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Government reforms 'too far too fast', warns King's Fund

By Gareth Iacobucci

The Government is moving too far too fast with some areas of its reform of the NHS, and should reconsider the pace and scale of its changes in order to deliver benefits to patients and improve NHS performance, the King's Fund has warned.

In its response to the Government's NHS White Paper, the influential think tank said it supported many of the proposals, including an enhanced commissioning role for GPs, but warned a ‘fundamental reorganisation of the NHS' was unnecessary given that ‘health outcomes and public satisfaction have improved in recent years'.

It argues that the scale and speed of reform will distract attention from finding the efficiency savings needed to maintain quality and avoid cutting services, as the NHS faces ‘the most significant financial challenge in its history'.

The Fund is the latest high profile organisation to raise its concerns about the speed and scope of the plans, with the BMA and RCGP issuing similar warnings in their consultation responses.

But despite the growing opposition to his ambitious timetable for reform, health secretary Andrew Lansley remains bullishly committed to his plans, telling the Tory party conference earlier this week that he would accelerate the shift of commissioning responsibility to GPs and proceed with plans to axe PCTs.

As well as giving GPs a stronger role in commissioning, the King's Fund said it also supported extending choice for patients and enhancing the role of local authorities in the health system.

But it urged ministers to think again about their plans for implementing the reforms, identifying key areas where it believes a more measured approach to implementation would be welcome, including:

• Giving GPs who are ready to embrace GP commissioning ‘real' budgets for some services as soon as possible and using their experience to inform the national roll-out, rather than imposing the GP consortia model in all areas of the country by 2013

• Streamlining NHS structures over time as new GP consortia get up to speed instead of abolishing primary care trusts and strategic health authorities in 2013

• Balancing the need for a regulatory framework that promotes competition to drive up quality, while encouraging collaboration where services should be co-ordinated - for example, in meeting the needs of older people and those with long-term conditions.

Professor Chris Ham, chief executive of The King's Fund said: 'There are areas where NHS performance needs to improve and we support many of the proposals in the White Paper. But we question the need to embark on such a fundamental reorganisation as the NHS faces up to the biggest financial challenge in its history.

‘I hope ministers will think again about the plans for implementing these proposals. This does not mean putting the brakes on across the board. In some areas, they could in fact move more quickly by beginning to test out and evaluate how key elements of the reforms will work in practice.'

Professor Chris Ham The Commissioning Countdown… Are you prepared?

The clock is ticking the end of the consultation on proposals on next Monday for the health white paper - Liberating the NHS: commissioning for patients. With the end looming, there is still a huge amount of uncertainty within the healthcare community, with questions being thrown up around the work and responsibilities that will be involved in the ‘new' NHS.

Come to the NAPC Annual Conference to hear from Andrew Lansley, secretary of state for health and help answer your pressing questions.

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