Darzi Review: Fine Words. Now Let's See The Action, UK

Main Category: Public Health
Article Date: 12 May 2008 - 9:00 PDT

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A welcome breath of fresh air seems to be wafting through the NHS. Health Minister Lord Darzi's latest announcement from the Next Stage Review: Leading Local Change, talks about five principles that everyone should be able to support.

They are about making sure that change: always benefits the patient; is based on good clinical evidence; is led locally instead of imposing national solutions, and depends on the involvement of patients, the public and other key partners. Finally, the Health Minister says that existing services should not be withdrawn until the new service has proved itself.

These are principles that the NHS Alliance has long argued for. But the health service has always been a top-down - some would say top-heavy - organisation where power resides in rigid hierarchies. Many clinicians and patients feel they have less influence now than perhaps at any time in the health service's sixty year history.

Paradoxically, turning Lord Darzi's excellent principles into reality will depend on genuine commitment and firm action from the top of the hierarchy. The Department of Health needs to:

- Strengthen practice based commissioning so that decision making power is devolved to frontline clinicians.

- Set up a Clinical Leadership Academy so that innovative clinicians can develop their skills and play a central role in steering change.

- Encourage community involvement and local democracy, such as the development of Practice Participation Groups.

Dr Michael Dixon, NHS Alliance chairman, said:

"We applaud Lord Darzi's five principles. But now we need to see clear evidence that the NHS supports him and that there is a real change in the way the health service operates.

"Frontline clinicians and managers should be the power source of change instead of merely being 'engaged' and 'consulted' about change directed from the top."

Notes

1. The NHS Alliance is a collaboration of clinicians, managers and board members who put patients first. It is the independent body that represents NHS primary care. Values based, it is the only organisation that brings together PCTs with GP practices, clinicians with managers and Board members, and NHS primary care with its patients. The Alliance membership and its hard working national executive is fully multi-professional. It has twelve professional networks, including Providers Networks.

2. The Next Stage Review: Leading Local Change is to be published by the Department of Health 9th May 2008.

http://www.nhsalliance.org