NHS Confederation members' views and concerns are reflected in the Health Select Committee's review of health and social care finances, published on 24 January. 

The committee's final report agreed with many of the pressures that had been detailed in the evidence given by the NHS Confederation's Mike Farrar and Jo Webber.

Evaluation of efficiency gains

The inquiry had been looking to evaluate progress on the efficiency gains required by the ‘Nicholson challenge', and to assess the ability of adult social care services to meet the demands made upon them and councils’ budgeting constraints. 

MPs heard oral evidence from the NHS Confederation in October 2011 on the interactions of slower growth of available resources with the increasing demands on health and social care resources. Our oral and written evidence covered a wide range of issues which were vindicated in the final report.  

Financial savings

NHS Confederation chief executive Mike Farrar gave evidence that 82% of our members believe that NHS organisations are “achieving short-term savings which allow them to meet their financial objectives in the current year” but that 4% year-on-year savings were not sustainable as the majority of savings were from non-recurrent savings and reserves.

The Health Select Committee also agreed with our conclusions that savings were being made by 'salami-slicing' budgets, rationing patient services, and making cuts to planning services which would allow services “to meet their financial and quality objectives in later years.”  

NHS reforms

We are pleased to see the committee’s support for our members’ concerns about making these savings while the Government is implementing its sweeping programme of NHS reforms. The final report also reported our evidence that the “balance between quality and savings becomes more finely balanced” as the years progress. 

Reconfiguration of services

The committee supported our view that there is a real need to reconfigure some services in pursuit of efficiencies. In our evidence we had also made the point, supported by the Local Government Association, that planning was critical at this point and that health and wellbeing boards would play a key role in enhancing integration.  

Use of tariff

Our evidence was that the tariff is a 'crude mechanism' that does not take account of variations at a local level and did not cover all services. Mike Farrar said that tariff may only be effective in driving efficiency at an aggregate level.

NHS Confederation reaction  

Speaking when the Health Select Committee's report published on 24 January, Mike Farrar said: "This report starkly highlights the weight of financial pressure that is bearing down on the NHS. It shows the uncertainty people are working with and how dangerous it could be for short-termism to dominate the response.

Plea to MPs

“I would urge all MPs to take on board the findings of their own committee’s report and to back NHS leaders as they seek to drive the necessary changes. It is not always right to lead the protest march. MPs should back change where there is a persuasive case that it will deliver higher quality and sustainable services for patients. 

"Anybody who thought the NHS was simply ‘protected’ is sleep walking into some serious difficulties. 

Decisions needed to allow proper planning

“We don’t want to see local NHS leaders making unplanned cuts in response to crises caused by problems that have festered. We need politicians to face the issues and to take the decisions that will allow people to plan properly. 

Once in a generation challenge

“The NHS faces a once in a generation financial challenge that is still to be explained properly to the public. If we are to keep the NHS sustainable in the long term, we need to fundamentally reorganise the way we deliver care in the best interest of patients. 

More care in community

"More care can be provided in the community while some hospital services will need to close and be provided in larger specialist centres. This can be better for patients, particularly those who make up the vast majority of NHS patients: older people with various long-term conditions. 

Getting ahead of the curve

“The overall impact in making these vital changes can be positive for patients. But we will only be able to do this if we can get ahead of the curve and take the public with us.”