5.12pm: Lizzi Easterbrook writes

That's almost all from us for today. We hope that those of you at the conference have enjoyed the day and that the blog has kept those of you not attending up to date with all the latest action.

Before we go, the Guardian's live blog on the doctors' strike is still going strong, you can see all the information from today here.

We will be back at the NHS Confederation annual conference tomorrow. The agenda features speeches from Jan Sobieraj, the interim managing director at the NHS Leadership Academy, Dr David Bennett from Monitor and Dr Clare Gerada.

4.39pm: Clare Horton writes

A number of the conference speeches - including Andrew Lansley, David Nicholson and Malcolm Grant's - have now been uploaded to the confederation's conference pages:

Videos of the panel sessions are also going online.

4.23pm: Jessica Fuhl writes

At 4.30pm delegates here at the conference will again break into different strands for more sessions. Among the sessions will be one on low cost integrated care and what lessons can be learnt from Europe. There will be a panel discussion chaired by Dr Yi Mien Koh, who is chief executive of Whittington Health.

The integrated health organisation is a merger of the formerly named Whittington hospital, Islington PCT and Haringey PCT – including Haringey children's services. Dr Yi Mien Koh has previously spoke to the network about the work that they are doing on integration at Whittington Health and told us that one of the biggest challenges of the merger was integrating staff's ways of thinking:

It was three different cultures, three different ways of working, three different sets of conditions. But as a result what we now have is one structure that takes the patients all the way from the front door in to the community.

Also speaking this afternoon is chief economist on health policy at The King's Fund, John Appleby. He will be talking about the financial future of the NHS with Paul Corrigan and director of KPMG, Nigel Edwards. If you want to do a bit of background reading ahead of the session, then Appleby has written a lot for us on health policy finances previously.

4.06pm: Clare Horton writes

Earlier this afternoon, I attended an interesting session on personal health budgets, chaired by Jeremy Taylor of National Voices, who summarised one panellist's views succintly:

Learn to let go and learn to love your local authority

Trudy Reynolds, a personal health budgets project manager for NHS Oxfordshire and Department of Health adviser, admitted there had been nervousness about how service users would spend the money, but professionals soon learned that budget holders didn't organise "ridiculous" care for themselves. She added:

We are not very good at trusting people and patients.

From the floor, Tina Coleman of the Social Care Institute for Excellence, said healthcare professionals could learn from the experiences of their counterparts in social care, and also from local user-led organisations. It's an issue I think we will return to on the network soon.

3.58pm: Clare Horton writes

Sir David Nicholson, chief executive of the NHS. Photograph: Government News Network

David Nicholson, as well as delivering today's conference keynote speech, has published his annual report, in which he looks back over the last year and considers the challenges ahead for the health service.
In his introduction to the report, Nicholson says the NHS has seen unprecedented challenges over the last year, and its achievements are due to the "heroic efforts" of its 1.2 millon staff. He adds:

But although there is much to be proud of, there is also much more to be done to make sure that all of our patients get the very best quality care currently available in the NHS, so that our very best practice becomes standard practice, and we root out and end unacceptable practices wherever we find them. The journey to high quality care for all is a never ending one, and we must continue to learn from our failures, as well as our successes, if we are to harvest developments in knowledge and technology for the benefit of all our patients. The report on the public inquiry into Mid Staffordshire NHS Foundation Trust will be published later this year. This will provide a salutary moment for the NHS to reflect on the learning that emerges from Robert Francis's report. We must use it as a catalyst to raise our ambitions and drive further service improvement.Because that's what we do when we are at best: we take the resources we're granted by Parliament, the reforms and tools for delivery, and drawing on our experience and judgement deploy them to meet the current needs of patients and drive the transformation required for the future.

3.41pm: Jessica Fuhl writes

Graham Kendall is a health policy advisor. He was also in the session on what matetrs to patients and has just tweeted this.

The hashtag for the event is #Confed2012.

3.28pm: Jessica Fuhl writes

Don't forget that we've got a stand here at the conference exhibition centre in Manchester. Pop over to stand B36 say hi to the team, or sign up to become a member of the network (it's free!) using our sign up sheets.

