NHS 'on high alert during change'

Surgical operation Ministers maintain the NHS is performing well despite the pressures

The NHS in England is on "high alert" to make sure there are no failings as it gears up for the biggest change in its history, the head of the NHS says.

In an interview with the BBC, Sir David Nicholson said the coming months were "significant".

The health service is currently busy getting ready for the government's reforms to go live in April.

Sir David said he was determined to make sure care did not suffer during the changes and bedding-in process.

Under the reforms, GP-led bodies, called clinical commissioning groups (CCGs), will take charge of much of the NHS budget, replacing primary care trusts (PCTs) which will be scrapped.

Sir David said: "I would say the NHS is on high alert in relation to the potential for quality problems as we go through the transition."

Productivity drive

Sir David also warned the health service not to take its eye off the bigger picture.

The NHS is at the start of a savings drive - it has been told to save £20bn by 2015 through becoming more productive.

Sir David said the NHS had "started well" but more change was needed.

Start Quote

There are signs that future years will be harder”

End Quote John Appleby King's Fund

His comments come as fresh fears have been raised that cuts will have to be made to the front-line of the NHS, if it is to cope.

The government promised to protect the health service, but research by the King's Fund, based on interviews with 45 NHS finance chiefs, raises doubts.

The majority said they were currently managing to make savings without harming care.

But the think-tank said 19 expected care to get worse over the next few years, and that 2013 could mark the turning point, with only eight believing it would get better.

Some 27 of the managers who took part in the online questionnaire also said there was now a high, or very high, risk that NHS would not meet its £20bn target.

Increased demand

Meanwhile, a BBC survey of 1,005 people suggested 60% believed services would have to be cut.

The poll, carried out by ComRes, asked members of the public in England a series of questions about the NHS.

Some 61% agreed that they expected the NHS would have to stop providing some treatments and services in the future due to rising costs and increasing demands.

Nearly three-quarters also said they did not trust the government with the health service.

Prof John Appleby, chief economist at the King's Fund, said: "There are signs that future years will be harder.

"The end of the public sector pay freeze next April may add to financial pressure and increase the strain on services.

"The difficulty will be finding ways to absorb these costs without compromising the quality of care for patients."

But health minister Lord Howe maintained the NHS was "on track" to achieve its savings target.

He said £5.8bn was saved last year, while performance remained good.

"Waiting times have been kept low, infections have been reduced, there are more doctors, more diagnostic tests and more planned operations," he added.


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  • rate this

    Comment number 115.

    The last round of cuts saw managers stripping frontline staff to a bare minimum. Is the next round going to see managers losing thier jobs? No as it is these people doing the cuts and will keep thier cushy office job safe. Mismanagement is why the NHS is so wasteful. Just look at th NHS organisation tree. Front line staff are the roots whilst it branches ever ever higher to the fat cats above.

  • rate this

    Comment number 114.

    This government wants good healthcare to be a preserve of the rich. They are all very rich and stand to make a nice tidy profit out of privatisation.

    As for the rest of us. We'll pay more US style without any tax cuts in return. The richest will avoid paying tax, whilst jumping to the front of the queue.

  • rate this

    Comment number 113.

    @109 lesdx

    "...the truth is current costs are more than this country can afford.".

    Will the nation be able to afford the future costs of a failing, poorly regulated and profit driven health sector? We have a blueprint of the Conservative's desired model in America; it spends more than any other nation and has some of the worst records re infant mortality and life expectancy.

  • Comment number 112.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this

    Comment number 111.

    The NHS is getting worse because this government hates public services. Didn't you realise the financial crisis was caused by lazy nurses in the bloated public sector with gold plated pensions sponging off the hard working bankers who pay for it all. Next time you are ill call your bank manager, he will be able to tell you whether you can afford to go private because all the NHS beds are taken.

  • rate this

    Comment number 110.

    The NHS must take care where imposing cuts.

    I am aware of midwives often working 12 hours plus on a single shift without having time to take ANY breaks. And who gets blamed should something go wrong and a new baby or mother suffers?

  • rate this

    Comment number 109.

    @101 Sunny Clouds 'One person in four has a mental disorder.'

    If you do some checking, I think you'll find the phrase 'at some time in their lives' appended to this statistic!

    REAL facts show how inefficient and wasteful the NHS is. Whether triggered by PFI, health immigration, or just poor purchasing, the truth is current costs are more than this country can afford.

  • rate this

    Comment number 108.

    'Care from cradle to grave, free at the point of need.'

    This is what the government extorts large sums of money from my pay packet to provide... so they had darn well better provide it or give me a refund! I pay tax so that citizens receive services, not so that bankers & politicians can live in luxury!

  • rate this

    Comment number 107.

    I can;t see how it could be much worse than it already is. An easy way tp save money would be to stop paying GPs huge amounts for a very limited and poor primary care "service" and stop free treatinment for non-citizens and immigrants who have made no contribution via tax and NICs.

  • rate this

    Comment number 106.

    Would love to see an advert where a nurse is treating a patient and a voice over says "I've gone ages without a break" and "I've had nothing to eat all day" "I have to work long hours to keep my job" ect and at the end you realise it isn't the patient talking to the concerned nurse. It is the nurse talking.

  • rate this

    Comment number 105.

    In my view the key issue facing the NHS is the horrific rise in rates of obesity in Britain. One now constantly encounters fat people waddling along the street munching pizzas, hamburgers, fried chicken and the like. The issue - and its impact on the NHS - is well-covered in a trenchant London-based news blog: http://www.wandswortheye.blogspot.co.uk

  • rate this

    Comment number 104.

    Does anyone know what my legal position is here? If a doctor refers me to a private health facility can I demand to be treated by the NHS instead? Moreover where is my legal redress if that private company fails me? Where exactly does the buck stop?

    Back-door privatisation plain and simple.

  • rate this

    Comment number 103.


    if i'm not mistaken, the amount of tax we pay hasn't decreased, and everyting is undergoing crippling cuts e.g the NHS and the Army.

    so tell me, where is this money going? The MP's second homes in france?

  • Comment number 102.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this

    Comment number 101.

    @79 lesdx "Incidentally, 10% of the NHS budget is spent on 'Mental Health Disorders'!" Are you so shocked that it is so much or so little? One person in four has a mental disorder. So when your sister gets postnatal depression or your brother gets PTSD or your cousin gets schizophrenia or your father gets dementia, you may begin to realise how hopelessly inadequate the mental health budget is.

  • Comment number 100.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this

    Comment number 99.

    we have reached this point because of many reasons.

    The incessant tinkering by politicians who have their own ideologies.

    The Greed of Pharmaceutical companies who will charge you an arm and a leg for a drug that costs pennies [Lets not forget that these companies are NOT living entities but a group of human beings gathered together for one goal]

    The huge increase in non-health personnel

  • rate this

    Comment number 98.

    This country is skint so cuts must be made. But we cannot allow these cuts to impact on the medical needs and care of UK citizens bear in mind costs will increase with improved medical knowledge/treatment.
    Privatisation will lead to short term savings but long term increased costs and reduced medical care so privatisation should be limited to walk in/out of hours GP services.

  • rate this

    Comment number 97.

    In some countries you pay a small sum for such things as visits to your GP. We should introduce this to discourage people wasting their GP's time with minor ailments such as colds.

  • rate this

    Comment number 96.

    How can it get worse? I read today that babies are dead today because of a virus they caught in a NHS hospital. That sounds like the worst it can get.


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