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The NHS is no different to many other sectors having to find new ways to deliver value for money.
I agree with almost everything the NHS Mgt Board has to say with two provisos
1) I feel one of the substantial issues is in the implementation of change. I am less enthusiastic about innovation and new ideas than I am in helping people (who usually know what needs to be done) get things changed. This is incredibly more difficult that is seems. Most staff I encounter have fab and very simple ways to both improve quality and reduce costs, yet they come up against technical and bureaucratic barriers. The issue is not what but how - and now.
2) Most groups I work with in the NHS blame another group for the financial woes. My dream is for each group/level to focus on what they can change and to spend less time worrying about someone else's job. This does not mean they lose touch with the system they work in but rather take responsibility for implementing their own role and being accountable for it.