The scale of the productivity challenge facing the NHS is well understood. Health professionals and NHS managers have now had a year to prepare for the cold financial climate we are about to enter. In fact, many argue that the service is well placed to make significant productivity gains after record years of investment. Incremental change is not going to be enough, however, to yield the necessary £20 billion savings implied by growing demand, rising costs and flat revenues. Technical efficiencies are undoubtedly needed, but reforms will have to go further and consider what services are offered, by whom and in what locations. An underlying assumption, already reflected in the tariff for 2010/11, is that more care will be provided closer to the patient in the community and less in acute hospital wards. Much rides on getting this transfer right. If beds are lost before new services are in place, then patients will suffer. And Professor Chris Ham of the King’s Fund points out that the squeeze on admissions will either galvanise action to strengthen preventative healthcare or create financial difficulties and large job losses for hospitals.
Wilson R, "What price clinical innovation?", Health innovations: more for less in healthcare, Churchill N (ed.), The Smith Institute, 2010, pp28-37.