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Education And Debate

Model could work

BMJ 2004; 329 doi: (Published 16 September 2004) Cite this as: BMJ 2004;329:681
  1. Nigel Edwards, policy director (
  1. 1 NHS Confederation, London SW1E 5ER

    Degeling and colleagues provide an excellent case study of how an activity designed to help improve the quality and safety of health care runs the risk of being seen as an unhelpful managerial imposition.1 The reasons why this has happened and the possible responses to it provide some important insights into the more general project of improving the NHS.

    One of the biggest problems in many healthcare systems is the gulf between the front line clinical staff and policymakers and managers. In most organisations a strong link exists between the top of the organisation and the front line, and commands …

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