NHS making great strides but financial worries and new reforms could derail agenda, says The King's Fund

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Responding to Sir Nigel Crisp's annual report on NHS performance published today, The King's Fund chief executive Niall Dickson said:

'Today's announcement is further proof that health services in England are improving. The NHS should be congratulated for bringing down waiting times, transforming accident and emergency services, and for making real progress in tackling coronary heart disease and cancer.

'But as our report today warns, the health service faces real financial problems and patient services will suffer unless the government deals with hospital failures better. The NHS is ill-placed to prevent hospital failure from happening and to deal with it when it does happen. We appreciate government moves to bring in turnaround teams to help failing NHS Trusts hit financial targets. But this is just a first step. We would like to see a more rigorous financial distress regime that identifies hospitals at risk of falling into debt, and a well-thought out system for intervening when hospitals experience deficits.

'This will become even more important as the signs are that the financial difficulties will get worse when the new health reforms begin to bite in earnest. These could magnify already large financial imbalances at a significant number of NHS Trusts with a real risk that some of them will fail. We're already seeing a number of NHS Trusts cutting back on services to balance their books, but it's vital that patients do not pay the price of failure.'

Niall Dickson added: 'Despite the financial worries, this could well be a turning point for the NHS. Extra investment and reform are bringing about big improvements, such as reductions in delayed discharges and management costs, as well as more doctors, nurses and other health professionals. The most significant has been the drive to bring down waiting times. The days of patients being stuck on long waiting lists seem at an end and politicians should take credit for this as the health service and health care professionals have underestimated the public's appetite for faster access to hospital treatment. On top of this, the offer of choice is exciting and will change the way people regard the whole health system. We welcome these improvements.

'However, we remain concerned that the volume and pace of change that is being imposed on the health service may be too great. The sheer complexity and scope of the new reforms could jeopardise the government's plans - not least the large scale reorganisation of the NHS that is likely to take health care managers' eyes off the ball. This represents a major structural reorganisation of the NHS over a very short period of time just when the health service is trying to get to grips with all the other major reforms it has been tasked with introducing. We must ensure that health service staff are allowed to focus on improving services to patients.'

The King's Fund today published a report into NHS finances which says the health service urgently needs mechanisms not only to deal with hospital failure but also to head it off before it happens.

How Should we Deal with Hospital Failure? Facing the challenges of the new NHS market, by Dr Keith Palmer, is free to download.

Notes to editors

  1. For further information, interviews, or a copy of the Dr Keith Palmer report, please contact the King's Fund media and public relations office on 020 7307 2585, 020 7307 2632 or 020 7307 2581. An ISDN line is available for interviews on 020 7637 0185.
  2. The King's Fund is an independent charitable foundation working for better health, especially in London. We carry out research, policy analysis and development activities, working on our own, in partnerships, and through funding. We are a major resource to people working in health and social care, offering leadership development programmes; seminars and workshops; publications; information and library services; and conference and meeting facilities.