3.18pm: Jessica Fuhl writes

I've just popped into one of the breakout sessions on what matters to patients. Diane Thomas, chief executive at The Horder Centre, spoke about creating a culture where stagg go above and beyond what is expected to deliver care that patients want. Examples that she included to demonstrate this at her charity included parking attendants at the centre, staff looking after patients' dogs, massages for patients when they come in, and catering staff making home baked cookies and cake for patients when they leave.

Her presentation was followed by one from Ali Parsa, who explained how an organisation's values was the most important thing when making sure that they served their patients or customers. He said:

Martin Luther King had a dream. He did not have a business plan.

We also ran an online live discussion on this topic last week. If you would like to take a look at what our expert panel thought on this issue, then you can do so online here.

2.41pm: Clare Horton writes

We've a new story based on former John Lewis chairman Sir Stuart Hampson's speech to the conference. He told the onference that the John Lewis Partnership has grown in recent years through effective employee engagement:

the happiness of its members, through their worthwhile and satisfying employment ... It is a culture I believe can be copied by the National Health Service

We've also got a report on a speech made to the conference by David Sissling, chief executive of the Welsh NHS. Who says the country's integrated health system has allowed rapid improvements in its performance on emergency admissions, and that this would not have been possible in England's more fragmented and market-orientated health service. He told a session at the conference that Wales has cut emergency admissions for chronic obstructive pulmonary disease and diabetes by 16.5% and 14.6% respectively in just one year, with emergency readmissions falling even faster, although from relatively high starting points. He told delegates:

We don't work in a market. We work much more on an integrated basis ... There is no 'them'

1.29pm: Lizzi Easterbrook writes

The doctors' industrial action is still the main topic of conversation on the web today and The Telegraph has this piece looking at how the cost of pensions in the NHS have risen over the past 14 years. It reports that figures released under FOI show state contributions in 1995 were £525m but this had risen to £5.3bn by 2009.

For all the other news on the action, we recommend the Guardian's live coverage, where doctor and journalist Kate Adams has just commented on whether junior doctors are taking action today. She says:

I have just spoken to Dr Ben Molyneux, who said it is more tricky for junior doctors to take action. Ben said while there is a huge appetite to get involved in the industrial action, junior doctors are often in frontline jobs doing work that can not be delayed for patient safety reasons. Ben works in a paediatrics unit in east London that looks after sick children. The same applies to junior doctors working in A&E and those working for maternity services. He said that there is good camaraderie on the ground with doctors supporting their colleagues who may be struggling to cover today

Elsewhere, our colleagues on the Guardian Government Computing Network have a piece about the role technology will play in supporting change in the NHS. Following Andrew Lansley's speech to the NHS Confederation conference yesterday, they report that the health secretary sees telehealth and 111 telephone and web support as a vital opportunity to help redesign health services.

1.24pm: Clare Horton writes

David Nicholson continues his Q&A session, discussing collaboration, efficiency savings and building up surplus funds. Our colleague SA Matheson tweets:

Nicholson's speech is now available to watch here.

1.17pm: Jessica Fuhl writes

We're now on to questions after David Nicholson's stirring speech comes to a close.

Earlier in his speech he referred to dealing with the health reforms, was like a "bereavement". He's pressed a bit more on this but doesn't say too much.

Andrea Sutcliffe, chief executive of the Social Care Institute for Excellence, has asked about the role of social care services in commissioning. Nicholson responds by saying that the reforms "have opened a whole host of doors on things which we hadn't thought about before".

1.02pm: Jessica Fuhl writes

Nicholson has now moved on to talk about the importance of leadership and "optimism". He says:

You need to have confidence that you, as leaders, can make these changes. Think forward to 2020. Let's be honest, none of us will be able to retire by then. I can imagine a grandchild sitting on my lap and saying, "what did you do during the transition". I want to be able to say: "I sought to focus on outcomes like never before, we took the NHS from a place where people were waiting for treatment for years, to one where we delivered the best care in the world." That's the place we need to be at in the future.

"We need to connect with local people to make changes happen", he adds.

Nicholson finishes by quoting what he says is the best part of the NHS constitution:

The NHS belongs to the people. It is there to improve our health and wellbeing, physically and mentally, to make us get better when we're ill , and when we cannot recover to make things the best they can be until the end if our lives... It touches our lives at times at basic human needs.

