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Managers predict “managed decline” of NHS due to finances


25 September 2015

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More than 80% of health leaders agreed that financial pressures would lead to a “managed decline” of the NHS, a survey from think-tank Nuffield Trust revealed.

The majority (83%) of respondents agreed with a statement that David Nicholson, former health service chief executive, told the BBC in April. He said that financial pressures would lead to a “managed decline” of the NHS.

More than 80% of health leaders agreed that financial pressures would lead to a “managed decline” of the NHS, a survey from think-tank Nuffield Trust revealed.

The majority (83%) of respondents agreed with a statement that David Nicholson, former health service chief executive, told the BBC in April. He said that financial pressures would lead to a “managed decline” of the NHS.

Nearly two thirds of the Health Leaders’ Panel, which includes 100 senior clinicians, managers and other figures, said they are not confident that local efficiency plans could achieve the savings required, and many predicted that increased waiting times would be a consequence of this. 

Nigel Edwards, chief executive at the Nuffield Trust, responded:
 “It is worrying that a majority of members of our panel believe planned savings will be very difficult to achieve. 


“Moreover, longer-term efficiency plans often appear to be based on achieving savings in areas that have proved very challenging in the past, such as avoiding needing to admit patients to hospital and reducing demand for services.”


Almost all (96%) of respondents thought delivering seven-day urgent services should be a priority, but there was common concern over the affordability of this.

When respondents were asked which budgets most needed to be protected for the sake of the public’s health and wellbeing, most pointed to social care for older people.

The survey also showed that just over half of respondents felt that pressure to comply with government guidelines by 2020 was resulting in quality being compromised in other areas.

One respondent said: “We have credible plans in place and are making real change… Positive changes are happening but will there be time?”


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