Well done, Kingsfund, for again exposing bad news, that nobody wants to hear, but we must, if the NHS is to survive. A million of us in England go to the doctor (primary care) every day to be cured of our distressing conditions, but the only remedy provided is drugs which don't even claim to cure, but only relieve our symptoms. However, they have harmful side effects, making them toxic, and addictive, creating Long Term Patients, condemned to keep coming back in a revolving door. I show in 'Who's killing the NHS?' (9.129 of www.reginaldkapp.org) that it is this harm that is the root cause of the sudden mass-exodus of GPs, and you show that this toxicity has also infected senior managers.
The solution is to detoxify the NHS by councillors on Health and Wellbeing Boards calling their Clinical Commissioning Groups to account to mass commission NICE recommended talking therapies, and decommission harmful drugs under a policy of 'medication to meditation'.