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If you are on a burning financial platform the first thing to do is - put the fire out.
Massive pressure is being applied to force efficiency savings with inevitable consequences on quality of care, staff relations and co-operation with positive reform.
The NHS benefits from centralised pay bargaining. Better by far to use this to do the fire extinguishing. National negotiations with the suppliers should do the rest.
Then when all around you are losing their heads the next thing to do is- avoid throwing petrol on the flames.
That means not making things worse by squandering billions on unproven strategies designed to kill the NHS as we know it on the basis that something better might replace it.
If you really want to improve primary care nationalise GP's, but putting them in charge of commissioning and encouraging them to withdraw funds from A&E services and hospitals will - lead to the inevitable results.
Other pitfalls to avoid:
1. Do not expect to benefit the UK by copying the US- Surely we all know that it is more expensive and delivers both overconsumption for many and underconsumption for those without access.
2. Innovation cannot be assumed by demonstration in theory alone. Learn from the failures of the NHS to innovate- why has the NHS Pathology modernisation strategy been a failure?
As i understand it most of the supposed benefits of reconfigurations and out of hospital care are unproven in the uk in practice. Only proceed in general as controlled experiments demonstrate success in practice.
3. Avoid using nhs capital to fund risky ventures. if the private sector are unwilling to invest hundreds of millions into innovations the nhs should avoid doing so. That means the NHs shouldn't also underwrite or provide guarantees.
4. Only invest NHS capital if there is a cast iron business case showing investment provides a return ,is affordable and deliverable.
5. Do not believe everything that expensive management consultants or the Kings Fund say. Learn to think for yourselves.
Follow that advice and this may avoid the premature death of the NHS.