The arid financial landscape for the health service confirmed in yesterday’s Budget means the days of clinicians avoiding responsibility for managing money are over.

Doctors and other professionals have too often felt they could leave the financial heavy lifting to managers. As the years of growth come to an end that is no longer tolerable.

It should be seen as a professional duty to manage resources effectively to provide the best possible service to the most patients.

The scale of the challenge facing the NHS - rising demand and expectations colliding with tightening funding - means the remedy will not be found among traditional approaches such as salami-slicing costs or getting tough with procurement.

Commissioning will help, but it is certainly not a cure for all financial ills.

‘Time and money can be saved by eliminating waste from clinical pathways’

It is the clinical pathways themselves where swathes of time and money can be saved and the patient experience improved.

Eliminating waste from the system must now be regarded as a core skill for clinical teams. Unnecessary operations, compelling patients to make repeat visits and squandering patient and staff time must be tackled vigorously. Clinicians rightly want more power in the NHS, but power is inextricably linked to responsibility for the cash.

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