Pessimism grips NHS managers

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New research has indicated that the financial squeeze is beginning to have an impact on quality and access to NHS and social care services.

Health think tank The King’s Fund said pessimism is growing among local leaders in the NHS and social care, according its the latest quarterly monitoring report on service performance.

For the first time, the report includes a survey of directors of adult social services in English local authorities alongside its usual survey of NHS finance directors.

Both surveys suggest that the financial squeeze is beginning to have an impact on quality and access to services in some parts of the country.

A third of NHS finance directors report that the quality of patient care has worsened during the last year and more than a third of social services directors expect to have to cut services over the next year.

Professor John Appleby, Chief Economist at The King’s Fund, said:

“The NHS faces unprecedented financial pressures, and there are growing worries that patient care will suffer.

“For social care, it will be increasingly difficult for councils to make further savings without directly cutting services or affecting quality.

“Health and care services have coped well until now, but it is clear that many organisations expect things to become much more difficult over the coming year.”

While most NHS organisations are on track to meet financial targets, pressures are growing towards the end of the second year of the so-called Nicholson Challenge to find £20bn in productivity improvements by 2015.

The survey found that one third of NHS finance directors report that the quality of patient care in their area has worsened during the past year.

Two thirds were pessimistic about the financial state of their local health economy.

With local authorities grappling with the second year of a budget squeeze that will see an overall cut of 27 per cent in central government funding by 2015, directors of adult social services were also are pessimistic about the financial outlook.

Financial pressures are set to have a significant impact on access to services, with more than a third anticipating having to reduce services and nearly a fifth expecting to increase charges over the next year.

Nearly three-quarters said that they are pessimistic about the overall state of the local health and care economy over the next 12 months.

The King’s Fund said with more than a quarter of trusts reporting breaches of the target, it is clear that many hospitals are struggling to maintain performance in emergency care.