Abstract
A wise man once told me, ‘if you don't like the rules, win the game and change them’. As clinicians, we can use this analogy to make the best of our clinical expertise and knowledge to change policies to improve patient care and outcomes. Within trauma and orthopaedics, we have numerous examples of the successful use of policy to deliver more consistent care to our patients, with the aim of improving outcomes. One of the most successful policies is the Best Practice Tariff for hip fractures, which has completely transformed our care delivery to a multidisciplinary and more timely approach and has shown clear improvements in outcomes. There was strong clinical engagement in the development and implementation of policy to commission our major trauma networks and centres and ongoing oversight from NHS specialized commissioning. As a clinical member of the National Clinical Reference Group (CRG) for Major Trauma and Burns, I have led the update of a number of policies and will provide an insight into the change process. The National CRGs play a vital role in providing clinical expertise to decision-making for NHS specialized commissioning.
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