Think tank urges commissioners to take leadership role

Commissioners should take a stronger leadership role across the NHS in developing a response to budget constraints, according to a think tank.

NHS leaders encouraged to take stronger leadership role in response to financial challenges ahead

A King's Fund report titled Windmill 2009 NHS response to the financial storm calls on local and national NHS leaders to be honest about the scale of the financial challenges ahead and engage the public and healthcare staff about how they propose to deliver quality while reducing costs.

The report is based on the findings of a simulation event which involved 60 policy-makers, regulators, commissioners, clinicians and patient representatives. Participants were given two near future scenarios that posed questions about how PCTs and local service providers should start preparing for the less generous period of NHS funding ahead.

An imaginary future DoH policy document was used in the workshop to provoke debate about how far NHS leaders may consider going to make the £15-20 billion efficiency savings the service is targeting by 2014. That discussion paper included fictional DoH plans to suspend contracts of inefficient GP practices, scrap practice boundaries, charge patients to see a GP, abolish PCTs and raise the age at which NHS staff can take their pension to 70 as possible cost-cutting steps.

The report drew conclusions from how the scenarios played out in the two-day workshop.

These included that PCTs must not delay planning — they need to start preparing now for how they will provide services with less generous budgets in future; government and regional health bosses must resist reverting to central 'command and control' and let local NHS leaders use their initiative to make decisions; and opportunities for new private or third sector providers to get involved in providing services for the NHS should not be limited.

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