Rebuilding public confidence a must for tough choices ahead


15 / 3 / 2013 14:05 PM

The NHS must rebuild confidence if it is to have a credible mandate to deal with the tough choices ahead, the head of the NHS Confederation said today, as the service contends with difficult financial times.

It will also need to reassure the public that they will be involved in decisions about the future of their health service.

This will help the public understand why changes to the NHS are necessary and encourage people to put forward their views on what action needs to be taken in the long term.

Critical juncture

His comments come as recent criticism of the management capability and quality of care shows the NHS has to do more to regain public confidence.

This will require the NHS to be more transparent about variations in outcomes and costs of care.

"We are coming to a critical juncture and need to have a frank discussion about the road ahead", said Mr Farrar. "This is a crucial time to show our commitment to improving the way we work and how we involve the public in decisions about their care.“

Finances and quality

Improving outcomes, and care and compassion go hand in hand with managing finances well, and the NHS must maintain a focus on all three if it is to be sustainable.

Poor care costs money, and overspending badly in one area of the country requires other organisations to underspend, denying them resources. The best performing NHS organisations demonstrate that higher quality services can actually reduce costs and save money.

While certain improvements will help the NHS in the short to medium term, Mr Farrar argues that more radical changes are needed to improve outcomes and manage resources on a sustainable basis.

Increasing pressure

Tough times, tough choices, a new NHS Confederation report published today, sets out four ‘tough choices’ faced by the NHS and what the impact of each could mean for patients and local services.

It highlights the increasing pressure the NHS has come under to maintain funding in line with demand.

The growing impact of lifestyle choices means the NHS now spends almost a fifth of its budget on services to treat people living with associated diseases and conditions.

Despite a two-year pay freeze introduced in 2010, pay costs – often as much as 70 per cent of an NHS organisation’s budget – are not falling as fast as they might have done, due largely to incremental salary growth.

There are further pressures with the cost of financing initiatives such as private finance initiative (PFI) schemes likely to double over the next 17 years.

The Government, the NHS and the public must confront these issues and look at the options available to them.

Tough choices

Each choice needs to be fully considered to assess whether it will guarantee safe, effective and sustainable services in the future. Each brings difficult decisions and trade offs, some of which may be too difficult for the public or politicians to swallow.

The 'tough choices' are:

  • doing nothing at all
  • spending more
  • doing more for less
  • doing things differently.

Mr Farrar said: “We know we can do much more to create an affordable system that works in the best interests of patients. Getting real bang for our buck will require some tough choices and will require strong political will and public support."

The Tough times, tough choices report is accompanied by two factsheets providing an overview of NHS funding and an online animation (below) which aims to inform the public about the pressures facing the health service.

Find out more

Download the report and executive summary.

Access the factsheets:

An overview of NHS finance 

How does the NHS financial situation compare?

Find out more about how we are helping members rise to the financial challenge.

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