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Efficiency drive ‘could harm patients’, experts warn

By Gareth Iacobucci

The NHS's drive to save billions of pounds in ‘efficiency savings' is likely to cause 'substantial damage' to patient care, experts have predicted.

The warning came during a head-to-head debate at the King's Fund, where leading doctors, academics and economists debated the potential impact of making billions of efficiency savings to the NHS.

Professor John Appleby, chief economist at the King's Fund, said he did not believe the NHS could cut costs without significantly damaging patient care.

He warned: ‘The NHS is poor at measuring quality, and what goes "unobserved" can be at risk when the misplaced focus is on what gets measured - savings.'

From a primary care perspective, Professor Appleby warned that PCTs would have no choice but to ‘decommission relatively low value care in favour of high value care'.

He said that while there was nothing wrong with this in principle, it could allow for ‘one patient's welfare to be traded off against another's', and risked causing ‘a reduction in quality'.

Professor James Owen Drife, professor of obstetrics and gynaecology at Leeds Royal Infirmary, also warned that patient care would suffer from cuts.

He said: ‘In today's maternity services, senior midwives and doctors have to comfort younger colleagues reduced to tears by the disparity between what they want to do for patients and what they can do.'

‘This is just one example of the human cost of the bland phrase, ‘efficiency savings,' that we shall hear so often in the coming years. Does all this amount to substantial damage? I think so.'

But Dr Rebecca Rosen, a GP in south-east London and senior fellow at the Nuffield Trust, said it was ‘not inevitable that cost cutting will reduce quality', arguing that ‘much activity has no value in the NHS so it can be cut without detriment to clinical outcomes or patient experience'.

Professor John Appleby: NHS cannot cut costs without significantly damaging patient care Professor John Appleby: NHS cannot cut costs without significantly damaging patient care