Nicholson challenge

The term "Nicholson challenge" refers to a set of mandates that the former (2006-2012) leader of the National Health Service in England, Sir David Nicholson, has put forth to the entirety of the NHS in a drive to find "efficiency savings" amidst a UK economy in upheaval.

The parameters of the "challenge" by Nicholson to the NHS collectively add up to a demand by Nicholson for the NHS to find £20 billion in "efficiency savings" by 2015. The claim is that better ways of working rather than more spending must be found, amidst a warning that if the challenge were not met, either more money would be needed or fewer desirable results would be achieved.

The Health and Social Care Bill 2011's provisions, which greatly alter the fundamentals of NHS functioning (not just financing), is technically not a part of this "challenge" at all, but is happening separately. The Nicholson challenge keeps NHS law and regulations as they have been prior to the Health And Social Care Bill's passage, but asks staff and administrators to find these "savings" within those present parameters nevertheless.

The NHS faces unprecedented financial pressures, and there are growing worries that patient care will suffer. For social care, it will be increasingly difficult for councils to make further savings without directly cutting services or affecting quality. Health and care services have coped well until now, but it is clear that many organisations expect things to become much more difficult over the coming year [2013]. (John Appleby of the King's Fund)

Doctors and nurses across the NHS already complained early in 2011 that front-line NHS services of many different types were having to be cut immediately, and very heavily, in order to achieve these "savings", despite Nicholson alleging that they would not have to be. NHS workers still insist, up to the present day, that it is impossible to find these types of 'savings' in this amount of time without having to make drastic cutbacks to existing services. Even a late-March 2012 news article dealing with the risk register of the Health and Social Care Bill 2011 found fit to mention a few lines about the Nicholson Challenge's £20bn target, mentioning that in the 2010-dated risk register, "Civil servants ... rate highly the danger that the £20bn savings may not materialise as managers lose focus and ... quality of patient care suffers", even though "Ministers [today in 2012 say] that a report to be published on Tuesday shows that the NHS is on course to meet the so called "Nicholson challenge" to save £20bn over the course of this parliament."

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Wikipedia