A few weeks ago, The Times carried a front-page article purporting to reveal "a secret NHS plan to ration patient care". It turned out to be about proposals to monitor the way London GPs refer patients to hospital, with a view to reducing higher referral rates and saving £25m a year to reinvest in other forms of healthcare in the capital. All in all, no bad thing.

At the other end of the scale, though, some patients are not getting the hospital referrals they merit. And an analysis for Society Guardian by Dr Foster Intelligence, the main findings of which are outlined here, offers strong evidence that such patients are likely to be from disadvantaged groups and localities. As Nigel Edwards, policy director of the NHS Confederation, observes: "The level of need is not a terribly good predictor of whether or not you use outpatients."

Getting a better handle on referral patterns, and then acting to ensure greater consistency, is one of the ways in which the NHS will need to sharpen its act in coming months, as the service recovers from the shock of record debts and prepares for lower funding increases post-2008. Launching the new NHS Institute for Improvement and Innovation earlier this week, health minister Andy Burnham said improved efficiency could save £700m a year, including £50m by halving the number of unnecessary outpatient appointments.

This special pullout seeks to get behind the recent "NHS in crisis" headlines, however, by looking at some of the ways in which healthcare is changing for the better - in terms both of greater efficiency and, at least as important, of greater sensitivity to people's needs. On page 2, for instance, we describe a breakthrough in dialysis care with the potential to transform the lives of kidney disease patients by freeing up their daytime hours. On page 3, we assess a new bid to reinvigorate local government's role in public health and fulfil councils' potential to improve disease prevention. And on page 4, we look at a new joint degree course in social work and nursing, whereby students will be placed with families to get a better understanding of the often unmet healthcare needs of people with learning disabilities.

You won't hear as much about such initiatives as you will about NHS debts and cuts, but that's the nature of politics and the media.