The NHS is 'desperately short of leaders at local level', a senior NHS Executive director warned delegates.

South East regional director Barbara Stocking said the NHS had had its wake-up call and now needed to focus on the vision for a better future and developing better local leadership.

'We need people with a 'can-do' attitude, people with the skills to make change happen .And we need mechanisms to allow us to share our ideas, ' she said.

In the same session, 85 per cent of delegates backed significant change in the way the NHS runs its activities.

The audience poll came during a presentation from Ged Davis, a Shell vice-president who outlined the parallels between major global businesses and the NHS in managing change.

'Uncommon' leadership at all levels, capturing the hearts and minds of staff and ensuring that change is owned, supported and focused is the key, Mr Davis stressed.

He outlined Shell's experience of instituting a major reorganisation, stemming from external triggers , including the Brent Spar disaster and an increasingly educated and demanding customer-base.

It was clear that the organisation needed to become more accountable and transparent and to introduce a new culture which would ensure it could be a top performer.

First , staff had to buy into the need for change, aspirations had to be clearly communicated throughout the company and learning programmes had to be put in place for managers at all levels to focus energy into changing the business.

The organisations must be outward looking, forging relevant alliances, getting leverage from the capabilities of others as well as focusing internally on its strengths and shared principles, he told delegates.