Mike Farrar, chief executive of the NHS Confederation, has called for action on way health and social care is provided, saying that on its current path the National Health Service "looks like a super tanker heading for an iceberg".

His comments come on the back of a major survey of NHS leaders of more than 250 chairman and chief executives which has revealed deep concern over the impact of financial pressures on patient care.

Broadly speaking, the survey's findings show that patient care is already suffering from financial constraints and that the situation will likely only get worse.

Forty-two percent of those surveyed said patient experience has suffered most under current cost cuts to the health service, while 82% said financial pressures on their organisations will either 'increase' or 'increase significantly' over the next year.

Similarly, in terms of what aspects of care will be most affected by tightening purse strings over the next 12 months, 63% said patient experience, 49% said waiting times and 30% said the availability of particular treatments or drugs.

“Despite huge efforts to maintain standards of patient care in the current financial year, healthcare leaders are deeply concerned about the storm clouds that are gathering around the NHS," Farrar said.

“NHS leaders surveyed are clearly worried about standards of care", he added, noting that fears center around "the tight financial position; the even tighter financial position faced by local authorities; the distracting effect of the reforms; the time that it will take the reforms to bed in; and the chronic failure of political  leadership to secure the public support for the changes they know are needed".

In need of support

According to Farrar, the NHS "desperately needs" public support for planned change to services, "but politicians have consistently failed over many years at national and local level to put the long-term interests of their population’s health above their short-term electoral interests". 

Also speaking at the NHS Confederation Conference yesterday, Health Secretary Andrew Lansley stressed that “politicians should be there to provide support, not interference,” and that a change in services should only be underpinned by clear clinical benefits, clinician support, views of the public and impact on patient choice.

On the financial aspect, Lansley applauded the £5.8 million the NHS has delivered under the QIPP (quality, innovation, productivity and prevention) agenda, but also conceded "I know it's tough and it gets harder over time".

"To make savings and deliver improvements, I agree with [Farrar] that we need ‘service innovation’ to change the way we deliver services and to bring services together,” he stressed.

However, earlier this week an investigation by GP Magazine found that 91% of primary care trusts are imposing restrictions on procedures deemed 'non-urgent', such as cataract surgery or hip operations, highlighting both the lengths some are going to to cut costs and the impact on patient care.

While some NHS leaders have justified the need for case prioritisation, speaking on Radio 5 Live health minister Simon Burns told the BBC's Shelagh Fogarty that clinical commissioners could be sacked if guidance is not being followed.