The latest report by the influential think tank suggests that health and social care providers are "pessimistic" about the financial outlook of their organisations and some are concerned that the quality of patient care has suffered as a result.
Two-thirds of 48 NHS finance directors and 58 directors of adult social care services surveyed said they were concerned about the financial outlook across the local health and social care system in 2013. A third of NHS finance directors said the quality of NHS care in their area had deteriorated over the past 12 months.
And half of social care directors said they thought the quality of services they commissioned had worsened in the past year, with a third fearing they would have to reduce services over the coming year.
"The NHS faces unprecedented financial pressures, and there are growing worries that patient care will suffer," Professor John Appleby, chief economist at The King's Fund said. "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."
Mike Farrar, NHS Confederation chief executive, said: "Despite huge efforts to maintain standards of care and finances, NHS leaders are increasingly concerned about the pressures mounting on their organisations and the knock-on impact of reductions in funding for local government services. The findings of the Francis inquiry reinforce the fact that we must keep the focus on patients first and foremost."