As the economy starts to stabilize and politicians begin to look to the next election, the
over public spending has risen to the fore.
expected to be as high as 79% of GDP by 2014, there is little argument that the public purse will have to be tightened.
No party is yet talking of cuts to the NHS budget, and the Conservatives have promised that health spending will be a priority.
But even if funding is sustained at present levels, many believe big savings will still have to be made, as Professor John Appleby, chief economist at health care think-tank
The King's Fund
From 2011 the NHS will be extremely lucky to get even the smallest real growth in its funding. Zero real growth for some years looks probable.
But standing still in terms of funding will put the NHS under pressure. Some cost increases will be unavoidable and there are always pressures to do more because of a growing and ageing population.
The size of the gap between its actual funding and such cost-and-need pressures is debatable. Some estimate around £5bn a year (out of £105bn) for each of the five years from 2011 to 2016.
But it could be more depending on the state of the economy and choices over taxation and other spending priorities.
This gap is not catastrophic for the NHS - but it will be difficult and staff and services may be affected.
The key will be to make every health care pound work harder, minimising or avoiding real cuts and closing the gap through improved productivity.
So what should the NHS do now?
First, the service needs to improve the quality of care patients receive. For example, avoiding infections in hospital is good for patients and saves money.
Second, back office functions such as payroll and estates management can be shared between hospitals.
A big area for potential savings is reducing unnecessary variations in medical practice. For example, doing more day cases rather than treating patients in hospitals and requiring them to stay overnight.
Tackling drug spending by ensuring doctors prescribe more cheaper, generic drugs rather than branded ones would also release savings.
And, most importantly, the NHS could provide incentives to frontline staff to deliver more cost effective care by sharing savings between the hospital and departments that find the saving.
WE NEED YOUR HELP
The Today programme wants to find out practical ideas as to how the NHS can save money from people with first hand experience of the health service.
If you work in the NHS, or for an organisation which works with the NHS, we want to hear where you think savings could be made.
We will treat your emails in confidence and will not publish any information that could lead to your identification without contacting you directly beforehand.
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