ABSTRACT
This conclusion presents some closing thoughts on the concepts discussed in the preceding chapters of this book. The book shows how many practices have come to grips with difficult, immediate issues as well as begun to develop strategies and plans for improving underlying situations. Identifying common goals and visions, acquiring and maintaining high-level management skills, working across more boundaries than in a single practice and dealing with a range of accountabilities will be the name of the game at whatever level of involvement a practice places itself. The whole concept of working across boundaries will expand as localised collaboration becomes a necessary part of the complex set of relationships in health and social care. Accountability underpins the collaborative culture necessary for clinical governance to work. Corporate governance and enhanced professional performance review in primary care will create a new culture of change, improve average standards and reduce lower standards of care.
