NHS 60 week was full of celebration of the past and, as Lord Darzi unveiled his plans for the next 10 years, full of promise for the future.

Listening to the words of Aneurin Bevan at the Westminster Abbey service reminded us all that so much of what he had to say still has relevance, and that Lord Darzi is the latest in a long line of radical thinkers who have helped to shape the NHS we know and love.

Lord Darzi's report, High Quality Care for All, proposes some significant and radical changes to the way we deliver health services. It puts patients and the quality of care firmly at the heart of the health service. It makes three key points about patient care that will have a direct impact on how boards plan for the future:

  • information about the quality of care, including patients' views on their experience, will be systematically measured and made public;

  • from 2010, all providers of NHS care will be legally required to publish annual quality accounts, just as they publish financial accounts;

  • patients' views on the quality of the care they receive will have a direct impact on funding for hospitals.

New quality observatories, to be established by each strategic health authority, will help inform local quality improvement efforts.

The report also encourages innovation. Strategic health authorities will have a new duty - and receive funding - to promote innovation in their area by introducing awards.

Investing in boards

As well as investing in patient care, the report looks at investing in healthcare workers - and that includes board members. A new NHS leadership council, chaired by NHS chief executive David Nicholson, will be responsible for overseeing leadership initiatives and will have a dedicated budget and a focus on standards.

One of its first acts, and a very welcome one, will be to commission a new development programme for trust boards. The Appointments Commission looks forward to working with other partners to ensure that the roles and development needs of chairs and non-executive directors are recognised and addressed alongside clinical and other leaders.

The report aims to do more to free NHS staff and organisations from central control. Existing reforms such as NHS foundation trusts and practice-based commissioning will be extended and improved. We may see an acceleration in the number of FT approvals in coming years.

Making it happen

So what does this mean for boards? If the rhetoric is to be turned into reality, boards will need to take a firm grip of this agenda and ensure that their organisations are committed to meeting the challenges set by Lord Darzi.

Clinical engagement will be vital. So much of the development of this report has been led by doctors, nurses and other clinicians. If their enthusiasm is to be maintained, then boards will need to make sure they continue to be meaningfully involved in leading the development of services for the future.

A word of warning though! The health service has experienced pendulum swings on policy too many times for us to let it happen again. Two years ago, we were mired in headlines about financial problems and the turnaround on this has been impressive. As we move forward to develop proactive, innovative and patient-centred services, boards will need to make sure their plans continue to be financially sound. If not, all the momentum generated by Lord Darzi's proposals will be lost and we will have forfeited a fantastic opportunity to make a difference for ourselves and for the generations of the next 60 years.

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