If the Modern Service Framework is to deliver meaningful change it must be more than a well-intentioned ambition. ICBs and the Department need to be held accountable for meeting the Framework, with clear consequences if its standards are not met. We call on the Government to set out, in its interim Report this Spring, what accountability arrangements will be in place to support implementation of the MSF and what concrete steps the 35 Department will take with ICBs that fall short. The Government must also ensure that ICBs have the support, tools and resources they need to deliver on the MSF. (Recommendation, Paragraph 18) Commissioning