Hi. I’m glad to be contributing to ournhs.nhs.uk. As the National Director for Improvement and Efficiency, I’m responsible for looking at the issues surrounding how we achieve quality whilst also meeting the financial challenges ahead.

There is a deep understanding across the service that the current economic situation will require the NHS to identify significant efficiency savings so we can continue delivering our commitment to high quality care.

Over the last two months David Nicholson and I have been talking intensively to colleagues across the NHS, and its partners about how we should take on this challenge.

Energy and commitment are high.  Both in the managerial and clinical communities there is a recognition not just that we must respond, but that tackling the challenge represents an opportunity to achieve deep and sustainable improvement in the NHS.

There is a strong acceptance that we can drive improved quality and increased efficiency together.  Suggestions about the changes we should make that will deliver the change have been flowing in to the QIPP challenge inbox, regional events and local events.  From wholesale service redesign for people with long term conditions, opportunities for big back office service change to major opportunities for reducing waste in community and hospital services.  There is not a problem of identifying what we can do.

But the challenge of how we do it is huge.  Despite the understanding of the coming problem many organisations are currently still continuing to grow their cost base rather than starting now to deliver quality and efficiency gains.  Getting the change we need at the scale and pace required will require a maturity of relationships and capability to lead change across systems at an even greater level than we have had to date.

So we need to move from thinking to action.  Nationally we will use the period up to Christmas and the publication of the Operating Framework to set out how we think locally, regionally and nationally and what we need to do to begin delivery:

• Identifying the key changes that you have identified as making the most important contribution;

• describing how we will use the national system levers to drive and enable the necessary change;

• setting out how the commitments being made to drive quality and efficiency in local systems, across regions and across the country represent  an ambitious and coherent approach;

• describing how we support the spread of the innovation we already have, and identify the next big innovation challenges;

• engaging clinical and managerial leaders across the system to take ownership of the challenge of delivering change of this scale and at the pace required.

The scale of the challenge may be huge, but it has been matched by the scale of positive response from the leadership community across the NHS and in its partners.  I am looking forward to working with you through this next critical phase, as we convert that initial response into delivery in 2010.