At last week’s NHS Confederation conference, health secretary Andrew Lansley stressed the need for managers to engage with GPs, while batting away the question of how Treasury officials feel about giving them control of the commissioning purse strings - a question that is not going to go away.

But the debates over GP commissioning must not obscure the need for managers to engage with other clinicians - especially given the need to save NHS cash.

The NHS Institute for Innovation and Improvement estimates £9bn could be saved each year by achievable changes to clinical practice - preventing pressure ulcers, falls and urinary tract infections, for example.

These “high impact actions”, of which there are eight in total, are about small changes that can add up to large savings. Nurses are also being encouraged to reflect on their “moral responsibility” while money is tight - and not fall into the trap of thinking that saving money is someone else’s job.

Of course, embedding this kind of cultural change requires leadership. Managers must engage with all clinicians to help identify and deliver efficiencies. GPs might even thank you for it once they hold those purse strings.

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Clinical engagement is about more than GPs