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Picture, if you will, a typical range of people using NHS services. Who do you see? Perhaps a frail older person, a new mother, an anxious adolescent, an overweight middle-aged man. We can all come up with our own range of stereotypes.

What “something” are our communities missing which would draw people of all ages together and create a societal shift towards civic mindfulness, wellness and productivity?

Are you the same person at work as you are at home? Some? A bit perhaps? This might matter to you immensely, or not at all, but almost all of us would see there being some difference between how we think personally and professionally. Sometimes this is helpful (not everyone needs to know about your Panini sticker fascination), but sometimes it’s not.

Dissemination of research is universally promoted, clung to and agreed upon as vital to policy, practice and all users of research. We also seem to agree unanimously that bridging this gap between health research producers and users is hard.

My grandfather was one of the first NHS surgeons, becoming a consultant ophthalmologist in North Wales in 1948; my father was a consultant physician from the early 1970s. And I'm a consultant of sorts at Kaleidoscope, which is not part of the NHS but functions, we hope, as a benign disruptor in its ecosystem. 

Lobbying in the UK is a £2 billion business, making it the third largest worldwide after the US and Brussels. Most people will have heard about the fossil fuel and tobacco sectors trying, and succeeding to, influence policy through lobbying, but what does it  mean for the health sector?

We recently spent two stimulating days at HSRUK 2018. Our colourful tablecloth, quirky leaflets and coffee maker attracted a lot of great people and we asked them all the same question: "What gets in the way of research, policy and practice working together?" The good news: people not caring is not the issue.

I can't help but ponder the curious way we talk about and go about disseminating research: as dedicated but inexpert gardeners, and as children holding dandelion blossoms, respectively.

What drives successful (and sustainable) system change? This won't stop being a relevant and compelling question. We should perhaps acknowledge though that, at least in terms of healthcare, we have a prevailing orthodoxy - that top down, mandated and performance managed changed is the default method.

There is a long running joke in my family that I don't like change. It's true, I don't (the irony of having to make four major geographical locations over eight years working in the NHS hasn't been lost on me). Change is hard, especially when it isn't on your own terms.