Dealing with the downturn: the greatest ever leadership challenge for the NHS?

In spite of reassuring political statements suggesting real terms growth, commentators suggest that the NHS will face a real terms reduction of £8–10 billion in the three years from 2011 and the decline could continue beyond this. This means the need for strong leadership and radical productivity has never been greater. Time is short and experience of previous spending crises tells us that failing to rise to this challenge now will have serious consequences for the NHS, its patients and staff.

Some of the key points:

• The NHS is facing a very severe contraction in its finance with an £8–10 billion real terms cut likely in the three years from 2011. 
• The need for strong leadership and radical quality and efficiency improvement is therefore  greater than ever. 
• History tells us that letting waiting lists grow, diluting quality and structural change should be avoided. 
• The NHS will not survive the impending spending squeeze unchanged. 
• Courageous decisions are needed now to reshape services and help us prepare for the most significant leadership challenge