive Cabinets since 1997 have not implemented structural reforms designed to tackle economic inequalities, thus limiting the effect of their educational reforms.

The purpose of this article is to discuss lean as a learning system in a hospital ward.

Discusses lean as a learning system in a hospital ward.

The Toyota veterans are fond of saying, lean is about “making people before making parts” or, in the wards' context, developing nurses before delivering care.

This example in using lean to carefully build a learning environment for staff and management has implications for nursing practice, certainly, but also more generally for lean implementation at large.