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I am an entrepreneur from the private sector and have been reviewing the complexity and subsequent inefficiencies of service delivery throughout the nhs and particularly at PCT level in recent years, it is no wonder that the nhs has a forecast defecit of c£12bn in 3 years time.

Many of the comments made here are shamefully petty and small minded, from the private sector I have observed the refreshing changes that Mr Britnall has introduced towards improving overall efficiences in service delivery & design, in giving PCTs more freedom and flexibility to think out of the box, in reinvigorating PBC and putting commissioning in the hands of where it is most appropriate. He is not voted by your industry as the 4th most prominent and impacting figure in the health service for a consecutive year running for nothing!

It is a very sad day for the health service and the public to lose such a bright & refreshing intelligent innovator to the private sector, it is your sector that needs more creative players like him and not to lose them.

In our own recent engagement with PCTs throughout the country, as a provider we are witnessing greater efficiences and more positive responses to the practicle principles and the foundations that he has laid in WCC along with a far greater motivation from GPs and front line clinicians in PBC to work more closely together and taking responsibility for budget savings which is ultimatly enhancing and appropriatly commissioning patient care and saving substantial tax payer funds and making them go further which is now clearly a priority on the sectors agenda, as an outside observer I see that he has laid down some firm and concise systems that if implemented properly should pave the way for slashing the forecast defecit, all of those of you who have fired negatives and speculation, I urge you to step back and do a simple search on the HSJ site and note all of the marvellous practical differences this man has made, he has implementaed phenomenal practical shifts in the service which I am confident will pave the way for enhanced and more effective patient care without the excessive cost defecits that are currently forecast, its a shame you have lost him to the private sector, however he has left you a legacy with new systems that will ultimatly serve to deliver more positive patient outputs at a more cost effective price to the tax payer going forward in these forthcoming difficult years.