The government’s NHS reforms may jeopardise the health service’s ability to meet efficiency targets, a report by the Health Select Committee has concluded. The MPs criticised the “surprise” nature of the NHS reforms, saying  plans to abolish PCTs and transfer commissioning responsibility to GP consortia had not been expected. “This ‘surprise’ approach created uncertainty among commissioners and therefore increased the risks and costs associated with delivery of the Nicholson Challenge,” the report said, referring to the NHS targets set down by chief executive David Nicholson to achieve a 4 per cent efficiency gain for four years running. The “relatively protracted timescale” of the planned reforms would also affect the ability of the NHS to make efficiency savings, the MPs said. And the report was critical of plans to see commissioning led by GP consortia, saying doctors should not be the “ultimate arbiters of all commissioning decisions”. Instead the committee called for commissioning “to draw from as wide a pool of practitioners as possible”. Although the committee agreed on the importance of PCT clusters in implementing the reforms, it said they must play a vital role instead of being “merely a short-term expedient”. The report went on to highlight the need for performance management and a culture of accountability for the NHS  among MPs as well as the public. The committee said it intended to “review the lines of accountability between the NHS Commissioning Board, the Department of Health and the Secretary of State.” The King’s Fund supported the Health Committee in its findings. “The committee is right to highlight the risk these reforms pose to delivering on the key priority facing the NHS in the period ahead – finding up to £20 billion in productivity improvements,” said King's Fund chief executive Chris Ham. Mr Ham also agreed the roles of GP consortia and PCT clusters should be reviewed.