Published: 01/07/2004, Volume II3, No. 5912 Page 7

The NHS will be asked to set local targets for the future against five specific principles, NHS chief executive Sir Nigel Crisp told the closing session of the conference.

In a speech focused on the road to devolution - reversing the 80:20 national to local initiative ratio - Sir Nigel acknowledged tensions in changing the nature of relationships within the NHS.

He described the journey as 'a local quest for improved health'.

Sir Nigel told delegates: 'The journey will not be a straight line.

There will be times when the centre will seem to be too interfering and too controlling and other times when it will seem too decentralised, with accusations not just of postcode prescribing but of 'postcode healthcare'.'

Reiterating health secretary John Reid's promise of 'far fewer' national targets, Sir Nigel said people would be asked to set local targets against five principles:

identified service gaps; the needs of the local population; an equity audit which will pay particular attention to the needs of black and ethnic minority groups; evidence-based actions and interventions; and where possible, shared targets with other NHS and local organisations.

Sir Nigel said the introduction of a combination of national and local targets would take place over the next three years. And he told delegates: 'I think this moment in the NHS journey feels as important as the launch of the NHS plan four years ago. The direction is very clear. It builds on success. It is both very radical and very ambitious.'

And Sir Nigel flagged up future work, including the publication in the autumn of an evaluation of current models to co-ordinate services for people with longterm medical conditions. He told delegates: 'We now need to put as much effort into this as we have into waiting lists.'