NHS chief executive Sir David Nicholson has warned managers they need to “maintain a strong grip” on productivity and performance during the coming winter pressures.

In a letter to chairs and chief executives of NHS and social care organisations, Sir David said keeping on top of performance was “pivotal” to the success of the transition to GP consortia while maintaining quality services through the winter.

He said: “It is critical that as leaders we do not lose sight of delivery, notwithstanding the demands of QIPP [Quality, Innovation, Productivity and Prevention] and the transitional and many other challenges we face.

“Strong, skilful, and energetic leadership will be key to delivering good quality care for patients at a time when we routinely see services under the greatest strain.”  

Sir David added: “I would look to all chief executives to assure themselves that their organisations are well prepared and appropriately resourced to maintain a strong grip on performance and productivity.”

He also highlighted the need for health and social care organisations to work across boundaries to maintain a “whole system approach” to managing the winter.

He noted the success in previous winters of rehearsed collaborative escalation working arrangements with other agencies and open communication lines between key sector partners.

However, Sir David warned: “There are significant efficiency requirements facing both health and social care. It is key that the implications of any proposals for changes to services are discussed between health and social care before decisions are taken.

“This will allow, wherever possible, the potential for mutual support to be addressed, and appropriate preparations to be put in place across the local care system.”