A very belated happy new year to all my colleagues. If your January 2009 has been anything like mine, it will have presented time to reflect on the past while managing the present and identifying aspirations for the future.

It would also have provided a chance to review the opportunities and challenges the NHS operating framework for 2008-09 brings to our attention. So let's consider that for a moment. We are all pleased that there are no surprises and in the main we have welcomed chief executive David Nicholson's promise to build on the current reforms and strengthen them within the context of the next stage review.

In short, the health and service priorities for the year ahead: freeing up the front line by moving towards local stretch targets, while delivering on national priorities. 2008-09 is the start of the next three-year planning round. In this context, the operating framework sets out the priorities and planning framework for the NHS for the 2008-09 financial year, within the context of the three-year spending review period 2008-09 to 2010-11.

The focus will be on developing world class commissioning as the key agent for change on behalf of patients and the public, using the full range of levers and incentives to transform services and improve outcomes.

Balancing act

With reference to the financial regime, the challenge is to set out a framework that fully supports the next stage review. Understanding the purpose of the reform goals and how they can be used to bring about transformational improvements in services using available resources is crucial. Key to this will be the need to sustain the surpluses the NHS is expected to deliver. Boards must appreciate the delicate balance between delivering national priorities and local targets while at the same time investing in quality and safety improvement.

Thus, business processes become ever more important in securing our futures. Without them, how will boards ensure a business-like and transparent approach to planning that supports locally led decisions while providing accountability? Genuine partnership working at a local level will help ensure that local health and well-being needs are better understood and addressed.

Board challenges

So what is the leadership challenge for boards in 2009? In my view, it is business as usual. In other words, continue to build on the strategic foundations that will help deliver our shared vision and commitment to put quality at the heart of all we do.

We know, for example, that the most effective treatments are often the most efficient. We also know that focusing on driving up quality will contribute to improving efficiency. We must therefore continue to focus on achieving value for money improvements by prioritising the most effective treatments and reducing errors and waste. This will improve the patient and staff experience and embed quality.

Ultimately, we need to invest in developing new ways of working and leading in order to drive transformational change that we value and are proud to be associated with.

Another day in another year is just that until you make it a different day in a better year. That difference is measured by improved patient outcomes and an NHS narrative that unites, engages and delivers improved and safer integrated patient pathways.

What are your board's goals for 2009? Click on post your response below and let us know.