The government will need to go to greater lengths to demonstrate how NHS reforms will be pushed through without damaging patient care in 2011 in what has been heralded by many as "the toughest year" in its 62-year history, a leading body has warned.
Nigel Edwards, acting chief executive of the NHS Confederation, said the government had not yet provided sufficient evidence as to how it would manage the move to a radically different set-up or protect accountability whilst maintaining high standards of patient care.
The call from the head of the independent membership organisation, who said he backed the principle of the radical shake-up, follows expert warnings that waiting lists could increase if the government fails to invest in the health service.
The majority of the multi-billion-pound NHS budget will become the responsibility of GPs by 2013, who will take charge of planning hospital care and services for patients after primary care trusts and strategic health authorities are abolished as part of the reforms.
The Confederation supported the objectives and also recognised the need for the NHS to cut costs in line with the squeeze on public spending - from which it has been directly spared - but retained serious concerns, he said.
"2011 will be really tough for the NHS, possibly the toughest year it has faced. If the issues are not fully recognised, they will be dealt with poorly and patients will be the losers," he told members.
"The NHS is going to have to get all hands to the pumps and it will need all the help it can get. We need policy makers to fully understand the pressures, to act to mitigate the risks and to persuade those involved that we are on the right course.
"The mechanics of who does what to whom and who oversees it is done correctly will be central to making the new system work. It needs to be crystal clear but it remains a grey area and is, therefore, one of the biggest risks to the reforms working.
"Parliament will also have to grapple with the issue of whether the reforms are powerful enough to achieve their goals.
"However, it is the transition that is causing greatest anxiety to the NHS. Regardless of the strengths and weaknesses of the government's plans, we have to get there first.
"That will mean avoiding hazards such as financial problems and failings in patient care."
Health minister Simon Burns said: "Reform is a necessity, not an option. We consulted on proposals for reform in a white paper in July, and earlier this month published our response to these consultations and the NHS Operating Framework which set out how these will be taken forward.
"The NHS must now rise to the challenge of implementing these reforms and playing its part in creating an NHS that puts patients at the heart of everything it does, focuses relentlessly on improving healthcare outcomes and liberates professionals at every level to take decisions in the best interests of patients, rather than being micromanaged by politicians and civil servants."
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