No “whole hospital” will have to close as a result of the drive to find £20bn of efficiencies from the NHS budget, NHS chief executive Sir David Nicholson has insisted to HSJ.
Sir David’s claim comes as an increasing number of leading health service figures call on the government to face up to the need to close hospitals which are financially unviable in the new NHS economic climate.
In an exclusive interview, the NHS chief executive said: “In none of the [regional NHS savings] plans I’ve seen has [hitting the savings target] involved closing a whole hospital.”
Stressing that he believed he had seen “all” of the quality, innovation, productivity and prevention plans developed by NHS regions, he said: “From the evidence I have seen, it is perfectly possible to deliver your QIPP savings without closing hospitals. That’s not to say you don’t need big service changes.”
Sir David’s comments came after King’s Fund chief executive Professor Chris Ham criticised politicians for ignoring “clinical and financial evidence” and backing “campaigns to keep local hospitals open”.
Professor Ham wrote in The Observer: “Financial pressures are increasing by the day and will adversely affect quality unless ministers recognise the urgent need to change the way services are provided.
“Up to 20 hospitals may not be financially sustainable and will have to be merged or taken over. Many others face financial or clinical challenges that require changes to the services they provide.”
Royal College of Nursing chief executive Peter Carter last week told The Times there were “far too many acute hospitals” in metropolitan areas. He said the decision to reconfigure would be difficult because of political interference, but that a “paradigm shift was required”.
QIPP schemes across England show commissioners planning to move large sums out of the acute sector.
For example, Trafford Healthcare Trust in Manchester faces its core contract for acute work being cut from £75.5m to just £39.5m over the next five years, while the South East London cluster plan involves taking £126m out of its main providers over the next four years.
Meeting the demands of QIPP plans may be made easier by the decision to drop the blanket April 2014 deadline for all NHS trusts to become foundation trusts.
Sir David told HSJ the foundation trust authorisation process was being used as the “mechanism” to ensure the “sustainability” of trusts.
One senior SHA official said: “The 2014 date could have forced us down a route we didn’t need to go down. Relaxing the date gives us more time to work plans through.”
The chief executive of one non-FT told HSJ he was “glad” the deadline had been dropped as increased scrutiny for would-be foundations was placing an additional burden on trusts at a time “when the money is also getting tight”.