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 155.

    I' ve not forgotten what thatcher did to the NHS, she destoyed it cutting beds, closing hospital, sacking nurses and doctors. It took years for the labour government to rebuild. Now cameron and osbourne will make it even worse than she did. The NHS is not safe in the hands of the tories , never has been and never will be. in fact nothing is safe in the hands of the tories, never will be.

  • rate this

    Comment number 154.

    Just found out I have to wait even longer for my next physio appointment because they got rid of another two of his colleagues this week, and the remaining professional staff are expected to take over the patients.
    Because of course his existing over-full diary could be squeezed somehow.

  • rate this

    Comment number 153.

    All this will lead to is having doctors who we are supposed to trust to give us the best treatment to now advising us to get the cheapest for them.

    This will slowly undermine their credibility....

    remember when bank managers were trusted to give you best advice ?

  • rate this

    Comment number 152.

    How remarkable I would have expected everyone to just hope for the best rather than be on the look out for problems in any change! Hang about what about their holidays, or golf game.

  • rate this

    Comment number 151.

    The country can easily afford the NHS if we want it, what we can’t do is provide the same excellent NHS on the cheap.

    This government want to privatise the NHS not because it’s too expensive but because it is a shining example of a nationalised service.

    Do you want a superb, universal NHS paid for by general taxation or pay as you go only the rich can afford; I know which one I want

  • rate this

    Comment number 150.

    An "NHS savings drive" can only be bad news for the rise of MRSA. I have personal experience of how the current level of cleanliness in hospitals is unacceptable. If you reduce the budgets that can only get worse.

    I do not blame the doctors and nurses but the hospital management and politicians. The current quality procedures are not effective enough, if the cut the budgets they will worsen

  • rate this

    Comment number 149.

    The NHS has been bled dry by the way in medical staff (the "doctors") use every opportunity of changes in their work to argue for an increase in salaries. This is matched only by the incompetence of successive governments in giving way to the blackmail involves. E.g., they got an increase to compensate for doing "out of hours" work, and then another increase to compensate them for not doing them!

  • rate this

    Comment number 148.

    By "Biggest Change in NHS History" you mean this Tory government's stealth privatisation that will see 10's of billions of pounds of tax payers money go into the hands of a small number of corporations, with tax avoiding executives and Tory party funding and future directorships for those who are currently pushing this through.
    Stay healthy people, you now have no option.

  • rate this

    Comment number 147.

    the trouble with the so-called reforms is that no-one in parliament et al will be the subject of these changes, they are alright jack, it's the rest of us that will have to wait, join this queue, join that queue, wait,wait wait!!

  • rate this

    Comment number 146.

    @redhotific You need to get away from the idea that you pay your taxes and you can do whatever you like. Its that attitude that puts so much pressure on public services in this country. Regardless of whether you pay taxes or not there should be a recognition that we can't pour money down the drain on patching people up who simply don't deserve it. There's better money that could be spent on.

  • rate this

    Comment number 145.

    The main reason the NHS is broke is because doctors salaries were grossly inflated from about 60k to over 100k sometime back; of course, there is no way any government can continue to finance it, with 100k-plus salaries.

    The only way out is for doctors to agree to go back to the old salaries or NHS privatisation, which the authorities seem to favour. Everyone for him/herself.

  • rate this

    Comment number 144.

    There is NO "could" at all!!

    WILL is definitely there.

    It's rare that I swear but this "£$$$^%&&^%" government should be ashamed for even existing

    It's about PEOPLE not about pounds.

    It's greedy nasty people who think money first people second and sadly this country is full of them and even worse people vote for them.


  • rate this

    Comment number 143.

    I have an ongoing medical condition- I've lost count of the times I've been given a course something to 'try' instead of having any tests (medication works out cheaper than the test). It's been going on for 3 years, and would have been cheaper to get the tests in the first place.

    I in favour of introducing charges - my NHS dentist charges £10-25 for a missed appointment, GPs should do the same.

  • rate this

    Comment number 142.

    The NHS and others complain about smokers and yet we help fund it . Also I'm going to die younger , so I'll be doing the NHS a favour by not becoming an old wreck in my nineties .

  • rate this

    Comment number 141.

    I heard this on BBC News this morning "nearly half of NHS managers expect care to get worse". Try a different perspective on story "58% of NHS managers think they can achieve the necessary savings without harming care in future and the majority also think they are currently achieving this" BBC should report balanced news not simply provide a platform for any group against reductions in spending

  • rate this

    Comment number 140.

    My son-in-law went to Medical Centre, Herts, for his back problems and was told that no x-rays or scans would be done due to lack of NHS money. He was told that if he felt it was neccessary he would have to pay for it himself privately.
    What is going on?

  • rate this

    Comment number 139.

    We have a problem? With an aging population more not less, services will be required. Yet, this is one area that tends to bare the brunt of financial constraints. There are signs this is already a reality, with a number of essential services now being provided by the Voluntary sector. My motto is: I cannot die before my wife.

  • rate this

    Comment number 138.

    John Major's government introduced PFI, they were carried on by Blair & although Osborne made out he was against them he authorised £6.9 billion of them in his first year and has continued to do so. Company house stated that of the top 12 PFI's the rate of return to the private companies was 58%! Banks lending our money to build our Hospitals, Schools etc and getting 58% profit for doing it.OMG!

  • rate this

    Comment number 137.

    I'm trying to think when outsourcing has been a success. All the ones that I know of have resulted in less quality and more costs to the taxpayer with private firm's HQs being based in tax havens so they don't even pay tax on their profits. It is even worse for PFI. Look for any recent ex-public servants (politicans and civil servants) on these boards. IT'S A GRAVY TRAIN!

  • rate this

    Comment number 136.

    People from abroad should not get free NHS treatment unless they have lived continuously in this country for at least 3 years. Too much NHS money is being spent on those who have paid nothing into the system.


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