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I am a great believer in the NHS being based more on design that piecemeal evolution, but in the current circumstance my preference would be for NHS England to focus on just 2 big important priorities:
1. Help build & protect a strong, open culture based on positive values as these naturally encourage good things to flow to improve performance & eject bad practices & poor ethics.
2. Rethink mechanisms such as Tariff & Targets so that service providers see them as supporting greater collaboration, rewarding upstream investments, & the provision of seamless, integrated care pathways.
I would suggest that these 2 things together will be more powerful, effective, & longer lasting than any centrally imposed transformation plan, no matter how well conceived or robustly enforced.