The other day I was asked the rather ambiguous question, 'How many inches have you got?' I was taken aback until I realised the question was about my TV.

A fun lunchtime discussion has been revolving around men wishing to go out and buy large plasma TVs and female partners not sounding too happy about the whole business. As the proud owner of a 50-inch specimen, I have been happily goading the men to stand up for themselves and to do the right thing, much to the chagrin of the female managers.

The point of raising this double entendre-laced story is that the issue of whether it is better to ask permission or to say sorry after doing something is relevant not only to this but to many issues we face daily as managers. One of the most talked about yet underpractised pieces of management jargon today is "empowerment".

We all talk about empowering our staff and how we want them to take responsibility and make decisions. We also talk about a no blame/fair blame culture, nodding approvingly at the thought that a sublime balance of encouraging staff to take decisions, yet coming down on them heavily when things go wrong, has been struck simply by saying it has.

The reality is still somewhat different, but there are ways to make instant and dramatic change.

At the time of writing, we have all just received the scores on the doors for the last financial year. It's been an amazing internal transformation in Brighton and Sussex as we continue to head the national performance tables for type 1 accident and emergency departments and exceed the March 18-week milestones; and our evidenced staff appraisal rates have gone from 19 per cent to 97 per cent in the past eight months. There is clearly a big story behind this which I could not do justice to in this short space, but the strongest themes are role clarity, accountability, creativity, forensic attention to detail and, yes, empowerment.

One of the areas that has been highlighted is establishing overriding authority in individuals as opposed to committees. These people are given responsibility and accountability for particular issues. They have then been further empowered by the executive team to remove blockages, sort out problems and make things happen. It has been a revelation and a revolution in the making.

At my last trust I remember our medical director suggesting something similar in clinical governance. He was frustrated that committee structures meant that you proceeded at the pace of the slowest part of the decision-making process. I guess the obvious analogy is the saying that a camel is a horse designed by committee.

Does this mean the end of all committees as we know them? Unfortunately, I suspect we will all end up in many more committees, project groups, steering groups, boards and sub-committees. However, the road to making the holy grail of staff empowerment a reality may not be as long and winding as we sometimes make it.