Introduction

To be effective, values-based practice demands leadership that ensures the values of all those involved are obtained and used to decide on the right commissioning programmes. We have seen the importance of priority setting and resource allocation and we have supported the Department of Health Right Care programme that places an emphasis on programme budgeting and marginal analysis (PBMA) (Brambleby et al., 2010) and mechanisms for making rational decisions about priorities. Those priorities usually address groups if not whole communities; and we were concerned that the Right Care programme did not emphasise enough the need for values to be incorporated formally and widely in the decisions taken.

Values-based leadership supports the importance of V-BP. As we shall see, there are a number of important processes that support V-BP and go beyond those correctly suggested by the Right Care team. If we are to have a values-based system, what do we need to do to ensure that it is effective? First we need to enshrine values diversity in the process of capturing values; and second, to use values diversity to provide the framework for reviewing the evidence and the background information on which to make commissioning decisions.