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Scrapping PCTs ‘risks undermining NHS savings drive’

By Ian Quinn

The massive re-organisation planned for the NHS risks scuppering the plans for £20bn efficiency savings, according to a report published today by the National Audit Office.

The report warns the focus of PCTs and SHAs on the so-called Quality, Innovation, Productivity and Prevention (QIPP) agenda could be lost because of their looming abolition in 2013, leaving GP consortia to pick up the tab.

Pulse revealed last month that the Department of Health plans to set GPs a series of brutal targets under QIPP, including a 20% cut in unscheduled hospital admissions, a 10% cut in A&E attendance and a 25% reduction in length of hospital stays by the end of 2013.

But the NAO report says: ‘The abolition of SHAs and PCTs, which have a lead role in delivering the QIPP agenda, and the establishment of new organisations, could distract staff at all levels from focusing on the achievement of the necessary productivity improvements.

‘The additional cost pressures of the reorganisation are also not yet known.'

Elsewhere the report found that hospital productivity had fallen over the past 10 years, despite significant increases in secondary care funding.

It said hospitals needed ‘more leadership, management and clinical engagement to optimise the use of additional resources and deliver value for money.'

Professor John Appleby, chief economist at The King's Fund agreed with the NAO's findings. 'Today's report highlights once again the scale of the productivity challenge facing the NHS. Despite some welcome announcements from the Government this week, there is no doubt that the structural changes to the NHS will distract attention from this essential task.

‘But this is not a counsel of despair. As the report points out, there are significant opportunities for the NHS to improve productivity, especially by reducing variations in clinical performance between front line teams delivering health care. With evidence emerging that some services are already being restricted, an intelligent approach is needed that focuses on these opportunities. This will take time to implement and the financial squeeze is already severe, but it is vital to avoid a ‘slash and burn' approach.'

Scrapping PCTs risks undermining NHS savings drive