Our cover utilises a word cloud design to reflect the range and complexity of issues raised by our authors in their articles. In our first article, Day and South provide an analysis of management practice that questions health systems improvement as a means of achieving real gains and also asks if it is unnecessary work. They question if these approaches can be effective in avoiding major systems failures while supporting the relevance of timely, effective performance measures at the organisational level rather than comprehensive data analysis that does effect improvement.