Pace of implementation must quicken as general election looms

Welcome back to reality: if your Christmas and new year break began early, you may have missed the pre-festive missive from NHS chief executive Nigel Crisp and the modernisation board, thoughtfully setting out the service's tasks for the next 12 months and beyond. Whether or not you subscribe to the view that 2001 is the real start of the new millennium, there is no escaping that it will be the first full year of the post-plan NHS. As Mr Crisp's guidance makes plain, that means managers throughout the service can look forward to perhaps the most hectic and demanding year they will ever have known.

The pace of implementing the NHS plan on the ground is set to quicken. Every health service organisation must complete a 'modernisation audit' by the end of March and have a local implementation plan in place. Every health authority must set up its own modernisation board involving frontline staff, local authorities and other key partners.

Crucial tasks for managers will include maintaining their organisations' financial balance as well as achieving 2 per cent efficiency savings; nurturing joint working; ensuring effective emergency care; taking careful heed of bed numbers while reducing maximum waiting times; and paying attention to improving staff conditions.

By April, the entitlements in the Patient's Charter will have been replaced by those in Your Guide to the NHS. By December, every hospital will have to offer a 24-hour food service reflecting the national menu. Following hard on the heels of these requirements - and demanding preparation simultaneously - will come the establishment of the patient advocacy and liaison service and the eradication of mixed-sex wards. Major strides in bolstering the IT infrastructure will have to accompany some of these and many of the other developments contained in the NHS plan.

Public and politicians alike will be watching eagerly for signs of the plan making a real difference. If it is not noticeable, it will not be working - a crude and harsh criterion when managers know that much which is of the greatest value in the plan will take time and patience. But it is an unavoidable fact of realpolitik. And at the heart of it lies the looming general election - in April? May? The NHS has been a high-profile issue in the last two elections, though never the ultimately decisive one. After more than a year when it has seldom been out of the headlines, it will undoubtedly play a prominent role for all parties in the next campaign. At stake for Labour will be the very essence of the plan itself; for the Conservatives, it will be their high-risk strategy of a much greater role for private health insurance than they have ever embraced in 50 years of near consensus on a comprehensive NHS.

So 2001 promises to be one of the most interesting and memorable in recent NHS history.