3 Confirm and co-ordinate a strategy to move towards specialist-delivered services.
4 Promote the recognition of generalist skills as desirable for all doctors.
5 Review the hospital career and training grade structures: This is urgent
include the staff and associate specialist grades;
take account of recommendations to modernise the SHO grade;
consider how short-term service appointments can contribute to the provision of services and the development of the workforce; and
consider different models for specialists using listing on the Specialist Register of the GMC as the basis for identifying a trained doctor.
6 Plan the training grades to satisfy the need for trained doctors, not to provide service.
7 Give service re-design high priority as a co-ordinated, resourced effort covering primary and secondary care:
review all current acute service configurations;
involve patients and public in service re-design; and
promote enhanced services rather than institutions.
8 Identify and pursue opportunities for managed clinical networks:
ensure that their essential features are clear and agreed;
ensure that they are managed;
develop and co-ordinate networks nationally; and
explore the linking of employment contracts to networks.
9 Establish a clear position on intermediate care:This is urgent
10 Give the development of teamwork high priority:
11 Encourage the provision of more flexible opportunities for employment and career development:
12 Address the reallocation of administrative and other tasks currently carried out by doctors, to maximise the use of doctors' clinical skills.