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Responding to the publication of the Health Select Committee's report on public expenditure on health and social care services, John Appleby, Chief Economist at The King's Fund said:

'Today's report from the Health Select Committee hits the nail on the head by calling for fundamental change in health and social care.

'Our own work shows the financial squeeze is beginning to bite hard in the NHS and efficiencies are becoming harder to deliver, as one-off savings, such as cuts in management costs, start to slow. As the report points out, pay restraint and holding down prices paid to hospitals are no substitute for delivering genuine productivity improvements.

'Despite high-level political commitment, there has been a lack of urgency in developing integrated care - this now needs to happen at scale and pace. Major reconfigurations of hospital services are also needed to improve the quality of care and increase financial sustainability.

'The NHS and social care face huge challenges – addressing financial pressures and improving quality of care in the short term, and meeting the challenges posed by demographic change and changing health needs in the long term. This demands new thinking and radical changes to services.

'In focusing on the need to develop integrated care, the Committee has identified the right starting point. This should include making better use of existing resources by bringing together health and social care budgets locally and moving towards a single, strategic assessment of the funding needs of the NHS and social care in future spending reviews.'

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