This second edition reviews recent reforms and the likely impact of future developments in management and competition in the NHS. In particular, it reflects the growing importance of primary care and the continuing debates about health care rationing. It concentrates on the realities and how they can be interpreted to help strategists, managers, clinicians, students and those supplying the NHS understand the mechanism of efficient health care delivery.

In the face of the relentless rise in health costs, many countries have had to set priorities so that maximum benefit can be made of unlimited funds. This book shares the experience of those which have taken a lead in this field, and draws on models being developed in Oregon, New Zealand, The Netherlands and Sweden as well as the UK. It discusses the strengths and weaknesses of each system from which healthcare planners and managers can draw their own conclusions and apply to the situation for which they are responsible.

'Successful medical leaders are usually, but not always, experienced and credible clinicians with good people skills, who look beyond the boundaries of their own specialty or institution, who are positive and perseverant and who are prepared to take reasonable risks to achieve their goals. Most importantly they know how to engage their colleagues and effect change. They understand the principles of organisational performance and the balance between professional autonomy and corporate behaviour - ' Sir Bruce Keogh, in the Foreword This book is a comprehensive account of the key aspects of medical leadership. Easy to read and highly accessible, it explores how the medical profession has evolved in tandem with administrative and structural aspects of the NHS: previously reluctant leaders, doctors are increasingly positive about adopting management and organisational responsibility. Assuming leadership roles at all stages of their training and career is a progressively vital component of the definition of a 'good doctor'. Completely up-to-date, this book features exciting and critical developments such as the embedding of the Medical Leadership Competency Framework as a statutory element of the training and development of all doctors, and the establishment of a new Faculty of Medical Leadership and Management. It is highly recommended, inspiring reading for all medical professionals taking on formal leadership roles. Junior doctors, too, will find much of interest.