The impact of spending cuts is as big a challenge for the NHS as implementing the Health and Social Care Act, say healthcare leaders.
An exclusive Guardian healthcare network survey asked members what they think are the main concerns facing the health sector; 64% said implementing efficiency savings, 62% said the impact of the Health and Social Care Act, and 35% said planned NHS reforms.
Other responses included the increasing demands placed on the health service by demographic changes - citing both the ageing population and an ageing workforce. One member wrote the biggest challenge was "becoming more cost efficient while maintaining and improving quality"; and another cited unco-ordinated thinking and planning.
The issues of spending cuts and the government reforms are recurring themes throughout the survey, with many members blaming them for the aspects they like least about their jobs, and also fearing the effect they will have in the year ahead.
Our survey was launched before the health and social care bill gained royal assent to become the Health and Social Care Act, and asked members whether they personally supported the proposed reforms - 68% said no, 11% said yes, and 21% were unsure.
One member branded the bill "unworkable", another commented "this bill could well be Cameron's 'poll tax'", and a third said: "The NHS remains a political toy and is bounced on a whim from minister to minister."
Members were also asked whether they think there should be more private sector involvement in the health service - 56% said no, 27% said yes and 18% were unsure.
And the questionnaire - completed by more than 500 healthcare network members - also asked whether healthcare leaders think there should be more integration of health, social care and housing services. Some 89% said yes, while 5% said no and 6% were unsure.
The research revealed a very strong sense of public service among healthcare network members, with a large proportion saying the chance to help people, care for patients and improve others' lives was the most enjoyable aspect of their job. Many also cited patient contact, while the variety of their role and the challenges of delivering care were also repeatedly mentioned.
When asked what they liked least about their jobs, many members said they felt uncertain about their future - whether due to government policy, NHS funding or job insecurity. A number mentioned that politics - at a local and a national level - were having a negative impact on their work, and many felt that paperwork, meetings and administration (one member cited "death by email") were the least enjoyable aspects of their work. Other members cited workloads, staff shortages, work place pressure and poor morale.
Most members (73%) think their jobs will become more difficult in the year ahead - and cuts and reorganisations were again mentioned by many.
One member said: "We are fighting to understand the new NHS structures, in 12 months we will still be trying to understand them and delivering in a changing landscape."
Another commented: "There is a huge amount of work to do, and in some instances there is a lack of focus, vision and lack of support. With uncertain financial times, and in the challenging political climate. Things are very tough."
But 25% think their role will stay the same over the next 12 months - and 3% believe it will get easier.
The research is the second in a series of quarterly questionnaires sent to healthcare network members and promoted via Twitter and Facebook. The first questionnaire also found that spending cuts are the biggest challenge facing NHS leaders.
Watch out for further opportunities to contribute to healthcare network research later in the year, and in the meantime please add your comments on the issues discussed in this piece below. Guardian Professional.
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