while the nhs wales planning framework seems a useful step towards clarifying planning expectations there still seems to be scope for the government to be more prescriptive about exactly what is expected in terms of financing and budget allocation performance and efficiency and quality achievement and improvement from health boards and the providers they oversee the welsh government is already beginning to explore some of these issues for the health system as a whole and for health boards in the consultation document green paper our health our health service welsh government a and with the integrated medium term plans more also needs to be done to support health boards as they try to deliver meaningful and more significant system change with a focus on good collaboration between the welsh government and the health boards building technical managerial and leadership capacity in health boards and sharing of experiences and expertise across health boards and systemwide other oecd countries also struggle with the balance between national standards and control and local freedom and innovation and some offer lessons that wales could learn from box