'In the past we spent millions developing best practice, and then made implementation optional, ' comments Sir Ian.

'The major recent NHS cultural change is that best practice is no longer optional. We have to move from a phase of improvement to one of transformation, including much better use of resources. With the new NHS Institute for Innovation and Improvement, and the new style of leadership from [NHS chief executive] Sir Nigel Crisp and the 'top team', we have a great chance to truly transform the NHS.

All we need is a bit of space.'