A drop in hospital admission rates has been hailed by NHS chief executive Sir David Nicholson as evidence that clinical commissioning is beginning to deliver improvements in care.

At a conference for GP commissioners held jointly by the National Association of Primary Care and the NHS Alliance last week, NHS chief executive Sir David said emergency admissions and referrals to outpatients were both down in the first quarter of 2011-12.

He said: “Obviously one swallow doesn’t make a summer, but two of the big measures in relation to how we can make the service changes we need to make… both of them are down in the first quarter from this time last year.

“As far as we can see that’s never really happened before.

“I am sure that everyone will claim it was all down to them – but nevertheless there is something happening here which is potentially exciting and potentially shows the power of the work that you [clinical commissioners] are starting to do.”

Department of Health figures released this month show there were 1.32m general and acute non-elective admissions in the first quarter of 2011-12, down 2.5 per cent from 1.36m the year before.

Meanwhile GP referrals made for all specialities fell 4.1 per cent, from 2.99m to 2.87m.

Nuffield Trust head of policy Judith Smith emphasised that data for a single quarter is not enough to indicate a trend, and added this was the first year the NHS had been dealt a near-flat funding settlement.

“It may be a case of the financial context being the mother of invention,” she told HSJ. “But my guess is that primary care trusts are working with clinical commissioners to find different ways of managing urgent care and prevent avoidable admissions to accident and emergency.”

Kings Fund health policy fellow Chris Naylor said changes in commissioning were aligning financial and clinical decision making, creating stronger incentives to manage referrals.

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