The outgoing head of the NHS will spend his last months in the job forcing politicians to acknowledge the consequences of an NHS with reduced funding.
Speaking exclusively to The Commissioning Review, Sir David Nicholson said: “What I am absolutely determined to do is to make sure political parties and politicians nationally face up to the reality of what we need to do to make the NHS sustainable and deliverable.
“They have to face up to the reality that, although… they have been relatively generous to the NHS, for us it’s not generous in the sense that it’s way below anything we’ve ever had in our history before. That has consequences, you can’t pretend we can muddle through.”
Nicholson, who is due to step down from his role as chief executive of NHS England in March, said that politicians should be subjected to four tests in the same way any proposed service redesign is.
“The first should be to be clear and transparent about what the real financial pressures facing the NHS are by putting it in their manifestos. Second is to support service change when it’s evidence based and has clinical support. Third, no more top down reorganisations. And fourth, to support clinical and managerial NHS staff to make the changes in the NHS.”
Politicians are known for standing up for local campaigns to stop hospital reconfigurations which will be needed if the NHS is to meet the £30 billion funding gap identified by NHS England in its report, The NHS belongs to the People: a call to action.
Nicholson also hinted at the “radical changes” he is “determined to make happen” in the GP contract.
“We have come to the conclusion we need radical changes in the contract, a simplified QOF and incentivised care for vulnerable older people. Be reassured I am determined to get a GP contact responsive to the needs of older people and that needs to be sooner rather than later.”