Cancer waiting lists stand at 18 weeks and stroke care in London is being re-structured, a Committee of Public Accounts report into NHS efficiency has said.
According to NHS boss Sir David Nicholson, there is issues about people being assured that the nature of the cost reduction programmes in hospitals is not directly hitting the quality of care for patients.
He said, as outlined in the report minutes: "We are tackling that in two ways. One is to say that all the cost reduction plans for each individual organisation should be signed off by the doctor and nurse within that organisation, so we have clear transparency about the effect that it has on patient care-or not."
Margaret Hodge MP, chair of the Committee of Public Accounts, said: "The NHS has achieved its financial savings target, but this has in large part come from freezing wages. We are concerned that other savings are being achieved by rationing patients' access to certain treatments. These include cataract surgery and hip and knee replacements.
"Furthermore, the finances of some trusts are fragile, and there is a risk they may resort to simple cost-cutting rather than finding genuine efficiency savings."
"As the Francis report on the Mid-Staffordshire NHS Trust showed, financial pressures may already be causing some hospital trusts to cut staff with damaging effects on the quality and safety of care."
She warned the NHS must fundamentally change the way healthcare is provided to make the savings needed, for example by moving services out of hospitals and into the community.
The report stated that the centralisation of stroke care in London was an example of successful service change.
But it added: "However, major change of this kind is likely to be resisted by the public and their elected representatives unless the Department makes a clear, well-evidenced case for change."
Hodge said the committee was not satisfied that the Department and the NHS Commissioning Board was doing enough to help the NHS transform services.
She said: "Local people are understandably resistant when proposals are made to close their local hospital or reduce the range of services it provides. It is down to the Department to make a clear case for change from the patient's point of view, demonstrating the benefits in terms of the quality and safety of care as well as cost savings.
"Unless this is done urgently, the Department will continue to face resistance to change and the NHS will struggle to deliver the savings it needs."
