News / CIPs need to embrace quality and safety

Good cost improvement plans (CIPs) are not simply about saving money, but also include long-term plans to transform clinical and non-clinical services to produce cost savings and quality and safety improvements, according to a report.

The briefing, Delivering sustainable cost improvement programmes, found significant variation in approach to and success of CIPs. It said even the most successful trusts would find CIP delivery challenging in the future and should review their approach to managing their plans.

Delivery of CIPs is crucial to the achievement of the £20bn efficiency savings target by 2014/15. In quarter two of the current financial year 2011/12, the Department of Health reported the NHS (except non-foundation trusts) had so far released £2.5bn in QIPP savings against an expectation of £5.9bn over the full 12 months. The single biggest saving (£1.2bn) was in the acute sector.

The Department said it had seen a continued reduction in the level of non-elective admissions to acute services, indicating that the NHS was supporting patients with long-term conditions to avoid the need for emergency admissions.

Monitor said that at Q2, foundation trusts were 9% behind plan on cost savings, delivering £567m against a planned £620m. However, it added the sector was in better shape on CIPs than at the same point last year, when there was an 11% shortfall against plan.

Produced by Monitor and the Audit Commission, the CIPs briefing is based on interviews with board members and senior finance staff in 16 NHS organisations.

It said some of the more straightforward CIP schemes, such as vacancy freezes and a cut in the use of agency staff, have already been put in place in most organisations. A more strategic approach involving clinical leaders was needed now, it said.

Monitor chair David Bennett (pictured) said strong leadership was needed. ‘It’s the board’s responsibility to ensure the organisation is committed to achieving cost savings by changing the way services are delivered and improving processes, rather than by implementing cost-cutting measures that have a negative impact on the quality of care patients receive.

‘To really succeed, boards must put clinical staff at the heart of the process,’ he added.