MPs must do more to support GP commissioners in making difficult decisions on whether to close hospitals or other services, the chief executive of the NHS has urged.
In his closing speech to the NHS Confederation conference in Manchester, Sir David Nicholson said it was crucial that politicians backed clinical decisons on reconfiguration, and made the case to the public where neecessary.
Sir David told delegates that it was 'the most difficult time for the NHS', but praised NHS managers for their work on delivering QIPP efficiency targets in the face of the huge upheaval caused by the Government's NHS reforms.
But he warned that failing to address the need for service redesign was 'the greatest danger to quality and safety we face', and said QIPP would not be deliverable without difficult decisions being made.
He told managers: 'If you take the service change out of QIPP, you end up with just national action.That is the greatest danger to quality and safety that we face. Service change is not an added option. It's not something we can put off until the next general election. We need to do it now. The alternative is reducing quality and increasing cost improvement programmes.'
'Where we have the evidence and the clinical support to make service change which improves quality and reduces cost we should expect our politicians to support us, to take those arguments forward to their local communities. As difficult as that is, they need to do that. The alternative is real problems for the NHS. So that challenge for politicians I think is particularly critical.'
He added that it was imperative that PCT bosses retained a tight grip on the system in the short-term to give emerging clinical commissioning groups as much support as possible prior to the handover in 2013.
He said: 'You need the pace to move it forward but you also have to be really careful. We need to let go but we need to keep a grip. We need to make sure that we're giving clinical commissioning groups power and responsbilities, and the ability to make the changes that we need and service redesign.'
Sir David also sounded a note of caution over the Government's new transparency measures announced by Prime Minister David Cameron.
Sir David said: 'We are all in favour of transparency, but what we can't have is a series of witchhunts that go on around the system. Where people have got poor quality, they need help and support to make it better.'