Doctors and managers are becoming increasingly sceptical about the NHS’s ability to meet the government’s £20billion efficiency savings target by 2015, according to a report in

In the latest Quarterly Monitoring Report, from health think tank The King’s Fund, doubts have been voiced about the likelihood of meeting this target for productivity improvements.

The survey carried out in July, which gathered results from 29 CCG finance leads, 42 NHS trust finance directors, and 22 directors of adult social services, showed that only 10% of finance directors rated the chances of meeting the target as better than 50/50.

Just over half of them (56%) identified a high or very high risk that the target would not be met, while a third (34%) rated the likelihood of success as 50/50.

The survey, which this quarter includes finance leads from CCGs as well as trust finance directors, highlighted the growing pressures on NHS providers, said The King’s Fund.

Only a third (33%) of trusts surveyed said they expected to meet their cost improvement targets for 2013-14 - a sharp fall on the same quarter last year when nearly three-quarters were confident of meeting their targets.

Commissioners, however, were more optimistic, with 72% of CCG finance leads expecting to meet their organisation’s targets.

Analysis of NHS performance data for the first quarter of 2013-14 in the report shows most indicators are broadly stable, although A&E waiting times remain comparatively high.

Over the quarter, 241,000 patients (4.3%) spent four hours or more in A&E, which means that although this is back within the target range, it is the highest level for this quarter since 2004.

The survey of CCG finance leads and trust finance directors also found that the vast majority (89%) expected their organisation to be in surplus or to break even in 2013-14, with 11% expecting to be in deficit.

Almost a third (31%) said patient care in their area had got worse over the past year, compared to 14% who said it had improved and 55% who said it had stayed the same.

Professor John Appleby, chief economist at The King’s Fund said: “The findings from our survey of finance directors have become significantly more pessimistic over the past 12 months, reflecting the growing pressures on the NHS.

“Now just over half way through the so-called Nicholson Challenge, it is clear the NHS will struggle to meet its £20 billion productivity target, with potentially serious consequences for patient care.

“The reality for many hospitals is that they face an uncomfortable choice between whether to prioritise the quality of services for patients or allow performance in some areas to slip in order to balance the books."