Ingredients for change
Addressing an audience of NHS leaders, Mr Farrar said unless "four ingredients for change" were pursued, the NHS would not achieve the outcomes it needs to be sustainable and achieve the best quality care for patients.
The ingredients, all of which he stressed as crucial to success, are: creating a strategy for the next decade; ensuring business processes support the strategy; addressing the problem of culture; and developing a new style of leadership, which reflects how the system operates.
Talking talk but not walking walk
Speaking of the need the create a new strategy, he said we need one that moves money into the community to relieve pressures on hospitals.
Outlining that considerable resources are currently deployed into the acute sector, he said "we are talking about a strategy but pursuing another".
Changing behaviours and financial flows
He raised the issue that the failure regime emulates how organisations fail in other sectors, and is organised around institutions rather than systems. Using an American football analogy – in which the bottom of the league receives the first choice of new talent – he said that the NHS should learn from this approach .
"Money should always follow the patient", he said, and the health service needs to define how it wants competition to work.
On the subject of culture, he acknowledged a clear need for a change in the NHS, saying the service needs a new learning environment where people can learn from failure without fear of reprisal.
He added that the NHS needs to be more transparent: "Transparency is a great friend to the service", allowing a dialogue with the public about variation. "When it says NHS above the door' people think it's the same everywhere".
Involving citizens in the shaping of their services and care, and engaging them in decision making was highlighted as necessary to success, adding that the health service must be confident enough to engage citizens.
Leadership, answer to quality
Citing leadership as the answer to quality – not an over-reliance on inspections and regulation post-Francis – he stressed the importance of local leadership.
These four ingredients are what is needed to avoid situations such as those that have arisen around A&E, he said.
Mike Farrar made his comments at the beginning of the NHS Confederation's annual conference and exhibition 2013 in Liverpool. It is the first time the whole NHS will gather since the establishment of the 'new NHS on 1 April, and publication of the Francis report and Government response earlier this year.
Watch Mike's speech below.