The Surgeon-Scrum Master: Embedding agile in the NHS with Rob Macadam

What happens when a consultant surgeon embeds agile ways of working into the messy reality of an NHS operating theatre?In this episode, Joe sits down with Rob McAdam, a Consultant Upper GI and Bariatric Surgeon who also happens to be a qualified Scrum Master. Rob is a rare example of a practitioner who hasn't just read the theory - he has spent years embedding agile ways of working into the heart of the NHS.For Rob, the "stable team", the "prioritised backlog" and the "retrospective" aren't just agile buzzwords - they directly map onto the most important parts of surgical practice. In this deep dive, we explore how he moved his department away from rigid, linear planning and toward a model that values human collaboration over top-down protocols.Rather than asking clinicians to work harder inside a rigid system, this work asks a different question: What if we trusted teams to redesign how the work gets done?In this conversation, we explore:Why the pandemic forced a shift to 24-hour sprints - and what was lost when things "returned to normal"How a theatre list already resembles a Scrum team, and what that unlocksWhy traditional list planning produces garbage-in, garbage-out resultsWhat surgical story points look like in practice, and how they've increased capacity without burning people outHow proper retrospectives surface the invisible frictions a debrief never catchesA real example of a tiny AI-assisted fix that's now spreading across an NHS trustWhy "the HIPPO effect" still shapes medicine - and how Agile challenges itHow psychological safety and team-led improvement could transform frontline NHS deliveryThis episode is especially relevant for:Clinicians, surgeons and NHS leadersPublic sector commissioners and service designersContinuous improvement and transformation teamsAnyone working on adaptive, team-led change in complex systemsStay connected:Follow Joe on LinkedIn: https://linkedin.com/in/joseph-badmanRead the latest chapters from our upcoming book: https://relationalservicedesign.comMaster the methodology: https://basistraining.co.uk/Partner with us: https://basis.co.uk