Dashed off early from the Skoll " World Forum" of social entrepreneurs in Oxford to get back to acevo's Health and Social Care annual conference. Not too tired he adds carefully, even after the grand drinks reception in the Ashmoleum Museum ( as you know I gave it up for Lent ! ). The beautiful mellow evening , the gleaming spires and it was hard to tear oneself away! Important not to be late as I was to greet Sir David Nicholson, the CEO of the NHS! He was giving the opening keynote. And I met him as he got out of his car! Key message; he recognised that for us it was "tough out there", but there are NHS challenges which make a strong case for more third sector involvement ! I have to say he gave a fascinating speech and I'm going to give you the key points he made here; #He said for the NHS it was important not to get caught up in detail and process and forget the purpose of the service and the need for good outcomes for people. So how do we get good outcomes? We need integration. And as people talk about this meaning many different things he use the example of dementia ; to tackle this we need a community who understand how to help and support , doctors who recognise early signs, hospitals who provide appropriate , good medical care. # He talked about their Budget challenge- they in a generous place compared with local councils but its still a push. Since the NHS was set up they have had budget increases that are on average 4.5% every year-largely driven by demand. But from now up to 2014- there is no growth. The recent Budget has extended that no growth policy to 2016. This a real challenge against rising demand and medical advances. How do we now sustain and improve a health care system against background of nil growth+ rising demand? Never had this challenge before. How will the NHS cope? # So innovation, quality and improvement needed. That means; 1 Deal only with those things at the centre that we need to. They will be Shifting resource from centre to locality. 2 Service change; essential to make service change to get more quality and improvement in services. And this is the problem. We are not making advances in service change . Why? Essential that happens in the next 4 years. Challenge basic tenets about hospitals. If don't make change this means take more out of services. Its business critical. #So how do we use the tools we have been given to make service change? He said there are many ideas and examples in our sector for this. He said the basis of the Act is around clinical commissioning. How do we use this? Built up from local communities- so GP leaders. They have a list of the population who need health care. Not just that- GPs can make small changes happen. They help navigate around system. Its a unique insight we need. # You need good providers. So AQP is crucial to change: this will bring new ways of operating and new ideas. Change is needed to make services more diverse. New providers will change landscape. He stressed patient and community involvement . Can't drive all change ourselves. So Health and Well Being boards are a key part of the new system. The traditional NHS has been hierarchical. That does not encourage ideas. Essential to break ir down. So the question for us : how to bring together a broad alliance for change. We need to make it a reality. Now Act is there we need to get on with it. Can't afford to go into our shells! We certainly needed coffee after that! And the conclusion I drew- get into the new clinical commissioning groups now. They are appointing their leads. Get their names. See them now! Left the day in an optimistic mood. This is a sector that knows about health. Knows what changes are needed. Its up to us as Leaders to make the most of the opportunities we have.