Head of NHS praises GPs’ plans for commissioning

BMJ 2012; 345 doi: (Published 14 November 2012) Cite this as: BMJ 2012;345:e7752
  1. Adrian O’Dowd
  1. 1London

The head of the NHS in England has praised GPs’ early plans for how they will take charge of commissioning care services from next year.

David Nicholson, the NHS’s chief executive, told MPs on the parliamentary health select committee that he had been impressed with the plans made so far by the new GP led clinical commissioning groups (CCGs) as part of an ongoing authorisation process.

The committee, holding an evidence session as part of its inquiry into public expenditure on 13 November, asked Nicholson how savings were being made in the NHS—in line with the government’s expectation of £20bn (€25bn; $32bn) of efficiency savings by 2014-15—and at what cost to the quality of care of patients.

MPs asked about situations where local NHS providers believed that they had to make “quick wins” to save money for required efficiency savings by cutting services.

Nicholson said, “If you are saying they are making short term cuts in order to balance the books then that is shortsighted and won’t deliver the medium and long term savings that we need. If we see that happening we would intervene to try and stop it happening.”

He said he was reassured about how money would be spent from next year and added, “We are going through a process at the moment of authorisation for all CCGs, and they are having to set out what they are doing, what their plans are for the future, how they are going to improve services and integrate care, and how they are going to develop their services for people with long term conditions.”

MPs asked where savings had come from for the latest £5.8bn efficiency savings made by the NHS in 2011-12, following evidence from a previous session in which other witnesses claimed that half of it had come from staff’s pay being frozen.1

Nicholson and his fellow witness David Flory, director general of NHS finance, performance, and operations, said that more than 90% of the savings were recurring, including £850m from staff’s pay being frozen and only 7-8% coming from sales of assets, such as land.

Other pay related savings included general productivity and efficiency savings, reductions in staff agency spending, falling absence because of staff sickness, and a reduction in “pay drift” in the system, which together came to around £1.5bn.

Earlier in the session MPs asked whether the savings expected by the government had had a negative effect on the quality of patient care.

Chris Hopson, chief executive of the Foundation Trust Network, which represents foundation trusts, giving evidence, said that the network had surveyed all its members. He said, “Broadly, the message it gives is that we are on course to achieve the challenge. The vast majority feel that it is not impacting on the quality of patient care. The issue is, going forward, how difficult it will be to continue that trajectory. What concerns us is that every trust, bar one, is reporting increased demand.”


Cite this as: BMJ 2012;345:e7752