Speaking at a King's Fund event on challenges for the NHS, Chris Ham said that debate on the QIPP agenda needed to move from a focus on cutting management costs and bureaucracy to looking at 'core medical decision-making processes'.
Addressing 'unacceptable variations' in clinical practice provides the best opportunity for efficiency savings and clinicians are key to this drive, he said. 'It's a simple point, but it is a very important point that we lose sight of at our peril,' he said.
'Unless we engage the people who make those clinical decision that commit our resources in rising to the QIPP challenge we are going to fall a long way short of the £20 billion.'
Mr Ham said GP budget holding showed 'huge promise and potential' for making savings, but that this would require strong incentives, and good clinical leaderships.
'Let's be in no doubt QIPP is the biggest leadership challenge the NHS has ever faced,'
he said. 'I would emphasise the importance of clinical and medical leadership in rising to that challenge ...
but we need excellent leadership at all levels within the NHS, from board level to ward level.'
Mr Ham also said that, in a 'much more challenging' financial context, a key challenge would be for the NHS to decide how it can continue to build on areas of achievement.
'It has been seven years of feast, and we are probably entering seven years of famine,' he said. 'To be able to hold on to 18 weeks for our (hospital access targets) and access to GPs is going to be a very big ask of NHS organisations as they struggle with the QIPP agenda.'