1. Snapshot survey of health leaders on NHS reform Survey results March 2013

2. Background The Nuffield Trust conducted a ‘snapshot’ survey of health leaders to test their views and attitudes towards the Government’s NHS reforms. The survey was sent to health leaders and commentators spanning Whitehall, Westminster, local government, academia, the private and independent sectors and the media. All respondents either attended, or were invited to attend, the Nuffield Trust’s Health Policy Summit. While it is not a comprehensive, representative sample, the findings provide a useful insight into the views of a selected group of health leaders. March 2013

3. Methodology The survey asked a range of questions: some to probe attitudes to the current developments in the English NHS, while others were more wide-ranging, designed to explore attitudes to some of the bigger questions facing the NHS. The survey was sent to 230 health leaders. 53 people completed the survey, representing a response rate of 23 per cent. The results are anonymous. The online poll was open between 1 February and 22 February 2013. March 2013

4. Which of the following statements comes closest to reflecting your overall view of the NHS?

5. In general, do you think the quality of medical care that patients receive from the NHS over the past three years has improved, got worse or stayed about the same?

6. ‘The NHS is on track to meet the challenge of generating £20 billion of efficiency savings by 2015’. How far do you agree with this statement?

7. 'The reforms to NHS structures and rules set out in the Health and Social Care Act 2012 are essential to achieving the £20 billion efficiency savings by 2015'. How far do you agree with this statement?

8. The NHS is heading for a decade of austerity and will need to make efficiency savings beyond 2015. How far do you agree with this statement?

9. 'Commissioning by Clinical Commissioning Groups will, in two years, result in higher quality, more efficient health care than commissioning by primary care trusts today'. How far do you agree with this statement?

10. 'Commissioning by Clinical Commissioning Groups will, in two years, be more effective than primary care trusts have been in breaking down the barriers between primary and secondary care'. How far do you agree with this statement?

11. 'There will be more local accountability over commissioning decisions as a result of the new Clinical Commissioning Groups and local health and wellbeing boards than there has been for primary care trusts'. How far do you agree with this statement?

12. 'Clinical Commissioning Group boards will be more accountable to the NHS Commissioning Board than the local populations they serve'. How far do you agree with this statement?

13. 'Greater competition between providers for NHS patients will increase the sum total of quality and efficiency of NHS services'. How far do you agree with this statement?

14. 'Competition between Clinical Commissioning Groups for patients should be explicitly encouraged'. How far do you agree with this statement?

15. 'Developing integrated care should be the NHS' top priority over the next decade'. How far do you agree with this statement?

16. In general, do you think the quality of care that patients receive from the NHS over the past three years has improved, got worse or stayed about the same?

17. The NHS Outcomes Framework will be an important driver of better quality care throughout the NHS in the future. How far do you agree with this statement?

18. In a time of austerity which dimension of quality is most likely to suffer?

19. In a time of austerity in which types of care services will quality of care be most likely to suffer?

20. Which organisations and groups will be most important for safeguarding the quality of care over the next decade?

21. 'It is inevitable, in the next three years, that a 'benefits package' of what is and isn't available on the NHS will have to be defined explicitly'. How far do you agree with this statement?

22. 'It will become necessary to impose new charges or co-payments on NHS patients within the next three years'. How far do you agree with this statement?

23. It is realistic to raise taxes to continue to protect NHS funding. How far do you agree with this statement?

24. The basic rate of income tax is 20 pence in the pound. An additional one pence would raise £4 billion in 2012/13. If the basic rate of income tax was raised to fund the NHS, what level of increase do you think the public would accept?

25. March 2013 © Nuffield Trust www.nuffieldtrust.org.uk Sign-up for our newsletter www.nuffieldtrust.org.uk/newsletter Follow us on Twitter: http://twitter.com/NuffieldTrust