Two in every five NHS senior leaders believe the health service is in a worse condition following the current government’s reorganisation, according to a survey by a consultancy firm.

One-fifth believe that the standard of care provided to patients is worse now than it was a year ago, Moorhouse says.

The biggest reorganisation in the history of the health service is said by the government to have been designed to improve patient care, but research by Moorhouse found a substantial proportion of those working at the top of the NHS were critical of recent changes.

According to Moorhouse, nearly half of senior managers say there is not greater accountability 45 per cent in the NHS since the changes, with just 3 per cent saying there is improved accountability. Only two in every five express optimism about the future of the health service and its ability to provide high-quality medical care over the coming decade.

Only around a quarter believe the reorganisation has led to better “efficiency savings” and around the same proportion think the NHS is now better equipped.

Moorhouse also says that just one in three senior NHS leaders agrees that the health service’s purpose is “very well” or “extremely well defined”.

Barely a fifth believe this new “vision” for the NHS has been well communicated to health service workers.

The survey was of 153 senior leaders in NHS commissioning and provision, in private healthcare companies and regulatory organisations. Its findings are published in a report called Fit For The Future? which describes the government restructure’s impact on the health service.

Around half of those who responded believe further deterioration of the NHS is on the cards, while just one in seven expect greater patient satisfaction with standards of care (14 per cent).

Forty-six per cent of senior people in the sector believe health workers are coping well with the increased complexity of their job.

Moorhouse director Richard Jones said: “This is an incredibly challenging period for the health sector, with every part of the system affected by its reorganisation.

“As a report card on the progress of transformation over the last six months, the research suggests that there are significant areas to be improved and that overall reorganisation is having a detrimental impact on the commissioning, regulation and provision of healthcare.

“To address this, leaders in the NHS and the wider health system must create a clear vision and purpose for their organisation, foster a culture that supports change and build working relationships with other bodies.”