Six years have passed since the publication of Sir Derek Wanless's interim report on the long-term view for the NHS. What has changed since then?

It has been a widely shared opinion by those who do not follow the recruitment manual to the letter that it is possible to judge a candidate at interview within seven seconds. Estate agents reckon potential home-buyers know in 11 seconds if they have found their dream location. Smokers arriving at a party take up to 23 seconds to find out whether and where it is OK to smoke.

So enough time has just about passed since the turn of the century to be able to make initial judgements on Sir Derek Wanless's forecasts and the effectiveness of the subsequent funding increases toward the delivery of a world-beating health service.

The NHS has aged six years since the publication of his interim report on the long-term view. Incredibly, the NHS plan has only two years to go.

Picker Institute Europe has analysed four years of patient satisfaction surveys. Many positive patient experiences are driven by what NHS staff do - effective treatment, involvement in decision-making, emotional support and engagement with family and carers.

Confidence and trust in healthcare professionals remains high and a significant majority of patients report that communications are good, although a third of inpatients felt they had been given conflicting information.

However, the 25 per cent increase in nurses over the past 10 years is not reflected in patients' sense of staff responsiveness to the call button and their availability.

The party conference season unleashed some suggestions regarding the future of the NHS workforce. Politicians combined a general tribute to the professionalism and dedication of frontline staff with a basket of policies designed to raise morale and motivation. The views on how good things are differ massively.

The Conservatives have committed themselves to trusting the professionals - with proposals that include the creation of trust clinical reference groups to promote dialogue with managers. Better practice will come with guaranteed employment for graduates and more robust workforce planning, especially in medical education. The package proposes work on defining professionalism and promoting clinical leadership with the theme of 'autonomy for professionals'.

Meanwhile, the government has announced proposals to personalise the NHS, encourage more prosecutions against those who assault staff and expand the role of matrons.

Sir Derek himself - via the King's Fund - has given his judgement on how things are going. While hailing the increase in staffing, he raises alarms that planned productivity gains and healthier lifestyles have not been realised. The review challenges the prevailing view that most of the growth in funding has gone to more staff rather than their take-home pay.

Criticism of the cost of pay reform has rung through the seaside debating halls but Sir Derek cautions those looking to tear up contracts. Managers need to acknowledge that they now have the structures to motivate people and get greater value for money. The levers to do this now exist locally - managers just need to learn how to use them.