Health leaders don’t see how local plans can achieve required NHS efficiency savings

Sixty per cent of a panel of health leaders surveyed by the Nuffield Trust have said they are not confident that local efficiency plans will be able to achieve the savings the health service needs to deliver over the next five years.

Asked whether they thought their local areas had a credible plan in place to achieve the savings required this year, an even higher proportion (67%) were not confident, and only one in six respondents said they were very or somewhat confident.

One member of the Health Leaders’ Panel, which includes 100 senior clinicians, managers and other figures across health and social care, commented that against a backdrop of years of efficiencies already achieved, “opportunities to make yet more savings within this year will be very difficult to identify”. Another said: “We have credible plans in place and are making real change…. Positive changes are happening but will there be time?”

The overwhelming majority (83%) of respondents agreed with a statement from former health service Chief Executive David Nicholson that these financial pressures would lead to a “managed decline” of the NHS, with many respondents predicting increasing waiting times as a consequence.

Nigel Edwards, Chief Executive at the Nuffield Trust, said:

“Despite the Government’s pledge to increase funding by £8bn, the NHS will need to meet very ambitious savings targets over the next five years if it is to maintain the quality of care and patients’ ability to access it.

“It is worrying that a majority of members of our panel believe planned savings will be very difficult to achieve.

“Moreover, longer-term efficiency plans often appear to be based on achieving savings in areas that have proved very challenging in the past, such as avoiding needing to admit patients to hospital and reducing demand for services.”

Almost all (96%) of respondents thought delivering seven day urgent services, in line with NHS England plans, should be a priority. But there were warnings over the affordability of the plans, with one respondent saying: “The ambitions in the drive for seven day services are welcome, however there is a real challenge as to how these will be afforded. Even if the finances were available then the challenge would be to find the additional consultant physicians to be able to resource this.”

The survey also showed that:

• Just over half of respondents felt that pressure to comply with government guidelines was resulting in quality being compromised in other areas.
• When respondents were asked which budgets most needed to be protected for the sake of the public’s health and wellbeing, most pointed to social care for older people.