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 unlocks
• Why traditional list planning produces garbage-in, garbage-out results
• What surgical story points look like in practice, and how they've increased capacity without burning people out
• How proper retrospectives surface the invisible frictions a debrief never catches
• A real example of a tiny AI-assisted fix that's now spreading across an NHS trust
• Why "the HIPPO effect" still shapes medicine - and how Agile challenges it
• How psychological safety and team-led improvement could transform frontline NHS delivery

This episode is especially relevant for:
• Clinicians, surgeons and NHS leaders
• Public sector commissioners and service designers
• Continuous improvement and transformation teams
• Anyone working on adaptive, team-led change in complex systems

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