NHS report - Good progress but major challenges ahead

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The King's Fund today warned the government that it faces significant challenges if it is to build on the big strides it has made in the NHS in recent years.

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

'Today's announcement is further proof that health services in England are improving. Sir Nigel has reason to be pleased - waiting times are coming down, accident and emergency services are improving and real progress in being made in tackling heart diseases.

'But this should not prevent us from recognising the fact that many services are still not good enough nor should it obscure the reality that we are entering a very uncertain period for the NHS. We are embarking on a major experiment using market forces and promoting patient choice. These changes together with new systems of payment should benefit patients - but if not handled well there is a chance we will see unnecessary instability. It is also vital that the disadvantaged as well as the more assertive and articulate are able to take advantage of the new system.'

The King's Fund believes there are several major challenges facing the NHS.

These include:

  • Managing the new NHS market: the economic regulation of the new market developing in the health service needs much more work - if services are not delivering patients should not suffer. We have to avoid unnecessary financial instability, but accept that the pattern of services will change. 
  • Commissioning: secondly, the government must get to grips with the whole area of commissioning services which remains the Achilles heel of the health service.
  • New focus on 'forgotten' areas: mental health, the care of older people and improving care for the 17 million people in the UK with long-term conditions have traditionally been neglected. Although the King's Fund welcomes the improvements that have been made, the government must keep to its pledge to give them higher priority.

On the day of Sir Nigel Crisp's progress report, the new Secretary of State for Health Patricia Hewitt made her first speech and outlined plans to expand the use of private contractors to carry out routine procedures on the NHS.

Commenting on this, Niall Dickson said:

'In effect the government is saying that it doesn't matter, in principle, where patients are treated as long as providers adhere to NHS standards and that care is free at the point of use. That is also the view of most patients and we welcome it. But as well as the obvious advantages it's clear there are potential pitfalls. This will have significant implications for NHS institutions and core services, as well as the training of doctors. The key point is that patients do not suffer as services adjust to new realities.

'In her speech today, the health secretary continually referred to extra funding being pumped in to the NHS up till 2008, which is welcome. But the key question is what happens beyond 2008 and how the health service will cope with lower levels of growth. This is a real area of concern - from then on the NHS could be in for a bumpy ride.'

Notes to editors

1. For further information or interviews, please contact The King's Fund media and public relations office on 020 7307 2585. 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 grants. We are a major resource to people working in health, offering leadership and education courses; seminars and workshops; publications; information and library services; and conference and meeting facilities.