The NHS is likely to miss its target to deliver £20bn (€25bn; $32bn) in efficiency savings by 2015, concludes the King’s Fund’s latest quarterly monitoring report, published on Thursday 27 September.

As well as analysing NHS performance as a whole, the King’s Fund surveyed 45 finance directors in July about the performance of their organisations for its report, How is the NHS Performing?1 Most (27) said that there was a very high or high risk that the NHS as a whole would not deliver the £20bn target, which has been dubbed the Nicholson challenge by ministers.2 And just four believed that there was little risk of failure.

This is despite the progress towards the four year target made during the past 18 months. Last year (2011-12) saw a small fall in NHS spending of 0.02% in real terms. As a …