National Health Service chiefs are more concerned with handling tightening purse strings than actually putting in place the government's health reforms, suggest findings of a survey by the NHS Confederation.

Its survey of 279 senior healthcare managers - 94% of whom were chairs and chief executives of NHS trusts - showed that 63% rate balancing finances and making cost savings as one of their top three issues, with 31% - the highest percentage by some way - noting this is the primary concern going forward.

Elsewhere, 46% considered maintaining, protecting and improving service quality as one of the top three issue, with 19% saying this would be most important area, and 46% felt understanding and supporting GP commissioning would rank among the top three, although just 13% put the highest priority on this. 

But by far lowest on the radar, just 32% put understanding the government’s white paper reforms, the transition and reconfiguration among their top three issues, with just 13% feeling this to be the most important issue.

The findings indicate that the priorities of the government and health leaders are not in sync, and acting chief executive of the NHS Confederation Nigel Edwards says alarm bells should be ringing. While the government is clearly focused on pushing full steam ahead with NHS reform, finance is actually the key issue keeping NHS chairs and chief executives awake at night, he said. 

"Our members are focusing on this issue because they know that good patient care depends upon financial stability – the two are inextricably linked," and "I worry that there may be a significant finance problem coming down the track" he warned. 

"We are already picking up worrying signals from a number of hospitals and primary care trusts about significant money pressures emerging, and this is before the very challenging rigours of next year’s tight financial settlement,” Edwards notes.

Efficiency savings and management cuts

The NHS has been targeted with finding efficiency saving of £15-20 billion over the next four years in order to place it in better stead to deal with dwindling resources at a time when demand on services is bulging. And this, coupled with an order to cut management costs by 45% alongside implementation of the biggest reform of the health service in history, has propelled finance up the agendas of health service leaders, the Confederation explains.

"It’s a mammoth agenda and the dangers of distraction are obvious. We need to make sure we don’t take our eye off the ball on providing high-quality services for patients as we go through what will be a really tricky period," doing everything possible "to eke out genuine efficiencies rather than simply shrinking services," warns Edwards.

In a statement to PharmaTimes UK News, a spokeswoman for the Department of Health said: "We agree with the NHS Confederation that good patient care depends upon

financial stability. That's why we're investing an extra £10.7 billion into the NHS". 

In addition, she said the government's modernisation plans will "release £1.7billion savings every year, helping the NHS meet its efficiency target," and putting the health service "on a

sustainable financial footing, with reduced bureaucracy and strong incentives for both quality and efficiency".

But Chris Ham, chief executive of The King’s Fund, told PT that the survey "shows once again that the top priority for the NHS must be to deliver productivity improvements to maintain quality and avoid significant cuts to services," and that "despite recent announcements of a number of measures to help manage the transition, there remains a risk that implementing the reforms will make this more difficult".