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 335.

    The NHS has a DUTY to the people to NOT meet the tergets. It should not be asked to reduce spending at the same rate as other less impportant ones. Reducing entertainment costs would be an appropriate start for all areas of Gov. not patient care.

  • rate this

    Comment number 334.

    Well done to all those NHS workers (or should i say plebs) who voted Tory, who were duped by airbrushed Butch Flashman :"I'll cut the deficit not the NHS" - yeah right.
    Turkeys voting for X-mas comes to mind. Still the already overpaid GPs will do very nicely out of thank you as they create mega empires.

  • rate this

    Comment number 333.

    If the problems facing the majority were served and those which treat the least number were cut it would be closer to the National service as intended. Life threatening as in physical problem is given more priority than depression which is also life threatening. Mental health provision will help more people back into work than one expensive operation. Sad....but

  • rate this

    Comment number 332.

    Management cost make up roughly 3% of total NHS spend, so if we scrapped the lot we'd make roughly £3Bn of savings - less than 1/3 of total savings the Govt are after.

    Some of those jobs might be a waste of space, but many are not & do we really want our Drs doing paper work rather than treating patients......

    ...& where would the other £7bn of savings come from...???

  • rate this

    Comment number 331.

    Where are these monumental savings to come from? You could knock a nought of each manger's salary & you'd be lucky to save a few million, let alone £10bn....

    The pro market capitlism WTO recently declared the NHS to be the MOST EFFICIENT health care system in the delevoped world...where will thse savings come from?

    We need figures for what amounts any given change will actually bring in...

  • rate this

    Comment number 330.

    Its a good job some people on this forum weren't around 200 years ago as you as so afriad of change nothing would ever happen.They are talking about saving £20bn, the NHS IT project that the last government made a mess of was £19bn.Savings can easily be found that dont affect pateint care, whether they will or not is down to the senior management in the NHS who I have little respect for.

  • rate this

    Comment number 329.


    On it's own like the information is utterly uselss. For it be worth placing as evidence you need to do two things:

    A/. Find out & provide information on the annual turnover of the NHS organisations who placed those adverts.

    B/. Look up a representative sample of businesses turning over the same sums of money every year & find out/tell us what their senior staff earn.....

  • rate this

    Comment number 328.

    "Innovation Is The Key To Success". My contribution to reduce demand & protect fellow human from wrong doings that go on in the NHS due to understaffing, using un-trained medical professionals to work like doctors help NHS sustain. Please test my hypothesis "Education using a simple tool "MAYA" developed with passion to alleviate pain & suffering" criticise me if I am wrong or join in to support.

  • rate this

    Comment number 327.

    My wife has recently handed her notice at a Hospital in Birmingham, the last two years have just got worse and worse, and now she can't cope anymore. She was a Healthcare Assisstant, the cuts are absolutely disgraceful, the care of people in the hospitals has never been worse, the pressure and risks to workers and patients is deteriorating down so quickly.
    What the hell is going on?

  • rate this

    Comment number 326.

    The NHS is, or at least should be, one of Britain's proudest achievements. A robust and reliable system that treats everyone, regardless of their financial situation. Having seen the healthcare system in other countries, they're not a patch on the NHS.
    I sincerely hope that someone slaps Cameron round the face until he gets it into his thick, Tory skull that privatisation is a bad idea.

  • rate this

    Comment number 325.

    A major problem with the NHS is that Britain treats the world, paid for by British tax-payers. The simple answer is a contribution-based system adopted by so many European countries including France and Spain. Treatment is free for qualified contributors and British children - the rest pays or fall into a charity scheme. What can be fairer?

  • rate this

    Comment number 324.

    The number one problem with the NHS is that 80% of hospital doctors cannot diagnose a fault first, second or third time. Paitents end up getting shipped from ward to ward and then discharged still half ill which means they have to come back again time and time again and all this costs millions. Bring back the matrons would be a start.

  • rate this

    Comment number 323.

    NHS jobs from the Guardian (where else!) job pages today:

    Chief Operations Officer £100,000
    Director of Healthwatch £90,000
    Assistant Director - Community Services £83,549
    Economics Director £108000
    Head of Commissioning and Partnerships £82000
    Chief Executive £85000

    Any PCT Director that hires this sort of employees whilst sacking front-line staff should be fired immediately!

  • rate this

    Comment number 322.

    Yes, change is required - for example cut salaries for senior medical and administrative personnel; educate staff to drop their pompous and patronising attitudes; and ensure wages are increased to a decent level for the staff who do most of the work, like the nursing auxilliaries and porters

  • rate this

    Comment number 321.

    "... there was now a high, or very high, risk that NHS would not meet its £20bn target."

    Of course it won't, it is being set up to fail so the gallant knights of the US health care corporations will be called in, banners streaming, to 'rescue' it.

  • rate this

    Comment number 320.

    to those who advocate paying to see the GP, that's fine if you are working getting an income, what about those without a job?

    =>Add the duty smokers pay onto the profits made from prescription charges and you pay for the NHS. You'd be surprised the number of people who still pay £7-something for 16 paracetamol.

  • rate this

    Comment number 319.

    I think if the government just left the NHS alone it would sort itself out.

  • rate this

    Comment number 318.

    Dentists, very expensive. If you are diabetic, how much will that cost you every month for medication? Some medication for that illness is on restriction, by the gov, or drug companies, as we find out when we have to re-order every month. U can bet the Gov will still want the N.I. contributions every month! I wonder, is it a way for the Gov to bump of the O A P quicker? and save money?

  • rate this

    Comment number 317.


    I think a lot of doctors problems arise from the fact that they are no longer revered and repected members of the community.

    Patients understand when their doctors are cutting corners and taking it easy - not the nice cushy number it used to be.

    Doctors are now being held accountable for mistakes, but the job is what you make it

  • rate this

    Comment number 316.

    Correct. How soon people forget it was Blair's government that began to farm out NHS services to the private sector

    =>How on earth were people bluffed by Blair, the rightist liebour guy on the block. Lawyer, with a barrister/judge for a wife and they're Labour? Yes, it was him who started this rot in the NHS


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