1. Kent & Medway Learning Network Launch event for PCT Top Teams 29 th January 2004 Edna Robinson Chief Executive Salford Primary Care Trust National Lead, Chief Executives Network, NatPaCT

2. Leadership Public sector leadership requires stewardship towards quality outcomes for the consumer, not people who will be diverted by organisational interests, or a political point in time.

3. Very successful year in getting more people through the current system Freedom is a state of mind, structures are usually an excuse for lack of creative thinking Booking is king. Understand demand and waiting will be resolved Different purchasing and provider arrangements are required for managed care and urgent care New NHS organisations are urgently needed Central leadership and control reflects risk averse system Anywhere health economy

4. Areas of urban and rural poverty may drive different solutions than self starting communities Local authorities must influence new organisational solutions as much as the NHS Anywhere health economy Money is only flexible at the margins as NHS consumers have already bought the bricks and mortar of their local NHS system Primary Care organisations want to do far more than buy treatments from others Private sector will draw in resources if the public sector remains incompetent

5. Anywhere health economy The Daily Agenda Access Waiting Times Urgent Beds Diagnostics Clinical Governance Resources Insufficient developments Uncapped Demand A&E Waits Out of hours services GP surgeries Chronic Disease Star Ratings Targets NSFs CHAI Reviews Foundation Trusts Network Developments Preventable Disease Smoking Mental Health ICT Data v information Workforce Availability New Roles New Contacts Choice & Consumerism PPI Dilemma re: local services Booking and Triage Leadership Performance Delivery Development Redesign

6. Anywhere health economy Our Current Responses Doing Same Better Doing More of Same Innovating Using Catalysts Reforming operational systems cleaning reportable data Additional capacity Growing the workforce Networks Tier 2 % GP referrals Modernisation Agency Action On Tsars Emergency Collaboratives

7. Anywhere health economy Return on Investment of Effort Turning Point? Delivery/Performance ? TIME

8. New Agenda Understanding Demand Difficult Access – a thing of the past Skill Mix and Triage Trust, co-operation and interdependence Consumer influences solution – real choice Anywhere health economy Networks not institutions Primary – secondary old speak