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June 2012
Key points from the 2012 survey of the leaders of the NHS
Healthcare chiefs say the financial position is very serious
The pressure is greater than 12 months ago and is set to increase further
Many say care has been affected, particularly the experience of patients
They expect to see the impact on care spread over the next year
There is also serious concern about the outlook for patient care nationally
Do you think the quality of patient s ervic es will improve, decreas e or s tay the s ame acros s the whole of the NHS over the next 12 months ? (n= 247)
0%
15%
38% 42%
5%
0%
20%
40%
60%
80%
100%
Will improves ignific antly
Will improve Will s tay thes ame
Will decreas e Will decreas es ignific antly
Cuts in local authority funding have added to the pressure
What impact have local authority cuts had on the following s ervices commis s ioned or provided by your organis ation over the pas t 12 months ?
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Delays to dis charge (n= 161)
Demand for community s ervic es (n= 133)
Demand for mental health s ervic es (n= 127)
Demand for primary c are s ervic es (n= 87)
Ac ute admis s ions (n= 151)
A&E attendances (n= 138)
E mergenc y re-admis s ions (n= 141)
Demand for ambulance s ervices (n= 84)
Increas ed s ignific antly Increas ed No impact Decreas ed
Managing these financial pressures while also meeting the needs of an older population will be the NHS’s biggest challenge over the next decade
Other
Spread of innovation
Service redesign or reconfiguration
Reducing health inequalities
Integration of care
Ensuring people take greater responsibility for their own health
Technological advancements
Demographic pressures
Managing expectations of patients and the public
Growth of long-term conditions
Increased demand
Pressure on finances
Care of the elderly
0 0.1 0.2 0.3 0.4 0.5
0.03
0.01
0.08
0.02
0.06
0.06
0.01
0.11
0.09
0.07
0.14
0.17
0.15
0.02
0.05
0
0.09
0.11
0.13
0.2
0.17
0.23
0.25
0.19
0.25
0.27
What do you think are the challenges facing the NHS over the next decade?
Biggest challenge
Other challenges
There is strong consensus that more radical longer-term action is necessary
In the short-term, the NHS is mostly responding by cutting costs
Whatever the benefits of government reforms, the process of transition to the new system has added to the risks facing the NHS
What do you think are risks to the success of the G overnment's NHS reforms? (n= 245)
7%
18%
17%
23%
17%
10%
18%
28%
37%
31%
40%
1%
1%
5%
2%
4%
4%
1%
5%
2%
10%
10%
0% 20% 40% 60% 80% 100%
Failure to s ec ure independent s ec tor involvement
Management c os t c ons traints for CCGs
Other
L ac k of c linic al s upport
Inc reas ed bureauc ratic burden
Too muc h c entral direc tion from the NHS Commis s ioning Board
Unc ertainty about roles and res pons ibilities
L ac k of s ys tem management
Financ ial pres s ures or c os t s aving targets
Dis ruption due to organis ational res truc turing
L ac k of expertis e or experienc e in new organis ations
B igges t ris k
Other ris ks
Confidence varies in the readiness of parts of the new NHS system
Monitor
NHSCB
NTDA
PHE
CSSs
CCGs
LA s
AHSNs
HWBs
CQC
Healthwatch
0 10 20 30 40 50 60 70 80
How confident are you that the different parts of the new system will be ready to ef-fectively discharge their roles and responsibilities in 2013?
Very confident
Quite confident
%
Healthcare leaders want the government to back them in addressing long-term challenges facing the NHS
Asked how the government could help the NHS implement the reforms, the most commonly cited responses were:
•Ending top-down interference
•Supporting NHS leadership
•Backing integration of care and reconfiguration of services
•Acknowledging the financial pressures
About the survey
The NHS Confederation asked the Picker Institute Europe to survey the chairs and chief executives of all its member organisations. The survey was conducted between 26 April 2012 and 16 May 2012. It was sent to 625 chairs and chief executives in 362 organisations. There were 252 completed - a response rate of 40 per cent - from 200 organisations.