rhetoric or reform? changing health and social care in wales

Throughout the united kingdom, the national health service (nhs) struggles to meet demand and achieveperformance targets. services need to work with individuals and communities to reduce avoidable disease and dependence. all four uk nations have separately realised the need for change but 20 years’ experience suggests that vision and rhetoric are not enough. success requires reformed systems and changed leadership behaviourto enable frontline staff to break the status quo. top down, target driven behaviour must be replaced with a realfocus on improvement, championing those who have the knowledge to deliver it.