The health and care system needs ‘fundamental change' and greater certainty around cost efficiencies if it is to meet the needs of patients, MPs have warned.
The Health Committee's annual inquiry into Public expenditure on health and social care said there is a question mark around sustainability and how effect the NHS efficiency drive has been.
Under the ‘Nicholson Challenge' NHS chief executive Sir David Nicholson had set targets for the NHS to achieve up to £20 billion in efficiency savings by 2015.
In the report accompanying the inquiry, MPs said the key question was not ‘what has been saved?' but ‘what has the money "saved" been spent on?'
The Select Committee concluded the reforms were transparent, and backed greater integration between health and social care budgets, as well as the creation of Health and Wellbeing boards.
Committee chair Stephen Dorrell MP said: "The Nicholson Challenge requires the health and care system to deliver fundamental change so that services are joined up and focussed on the needs of patients. What we have heard during our inquiry indicates that while many of the straightforward savings have been made, we have not seen the transformation of care on the scale which is needed to meet demand and improve care quality.
"The NHS budget is static, and the social care budget is falling. In these circumstances, the successful integration of high-quality health and care services represents a substantial and growing challenge.
"The situation is not helped by the current fragmented commissioning structures. The Committee's view is that, as Health and Wellbeing Boards have been established to allow commissioners to look across a whole local health and care economy, their role should be developed to allow them to become effective commissioners of joined-up health and care services".
Dorrell also backed recommendations that the current level of funding for social care should be ring-fenced.
He said: "Alongside the government's commitment to maintain health spending at current levels in real terms, this would give certainty about budgets for a whole health and care economy and provide a firm financial basis for Health and Wellbeing Boards to plan and implement transformative service change.
"Without stronger commissioners and ring-fenced health and care funding, we believe there is a serious risk to both the quality and availability of care services to vulnerable people in the years ahead".
