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The other ideology at play is that money is the beginning and end of every decision in the NHS. Managing money has become the de facto purpose for many leaders, rather than improving health and wellbeing. This compounds the negative impact of any financial squeeze, as it doesn't occur to us to unleash staff creativity to form new partnerships and find new creative solutions.

In other industries, great leaders have a chance to use necessity as the mother of invention. In the NHS, we assume it can only mean cut-backs.