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Pathfinder consortia: a step in the right direction

The second in the Fund's series of seminars on health and the Big Society provoked an interesting debate and very frank discussion on the challenges of balancing the reality of the financial situation with the vision expressed in the health White Paper, and indeed in other government initiatives such as Big Society.

Stephen Dorrell MP, Chair of the Health Select Committee, was yet again clear that the key challenge for the NHS is achieving unprecedented efficiency gains over the next four years. But there was concern in the room that the current reorganisation was distracting to the very staff that will need to deliver those efficiency gains. Even acknowledging the presence of some notable journalists and commentators in the room, one primary care trust chief executive stated: 'we could be heading for a train crash'. He was concerned that not only were the practicalities of the reorganisation taking up time that should be focused on efficiency gains, but also that he and his staff were faced with such a huge challenge at a time when many are facing redundancy.

What was clear from the discussion is that careful implementation of the changes will be key. The GP Pathfinder consortia, announced today, are a helpful first step in testing the reforms properly. The fact that the pathfinder consortia present a wide range of different models, covering very different populations in both size and geography, is positive; properly evaluated, this programme will help to uncover the practical lessons before a national roll-out.

A clear view from the Fund, and indeed other commentators, is that the effort that has gone into writing the NHS White Paper and the supporting consultation documents now has to be matched with the unglamorous, but absolutely critical, task of planning delivery. The pathfinders are a helpful first step in that process if the NHS is indeed to avoid a 'train crash'.