Closing the NHS funding gap: Can it be done through greater efficiency? Summary of a roundtable discussion, 30 January 2014

In 2014, we brought together senior health sector leaders to consider whether the NHS can close the £30bn funding gap through greater efficiency. The key points from the presentations and discussions on the day:

• The extent of the £30bn financial gap was accepted, but it may be too optimistic if the NHS budget is not protected in future years.
• The NHS in England does not appear particularly ‘flabby’ next to health systems in other developed countries.
• The current financial squeeze might affect the system’s ability to achieve the service transformation required to close the £30bn funding gap by 2021. Asking the system to deliver radical, transformational change may be unrealistic given the day-to-day pressures to deliver, but the financial squeeze may prompt the action needed.
• Proper alignment between quality, efficiency and funding decisions is vital. Short-term interventions to improve quality must not increase the scale of the financial challenge to come.
• There are a number of cultural barriers which make innovation more challenging. The system rarely tackles failure well and there is very little recognition or reward for success. As a sector, the health system could be much better at ‘spread’ of good and innovative practice.
• Radical transformation of services is required.
• The centre should play a bold, supportive and facilitative role and avoid the perception of micro-management.
• The time has come for an honest conversation with the public about what the NHS might look like over the next decade and how that vision might be funded.
• There are signs of optimism despite the financial challenges. For example, the prominent focus on integration and person-centred care could bring about positive changes.