Service quality and financial control at the NHS could suffer during the switch to GP commissioning, the organisation's chief executive has warned.
Sir David Nicholson (pictured, left, with health secretary Andrew Lansley) said there was a "significant risk" standards could slip during the transition period envisaged by the government's new health white paper, Liberating the NHS.
Writing in a letter to NHS staff, the chief executive urged those in senior positions to establish a plan of action to implement the proposals, adding the speed of change could create problems if the service was not ready.
"There is significant risk, during this transition period, of a loss of focus on quality, financial and performance discipline as organisations and individuals go through change," he said.
He also reminded managers of the urgent and overwhelming need to find £20bn in efficiency savings to be pumped back into improving standards.
Dame Barbara Hakin, a former GP, has been appointed NHS managing director of commissioning development, a role that will see her given responsibility for pushing through the reforms.
"Most definitely! While change is not necessarily a bad thing, change simply for the sake of it (to put this government's stamp on the NHS?) not only can be costly, it can harm the infrastructure. Careful consideration and time is the best way to implement long-term plans. Sadly, both seem to be lacking. RIP our beloved NHS ..." – Anita Jones, Bolton
"No. Why should there be a loss of focus? This is just another change brought in by a different govt but there has been so much change in the NHS it only proves that change is the only constant. While it gets me down at times, the constant challenge is one of the best aspects of the job though I am not convinced that constant flux neccesarily delivers I will not be sorry to see some of the PCT idiocies go" – Name and address withheld