This over-used phrase becomes very real in the case of Beth Seager, an Admissions Manager in a busy British NHS hospital. Someone with very little authority but a huge amount of responsibility. She has to find beds for patients in a hospital that is claimed to work at 98% capacity – an impressive achievement that means the maximum time a bed is empty is less than 15 minutes. It’s best not to mention the waiting times.

Unfortunately there are far more patients than beds and no money to bring more beds in. Someone has to decide whether a bed is taken by a patient who needs an extensive operation that will allow them to live a few more months, a breast cancer patient, or someone with two broken legs. Added to that, Beth is struggling against her caustic boss ‘Fearsome Fran’ and her meddling assistant ‘Evil Eddy’ who tries to undermine her and take her job.

Everything comes to a head when Fearsome Fran announces a new silver bullet plan to free up more beds. Beth knows that not only will it not work, but that she is effectively being demoted. But what can she do? She has 61 more patients than she has beds and a very short period to time to stamp her authority on Fran’s new plan in order to stop it making things much worse.

Her luck changes when eligible bachelor Professor John Summers becomes her unlikely ally after becoming frustrated with the number of his operations that keep being cancelled. She also starts receiving some interesting advice over email from her brother-in-law in the US and slowly starts to believe that she can unravel the mess of the health service system and find the core problem and then the main constraint of her particular hospital.

We All Fall Down. Goldratt’s Theory of Constraints for Healthcare Systems is a textbook written in the style of a witty, thriller novel. The reader is involved with Beth’s challenges and dilemmas, and through her experiences, discover how Eli Goldratt’s theories can be applied to the healthcare and service industries.

You don’t have to be mad to work in the health services, you have to be caring, dedicated and resourceful as any errors can have fatal consequences. If you know someone from the health service, buy them this book so they can see the whole picture and what they can do improve the system. However, this book is also essential reading for anyone who has been frustrated by hospital delays or who works in other service industries such as teaching.

We All Fall Down is destined to revolutionise the service industry and not-for-profit sector in the same way that Eli Goldratt’s book The Goal did for the manufacturing industry. Don’t be left on the waiting list!