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Thursday 20th June 2019

Sir David Nicholson says the NHS needs to change

25th February 2011

NHS chief executive Sir David Nicholson has spent more than 30 years in the health service, rising from management trainee to the top post. Here, he looks ahead at the forthcoming reforms after being appointed head of the NHS commissioning board in England.


While many people have been taken aback by the amount of power being given to GPs, the commissioning board will be able to keep an eye on how doctors are doing.

The GP consortia will have a variety of performance data covering the quality of care being provided to the financial state of the organisations through which they will be held to account and there will be powers to intervene if necessary.

But hospitals face major challenges and they must be prepared for change. Most will be able to survive and thrive but there will be those that will find it difficult and some will have to consider changing their structures.

This is against a backdrop of a tough budget settlement for the NHS and over the next four years, the budget will rise by just 0.1% above inflation.

But these challenges should not mean a fall in patient satisfaction.

However, this may not be the revolution people fear. It is more evolution because it simply builds upon what has been happening for some time in the NHS.

We have been working with GPs for 20 years to get them more involved in commissioning and shaping services and greater autonomy has also been given to hospitals over the years, meaning the push for all trusts to achieve foundation status was part of a natural move.

However, people should not underestimate the scale of the changes.


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