The Department of Health’s new head of quality, innovation, productivity and prevention, Jim Easton, has vowed to “follow through” on Lord Darzi’s commitment to quality.

National director for improvement and efficiency Jim Easton told HSJ: “There is a slight risk people will see what I’m doing as a shift of direction. It is the opposite - it is continuity in a new climate.”

News of Lord Darzi’s resignation as health minister was broken on last week. He is returning to his work as a surgeon and academic.

Mr Easton was appointed last month to lead quality and efficiency improvement. In his first interview since taking up the post he said Lord Darzi’s legacy would survive.

But he said: “This is about the quality agenda - it is not a distraction from it or an additional thing. Ara is leaving his ministerial post, but he is not leaving his commitment to driving quality in the NHS.

“Certainly the management board is absolutely clear we will follow through on the commitment to quality.”

Mr Easton said preparation for spending cuts meant accepting some changes would be made at a sub-regional, regional or national level.

“I don’t think anyone thinks sensibly you can [make necessary savings] by looking to every local organisation to find every solution. A lot of these productivity gains are not within organisations, they are across boundaries.”

Local discussions in coming months should include the “size and shape” of the workforce, Mr Easton said. Trusts have also been asked to suggest policy changes to contribute to the 2010-11 operating framework.

Mr Easton said innovation would “link” quality and productivity. Above “invention” itself, he emphasised the importance of spreading already successful and productive practices more quickly.

NHS medical director Sir Bruce Keogh said Lord Darzi had “embedded a scale of clinical leadership and involvement in running the health service that hasn’t been achieved before”.

This was now “pretty firmly embedded in the minds of the senior people running the NHS”, he said.

Sir Bruce said: “The great thing was having a guy like Ara as a minister, because ministers can have a huge influence.

“He has managed to embed clinical quality in the minds of everybody and he has also managed to link that to the importance of clinical leadership.

“The question is how we stimulate that debate [among] clinicians and middle grade managers on the shop floor.”

Sir Bruce said Lord Darzi was “right at that point where he has an opportunity to make a major contribution to surgery itself”.

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Darzi’s legacy

Robert Winter, NHS England medical director

“There is now an enthusiasm and momentum behind Lord Darzi’s work that will ensure it continues. The NHS medical board has very much taken quality as the main driver of all the changes we are hoping to introduce.”

Steve Field, Royal College of GPs chair

“The system is getting doctors into leadership roles and only someone who was both a doctor and minister could have pushed it as hard and got away with it.”

Professor Sir Neil Douglas, Academy of Medical Royal Colleges chair

“Lord Darzi has made a major contribution to a development that was taking place anyway in terms of embedding clinical leaders in decision making processes to the benefit of patients.”

David Dalton, Salford Royal foundation trust chief executive

“Any suggestion of trying to improve organisations centrally is doomed to failure. All the evidence shows staff on the ground know the things that can drive change and stop it happening.”