How can we build skills to transform the healthcare system?

Across the world, healthcare organisations are implementing radical change strategies in the face of unprecedented financial challenge. In this context, a focus on building capacity and capability for improvement is a key strategy. Global analysis shows that the most common characteristic of healthcare organisations that deliver outstanding performance in cost and quality is a systematic approach to capability building for improvement. The paper looks at where to start in order to build improvement skills at every level of the healthcare system and empower frontline staff to make changes that will deliver results. The current situation of the English NHS is used to illustrate the points made. What will it take to skill up and mobilise the entire healthcare workforce, to create a mass movement of change agents, to sustain the energy for change for the longer term and deliver the transformational results in cost and quality that are sought for patients and populations?