Lord Darzi's report calling for a 'world class NHS that is fair, personal, effective and safe' will come as a welcome relief to most in the NHS, as the patient becomes the central factor in decision making once more. Patient care and patient safety are of paramount importance as they journey through the NHS. In a difficult environment, with parties split over the effectiveness of targets in the NHS to drive productivity, cleanliness and time to care, there is an ever greater need for Lean to support staff in treating patients according to Lord Darzi's vision and achieving significant targets along the way.