What hopes for the NHS: the election and beyond?

If you could change one thing in the NHS, what would it be? That was the question with which The BMJ’s editor in chief, Fiona Godlee, chairing the session, began discussions.

Richard Jones, clinical director at Wessex Cardiovascular Strategic Clinical Network, kicked off by saying he would increase the focus on quality improvement and eliminating waste. The NHS should be “involving everybody in a quality improvement project within their workplace and giving them the support and methods to do that,” he said.

This view was echoed by Suzie Bailey, development director at health sector regulator Monitor.

“We need to be able to teach everybody who works in the health service the basics of quality improvement,” said Bailey, who added that patients should be directly involved in improving care in a more systematic way.

Jonathan Michael, chief executive of Oxford University Hospitals NHS Trust, said additional funding was of upmost importance: “The one thing that I would like to see for the NHS after the election is actually more money because many of the things we need to do that we’ve been talking about [at the Summit] are going to need investment. The balance between relentless pursuit of quality but continued increase in demand and money is inescapable.”

Nuffield Trust chief executive, Nigel Edwards, agreed that fiscal pressure was the biggest issue.

“Even with the money that’s signalled in [NHS England’s] Five Year Forward View, the amount of money per person in age adjusted terms is flat. And . . . that’s not very realistic, I think, given the rising expectations and a …