Easton: we must tackle cost-cutting masked as efficiency

Jim Easton, director of improvement and transformation at the NHS Commissioning Board, told HSJ that, in some areas the quality, innovation, productivity and prevention programme is being applied as a “label” to funding cuts.

He said a “quite complicated story” was emerging about the QIPP programme, which aims to secure efficiencies worth £20bn by improving services and making them more efficient.

According to the Department of Health, the QIPP programme saved the NHS a total of £5.8bn in 2011-12.

Mr Easton said: “On one level it has been an extraordinary success. We have delivered the money, and our quality markers are stable or improving.”

But he warned there were “two things going on that we need to address”.

“There are people who report [locally] that QIPP is being increasingly seen as just a label applied to what would once have been described as cost improvement plans, and that the focus on deeper change and focus on quality is less marked,” he said.

“We need to understand why that is and go forward. It is not endemic or dominant, but we’re not going to ignore it.”

A commissioning board spokesman said that although the quality of a local QIPP plan was hard to quantify, it had heard of difficulties in realising genuine efficiencies from both NHS commissioners and providers.

Mr Easton said that the second main risk to QIPP was that “while we have made this extraordinary progress on our early deliverables, we’re not quite as sure yet that we’ve made progress on the medium-term deliverables about change - about getting care delivered outside hospital”.

He said there was “good reason” why deeper service redesigns would take place in the latter years of the QIPP programme, from next year. But “we are not yet [certain] from what people tell us that we’re making the switch to that phase as completely and confidently as we would want”.

He acknowledged that, as HSJ revealed last week, GP referrals to acute services were going up after a short-lived dip last year.

“We were always very cautious about what that told us,” he said, although DH data did suggest that commissioners had been able to make an impact on hospital activities, “albeit not yet in a sustained way”.

Mr Easton added that the commissioning board would now look to give “support and information” to organisations which were struggling to implement real innovations.