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A better, cheaper NHS is possible - just


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Friday, 22 April 2011

A better, cheaper NHS is possible - just

Are the goals of QIPP realistic? Sir David Nicholson prefers to talk about the “NHS challenge”, which gives it a more sporty feel, but whatever you call it, the quality and productivity agenda is about two things: saving money and making the NHS better at what it does.

It’s fair to say that for many people QIPP has negative connotations. It pre-dates the current reform agenda but remains heavily implicated in it. The revisions to the NHS operating framework pushed back the deadline for completing the job of saving £20bn to 2015, clearly signalling that QIPP isn’t going to go away just because PCTs are. GP commissioning organisations will be expected to complete the job.

So what do you think? The answer is that most of you – by the narrowest margin – believe in the better/cheaper proposition. When asked “Is it possible to improve the NHS and cut costs at the same time?” just over half of respondents to our survey (50.5%) agreed that it was.

We had 600 responses from a broad cross-section of NHS Networks members including clinicians, nurses, AHPs, trust managers, practice managers and patients.

Opinions varied slightly between groups. For example, practice managers are more inclined than nurses to believe that quality and productivity gains can be achieved together, but not by a wide margin.

If the jury is out on whether the NHS can get better and cheaper at the same time, there was much broader agreement on the question of whether it could be more efficient. Just over 93% think it can.

You would probably have got the same answer to that question in every one of the past 62 years and you will continue to hear it for as long as the NHS lasts.

Perhaps more surprising is that very few people think that money is the answer. Asked what would make the biggest difference to quality of care, only 3% ticked the box marked “more money”. Nor is the answer better information (3.5%) or better clinical decisions (5.7%). Whichever group you ask, by far the most popular answer is that services need to be more joined-up (53.8%).

It would be wrong to pretend that investment in the NHS was not on anyone’s list of priorities. It’s just not at the top for most of us. Asked the distinctly leading question “Should the NHS be a special case for investment?” a sizeable majority (63%) think it should be, just under 15% disagree and 22% can’t decide.

We scoured the results of the survey for stark contrasts and revealing juxtapositions, but we are sorry to report that there is nothing much to choose between NHS people when it comes to the big questions.

Even self-interest doesn’t appear to have much effect on people’s views. PCT commissioners, whose endangered species status might entitle them a jaundiced view, are far more likely than other respondents to believe that a better, cheaper NHS is possible. 

Download a summary of the survey results here. We’ll publish a more comprehensive version after Easter.