The Department of Health will be “increasingly discriminating” between trusts that find genuine efficiencies and those that simply cut posts, national director for improvement Jim Easton has warned.

Mr Easton was speaking in a seminar about the quality, innovation, productivity and prevention programme at last week’s Healthcare Innovation Expo.

He said: “One thing we’re going to do, which you might think is unhelpful, is be increasingly discriminating between those people who are driving [savings] by doing the right things and those who are doing the wrong things.”

He said the department was about to launch “something that talks about the reduction in staff” and said trusts that simply cut posts without redesigning services “are not doing QIPP”.

Mr Easton emphasised the role of trust boards in delivering QIPP savings. He said they would be supported with better care and value measures provided by the DH.

Primary care trusts should question hospitals where quality was declining. “Commissioners should be saying [to providers] ‘it’s your job to figure out how to do it, but we’re concerned about the crude way this is having an impact on quality,’” he said.

He added changes to the NHS’s payment system would provide some financial levers to drive quality, but said: “it’s a bit of a mark of failure if people are relying on those.”

He said: “We’re confident that the challenge is achievable - but it is incredibly difficult.”

The impact of QIPP would be unevenly distributed across the country, with trusts with underlying financial or structural problems having the hardest time.

Mr Easton also told the conference working practices in many wards were “grotesquely inefficient” despite the hard work of many staff.

He criticised managers with a “perverse” attitude to learning, who were reluctant to copy successful ideas developed by neighbouring trusts.

Also speaking at the Expo was health minister Earl Howe.

He said NHS trusts should do more to realise the commercial value of the services they offer, saying there was a “global appetite” for NHS expertise. He estimated the potential income for the NHS from the worldwide healthcare market was £150m a year.