The report, which looks at how the NHS is performing under the coalition government, said that for the time being the NHS is ‘continuing to hold up well’.
However it warned that government policy has resulted in ‘major organisational changes and the loss of experienced managers’ leaving the NHS in a ‘precarious’ position. 'As unprecedented financial pressures start to bite, cracks are beginning to appear,' the report warns.
The report said that much of the current government’s ‘ministerial rhetoric' about a shift away from targets and performance management had been gradual, with much of the previous system still in place.
King’s Fund director of policy Anna Dixon said: ‘The NHS is continuing to perform well but there are treacherous waters ahead.
'There are huge risks, particularly in ensuring that quality of care does not suffer with the further financial squeeze. The stakes for patients could not be higher, and frontline leaders will have a crucial role to play in meeting the challenges ahead.'
Responding to the report, health minister Lord Howe said: ‘We are giving the NHS an extra £12.5bn. In the meantime, it continues to perform very well. As the King's Fund themselves say - waiting times are down, hospital infections are down, and mixed sex care is at its lowest ever levels.’
The report compared its findings to a previous review of NHS performance and found that since 2010, 12 acute or ambulance trusts were performing below par in respect of finance, and 15 foundation trusts finished 2011/12 in deficit.
There had also been a rise in emergency admissions for people with long-term conditions and in emergency bed days among the over-65s since 2010.
There had also been some improvements. The report found MSRA rates had fallen since 2010, and more than £10bn of planned efficiency savings have been delivered through the QIPP scheme.
Overall, the report concluded that more time will be needed to judge the impact of the reforms on NHS performance.