NHS financial crisis is “worst ever,” managers warn

BMJ 2011; 343 doi: (Published 11 July 2011) Cite this as: BMJ 2011;343:d4327
  1. Helen Mooney
  1. 1Manchester

NHS leaders have warned that the NHS faces a dire financial situation that will risk patient safety and clinical outcomes.

An NHS Confederation survey published on 6 July shows that NHS managers are also worried that patient access will worsen in the coming year and that waiting lists will increase.

The survey of NHS chairs and chief executives, conducted ahead of the NHS Confederation’s annual conference, showed that nearly 90% thought that the financial situation facing their organisation was “the worst they had ever faced” or was “very serious.”

Responses from the survey, carried out by the Picker Institute in May and June, came from 287 chief executives and chairs at 243 organisations—half of the confederation’s membership base.

Over half warned that patient access, including availability of care and waiting times, would also worsen substantially after the government’s changes to the NHS.

NHS Confederation chief executive Mike Farrar said: “People will overlook these worrying results at their peril. This is the view of those who run the service, who will implement the reforms, and on whom the immediate future of the NHS depends.”

He warned that it was getting harder to maintain the “great progress” the NHS had made in quality of care, and added that there was now concern about the speed of access to services.

Mr Farrar said he was also concerned that government reforms would lead to “excessive centralisation, bureaucratic restrictions on the freedom to act of local commissioning groups, the continued attack on management, and the lack of political courage when reconfiguration of services is justified on quality, safety, and on cost grounds.”

Asked what would help most to overcome external barriers and difficulties, 68% of those surveyed named certainty over NHS reforms, 53% said stronger partnerships with local government, and 32% said strong political support at a local level.

Only 15% named increasing clinical involvement in leadership and management as one of the top actions they were taking to safeguard and improve the quality of services.

Comments made by chairs and chief executives as part of the survey showed a degree of negativity towards the NHS reforms.

One manager warned: “Generally there will be an increasing postcode lottery, and the fragmentation of the NHS will occur. The underlying issues around value for money will not be addressed.”

Another added that there would be “longer waiting times, higher thresholds for putting people on waiting lists, [and] rationing.”


Cite this as: BMJ 2011;343:d4327