Intended for healthcare professionals


Transforming healthcare: necessary but difficult

BMJ 2014; 348 doi: (Published 25 April 2014) Cite this as: BMJ 2014;348:g2842
  1. Carole Kaplan, transformation programme director,
  2. Elizabeth Moody, group nurse and transformation programme director,
  3. Stewart Gee, programme manager
  1. 1Northumberland Tyne and Wear Foundation Trust, St Nicholas Hospital, Newcastle upon Tyne NE3 3XT, UK
  1. carole.kaplan{at}

Recent King’s Fund report on mental health services provides some useful pointers

Once again, changes are needed in the health service. The impetus comes from concerns about the quality and safety of services, combined with the need to save money. Although transformations are already widespread in the NHS, there is little consistency in approach, with recent reports of advances as well as retreats.1

What can we learn from previous large scale transformations in the provision of healthcare? Recently, the King’s Fund summarised lessons from the radical transformation of the UK’s mental health services—from a service based in institutions to one based in the community. Its summary is augmented by reports of two workshops attended by people with experience of transformation. What is interesting is how consistently their messages are reflected in informal discussions across the country.

As the King’s Fund report makes clear, change is a constant feature within public services. But if transformation is to succeed in increasing quality and reducing costs sustainably, many problems need to be dealt with. Doctors need to be able to identify waste in the system and accept that the old ways are not necessarily the best …

View Full Text

Log in

Log in through your institution


* For online subscription