12.55pm: Jessica Fuhl writes

Mark Newbold is chief executive of Heart of England foundation trust. He's just tweeted:

Please do get in touch by tweeting us or commenting below with your thoughts on Nicholson's speech so far.

12.50pm: Jessica Fuhl writes

North West London is given as an example of an organisation doing great things by David Nicholson. He says that they are good at driving efficiency, as well as being innovative.

The trust ranked joined first in green efficiency earlier this year - you can read more about that on the network here.

Nicholson is continuing to talk about improving patient care and the patient experience, this time for elderly care. He states that "we need to move away from this idea of having people in hospitals for a long time, and think about getting them into community care."

The chief executive of the NHS is now talking about how we can move forward with the reforms:

- "Relatively small changes in primary care can make a big difference"
- Adapting commissiong to population size, and making them work together "absolutely focused on the local, alongside other parties"
- "Provider should not do just what commissioners tell them to, they need to lead change". Our provider system needs to be clinically sustainable
- Using tools to bring in people from outside the system for help and support

Nicholson is also keen to assert that he wants to make commissioning "sexy"...

12.36pm: Jessica Fuhl writes

For Nicholson, the importance lies in connecting patients with outcomes, not clinicians. He also raises the same issue that Mike Farrar (chief executive of the NHS Confederation) raised yesterday - that looking forward in the future means changing things from the past. He adds:

What is clear is that if we try to deal with challenges in the financial situation by simply cost cutting, we're not going to get anywhere.

He also says that: "There's not a day that goes by in my life when I don't think about the Staffordshire enquiry." Improving patient care and giving patients more of a voice are key themes emerging in his speech today.

12.31pm: Jessica Fuhl writes

We've also created another storify of tweets form this morning so far.

We're retweeting some of your reactions so let us know what you think of Nicholson's speech too.

12.28pm: Jessica Fuhl writes

Sir David Nicholson, chief executive of NHS in England is now up. He explains that "a strong confederation is really important for the NHS overall". He has worked in the NHS for over 35 years and says that he has "never known a time like it". Nicholson says:

I absolutely acknowledge the kind of personal consequences that are happening to people across the system. But for me that makes what we've been doing even more extraordinary. Quality and phenomenal progress has been made on literally saving lives. We've taken a whole set of changes around lonterm conditions, at the same time we've improved access to services. People should be genuinely proud and on behalf of the community that you serve, thank you.

12.25pm: Clare Horton writes

The commissioning board's draft mandate is due to be published next month, says Grant:

This mandate is not about history, it is completely about the future.

For the first time, he says, the government is setting out its expectations of the NHS in England for the coming one to 10 years.
The new system will only work through partnership, collaboration and co-operation.
He adds:

I want to deliver a culture in which mistakes are an opportunity for learning.

12.11pm: Clare Horton writes

The commissioning board will not dictate to clinical commissioning groups what to do, says Grant. He declares:

The top down approach is dead

12.05pm: Clare Horton writes

Prof Malcolm Grant, chair of the NHS Commissioning Board, is now deliving his keynote speech. Healthcare systems around the world are struggling, he says. No nation has a sustainable system.

12.00pm: Clare Horton writes

Speaking from the floor, Andy Bell, of the Centre for Mental Health, says health and wellbeing boards offer an opportunity to get local people involved in thinking about health priorities in their areas and what matters to them, but funding needs to be in place.

11.45am: Clare Horton writes

Sarah Pickup predicts the long-awaited social care white paper "will not contain many surprises". She says despite straitened times, "there is a degree of optimism".

11.39am: Clare Horton writes

David Orr, chief executive of the National Housing Federation, has proved a thorn in the side of the coalition government. Photograph: Martin Godwin for the Guardian

We need to integrate commissioning to involve housing, health and social care, says David Orr. He admits:

Easy to say, harder to do

Health and wellbeing boards, have the potential to do that he adds. Commissioning should be something that happens in the community, rather than in hospitals and nursing homes. He closes by saying:

We need to make this work. If we don't make it work, then the challenges we have at the moment about funding adult social care, in 20 years these challenges will seem insurmountable.

11.30am: Clare Horton writes

Today's keynote panel session has just begun. Sarah Pickup, president of the Association of Directors of Adult Social Services, David Orr, chief executive of the National Housing Federation, and Sir Merrick Cockell, chair of the Local Government Association, are discussing health and wellbeing partnerships.

