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Gold, incentives and meh

NHS chief exec questions £1.4bn management costs

By Susan McNulty

PCTs and SHAs spend £1.4bn a year on paying managers, NHS chief executive David Nicholson has revealed, as he admitted that some of the money could be 'spent better'.

Speaking at the National Association of Primary Care annual conference in Birmingham, David Nicholson spelt out the challenge ahead for the NHS and the need to focus on quality.

He said there was a need to focus on areas that would make a ‘big difference' for patients.

He added: ‘We spend £1.4 billion on running costs of PCTs and SHAs.'

'Can we genuinely say that that money is spent to best effect? Can we say all of that money is there to support and facilitate services for patients?'

‘Can some of it be spent better? Can we organise ourselves in a better way? The answer is undoubtedly "yes".'

An ‘obsession with organisation' was holding back the transformation of community services, he said.

‘When you talk to people about community services they want to talk about governance issues. That's not what's going to win this battle.'

NAPC president Dr James Kingsland, who spoke after Mr Nicholson's address, asked the conference: ‘Why would David Nicholson tell us [the £1.4 billion figure]? Why would he question that? It must be that we need to use that better and more efficiently.'

Mr Nicholson also said that an announcement on changes to Payment by Results will be made before the end of the year.

‘There is a whole series of things we need to do to PBR,' he said. ‘PBR gives incentives to do more and more. It does not give incentives to improve quality and reduce costs.'

NHS trusts spend £1.4 billion on management costs NHS trusts spend £1.4 billion on management costs

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