I think the NHS Confederation is a really good thing. I don’t know if people say that very often, but I do. Ever since I first became involved in health stuff ten years ago, I suppose, I have always found it a very useful resource to go to I think it takes a very responsible on everything and I think it is a credit for its members, actually. The NHS is always changing. The speakers spoke about waxing and waning different types and ways of accountability in the NHS, different types of management expectations. These things change so regularly and I think that really what I took from this was that we need to learn from the past and we need to look towards the future It’s the opportunity to be with a group of your peers and hear what the issues are. Reassuringly, here the things that you think are the right things are happening and also that there are some very real challenges. And also to hear a bit more about how the NHS Confederation can, and is planning to, support us to deal with these challenges more effectively. It’s a really important meeting I think it’s always lovely to have eminent voices speaking and hearing perspectives from across the country and from different parts of the system I would say that that was a really valuable thing to experience. One of the take home messages was about the move to integration, to integrated care systems, and how helpful it was to hear people’s different experiences of that. These events are excellent. They really give the opportunity for leaders in the NHS to get together with industry and lots of different parts of the system so that they can really discuss the big issues.