10.56am: Jessica Fuhl writes

This morning's sessions have also included an interesting one on the relationship between the NHS and the press.

The panel for the debate included Branwen Jeffries (health editor at BBC television news) and Martin Barrow (health editor of the Times). Some of the points that came from the audience during the discussion was the possibility of the Department of Health implementing a more strategic approach to communications, and engagement with the press and public, as well as the media creating a greater space for education and explanation.

Don't forget to follow the debate at the conference on Twitter throughout the day using the hashtag #Confed2012.

10.10am: Lizzi Easterbrook writes

The doctors' strike is making a lot of headlines this morning, with the Telegraph reporting last night that two thirds of doctors were expecting to go about business as usual today. They suggest that this is a response to public criticism over the action and they reference a poll from yesterday which said that only a third of Britons backed the action.

The Independent are discussing the comments from Hamish Meldrum, chairman of the BMA this morning, who said that:

We doctors have enjoyed a good relationship, high trust, with their patients and we don't want to do anything to get rid of that, but what we feel we've had is lack of trust from the Government.

Our colleagues on SocietyGuardian will be covering all the latest news about the industrial action on a live blog throughout the day.

In other news, researchers at the Universities of Strathclyde and Newcastle have said that there is an urgent need to make primary school children more active. According to their study, girls are currently less active than boys, with some children only active for 20 minutes a day.

Our colleagues on Guardian Jobs have also informed us about some interesting job vacancies at London Bridge Hospital and Harley Street Clinic. You can find all the latest vacancies and advice on finding your next role on our website or visit our colleagues on stand B36 at the NHS Confederation annual conference

9.48am: Jessica Fuhl writes

Our colleagues Paul Owen and Denis Campbell are also live blogging the industrial action being taken by doctors today in response to pension reforms. You can read all the latest developments on that online here.

Health Secretary Andrew Lansley refered to the strike in his keynote speech yesterday at the conference, urging very strongly for doctors to "think again" about striking. He said:

I had direct meetings with the trade unions. I had meetings with the chair of the council of the BMA. He didn't turn up to a single on of those meetings, which doesn't say much. Rather than engage, the BMA choses to ignore the financial issues facing the NHS. We cannot prioritise doctors over other public service workere when we have to tighten our belts.

The BMA is seeking a less fair deal for NHS staff overall, something which others might not understand. Pensions will have to be paid for many many years after people stop paying a contribution. £83bn is the total cost of the pension scheme - around three quarters comes from the tax-payer. It is not fair and it is not sustainable. The BMA is creating uncertainty for patients who can only dream of getting a pension like that. I call for the BMA to think again.

9.44am: Jessica Fuhl writes

Morning all, myself and my colleague Clare Horton will be live blogging from the conference throughout the day today.

First up, one of the first sessions running this morning is one on the upcoming white paper. David Behan, the Department of Health's director general for social care local and soon to be chief executive of the Care Quality Commission, is leading the session and explains that he has had to concentrate on local Healthwatch for his presentation due to the delay in the white paper. He said:

I do think that organisers thought that we would be here by now [on the white paper] and to be honest, so did I.

He explains, however, how he envisages local Healthwatch working with health and wellbeing boards to develop join strategic needs assessments and joint health and wellbeing strategies. Behan explains that "making a difference" to patients, and providing "real joined-up care" is paramount.

The Guardian's public services editor, David Brindle, has recently explained the role that Behan will be taking on as the new head of the Care Quality Commission - something you can catch up on online here.

9.08am: Lizzi Easterbrook writes

Good morning and welcome to the daily blog from the Guardian healthcare network.

We are continuing our coverage of the NHS Confederation annual conference, and you can see all the news from the first day, including the speeches from Andrew Lansley, Stephen Dorrell and Mike Farrar on our live blog yesterday.

Today we will hear from Sir David Nicholson and Malcolm Grant as well as discussions on leadership and management, the relationship between the NHS and the media and integrated care. You can access the full agenda here.

We will also be tweeting from the event and you can follow us @GdnHealthcare and get all the tweets from the event using the hashtag #Confed2012

Today is also the first doctors' strike in over 30 years. They are protesting over changes to their pensions and will not undertake routine duties such as non-urgent consultations or repeat prescription requests. They will continue to deal with emergency cases.