Primary care trusts will have to make some tough decisions on how to prioritise spending during the recession, according to NHS Confederation Primary Care Trust Network director David Stout.

Speaking at the NHS Confederation’s Labour Party conference fringe event, Mr Stout said the reality of the funding situation meant there would “almost certainly be flat cash for the NHS” for the next few years, requiring a “more efficient health service” to deliver cost-effective care.

Commissioners will have to make choices about what types of service they invest in, and be held to account for these

“Decision makers in the NHS have always had to make hard choices about what to invest in and what not to invest in, but the economic recession has brought this further to the fore,” he said.

“As the population is growing older and new technologies are invented, meeting new demands with a flat budget means we will have to do things differently,” he added.

Mr Stout said PCTs would have to engage with patients and the public to identify local needs and prioritise areas for spending. “[Commissioners] will have to make choices about what types of service they invest in, and be held to account for these,” he said.

“We could provide considerably more care in community settings, but for that to work we will have to invest in community services to deliver it. This will mean taking resources out of the hospital setting because we can’t do both.”

“We have to be really confident that the investments we are making deliver the best patient care, and patients and the public have to be engaged in this debate,” he added.