Clinicians and managers need to look at working differently to acheive maximum benefit for patients. The current system of tariff based payments will need refining if it is going to prevent both the ‘gaming’ that currently occurs and the risk of cherry picking as alternative providers develop more services. Management costs vary widely and this needs to be analysed too.

This is an exciting time for clinicians and presents a unique opportunity to redesign outdated services. It is important for us not to get too mired in the process of organisational change nor procrastinate too long about getting involved and taking decisions.

Conservative Health is planning a launch party with the health team in the next few months and probably a clinical forum event.

I urge you to try to support us, even if it is by email. You can always contact me via the contact link. I am very interested in hearing about services that you have tried to set up but have been blocked by PCTs or measures which are anti-competitive. Some good news stories are also welcome.

Lastly I am always keen to have articles for the Express. We are collecting for the May edition. If you fancy writing on a subject dear to your heart, please contact me asap.