title: Leaders need to show more courage.
abstract: Since I wrote the editorial for Black History Month in 2011, the NHS has changed almost beyond recognition. The 'no major change' promised by Andrew Lansley on taking office as health secretary in 2010 has turned into a huge, organisational and economic restructuring. It has culminated in an entirely new ministerial team and the appointment of Jane Cummings as chief nursing officer and Viv Bennett as director of nursing at the Department of Health.