‘Treacherous waters’ ahead for NHS, says King’s Fund

28 Nov 12
The NHS is in a ‘precarious’ position as it grapples with major organisational change and financial pressure, the King’s Fund has warned.
By Vivienne Russell | 28 November 2012

The NHS is in a ‘precarious’ position as it grapples with major organisational change and financial pressure, the King’s Fund has warned.

In a mid-term review of the coalition government’s health policy, published today, the think-tank drew attention to the rising number of hospitals in deficit, particularly foundation trusts, and increasing Accident & Emergency waiting times. Structural changes and the loss of experienced managers ‘leave the service in a precarious position’, it said.

However, the review also highlighted some consistent improvements, including a reduction in healthcare-acquired infection rates and £10bn saved through the Quality, Innovation, Productivity and Prevention scheme.

Anna Dixon, director of policy at the King’s Fund, said: ‘The NHS is continuing to perform well but there are treacherous waters ahead. There are huge risks, particularly in ensuring that quality of care does not suffer with the further financial squeeze. The stakes for patients could not be higher, and frontline leaders will have a crucial role to play in meeting the challenges ahead.

‘Neither competition nor commissioning reform alone can be relied on to make the improvements needed. Fundamental change will be required to address the challenges of the future as the population ages and health needs change.’

The report also found that, despite ministerial rhetoric, the shift from the previous government’s target- and performance management-driven approach towards one focused on outcomes, transparency and competition had been gradual. Much of the previous system still remains in place, it said, and more time was needed to judge the impact of the government’s health reforms on NHS performance.

Mike Farrar, chief executive of the NHS Confederation, said the King’s Fund had produced a ‘fair and reasonable report card’ on the health service’s performance.

He added: ‘However, it is clear that there are a number of areas where we have to do much better. In particular, we need to do much more to make sure that every patient receives dignified care every time, and maintain a strong focus on reducing emergency admissions and avoidable mortality. We cannot afford to let standards slip in these important areas.

‘A growing number of organisations are finding themselves being pushed towards a cliff edge and tough decisions need to be taken if they are to recover their financial footing and deliver better care.’

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