A survey of 252 members of the NHS Confederation, which represents NHS managers, found that just 13% think GP commissioning is their main priority over the next 12 months.
Nearly a third (31%) said finding cost-savings will be their priority. Maintaining patient safety and quality of services was the top priority for 19%.
Acting NHS Confederation chief executive Nigel Edwards said the results 'should set the alarm bells ringing' in Westminster about the timing of the Health Bill reforms.
'The results show that while the Westminster village is focussing on NHS reform, finance is the issue keeping NHS chairs and chief executives awake at night,' he said. 'Our members are focussing on this issue because they know that good patient care depends upon financial stability.'