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NHS chief warns of 'enormous' financial challenge ahead

By Susan McNulty

NHS chief executive David Nicholson has issued a grave warning about the scale of the financial challenge ahead, and said smaller hospitals and an expanded primary care sector will result.

In a speech to delegates at the NHS Alliance conference in Manchester, Mr Nicholson warned that the financial pressures facing the health service would be ‘massively greater than anything any of us have faced in the past'.

He invited comparisons between the current situation and in 2004/05, when 'the NHS was moving towards a £1bn deficit, which had people marching in towns and cities'

‘The challenge we face in the future is 10 times that. Its absolutely enormous, and its over a sustainable period,' he warned.

Mr Nicholson said it was imperative that primary and community care took on a bigger proportion of work from secondary care, and said it was possible to improve quality and reduce cost, by focussing on areas such as long term conditions, and greater integration of health and social care.

However, he said that while there was some good examples of that kind of approach already, he concluded that the service had so far failed to make it happen.

‘We are going to have to [make it happen],' he said.

‘The engine for that change is primary and community care. The outcome to all of this is significantly smaller secondary care organisations, and we have to be clear to the politicians and the public of its consequences.

‘It doesn't mean we hate hospitals, but a lot of the things that we do in hospitals simply cost a lot of money and don't deliver the quality of service for our patients.'

NHS chief executive David Nicholson NHS chief executive David Nicholson

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