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The real shame is Lansleys' NHS vision could have been achieved by evolution rather than revolution. GP's could have taken over PCT Boards and Commissioning Support Units created by merging PCT commissioning staff, in order to enjoy economies of scale. Valued staff would have been retained whilst employees who were 'surplus to requirements' or'less able' would have been made redundant in order to meet the Nicholson challenge. SHA's would have merged into NHS England regional offices without needing to be closed. It's looks like we've wasted £2-£3 billion in order for the Coalition to demonstrate to a disinterested electorate that there was a 'new sheriff in town' when it came to NHS strategy.