Doctors have to seize the initiative and make the changes they think are needed if clinical excellence is to be put at the centre of NHS reforms, a conference was told last week.

This idea was endorsed by several panel members at the conference, held to launch a report on clinicians' views of the NHS reforms to an audience of more than 100 NHS trust chief executives, clinical directors, medical directors, and representatives of primary care trusts.

The report, which contains “design rules” that are common to best practice, was …