In the budget for 2009, it was announced that the Department of Health will be contributing £2.3 billion in additional savings to the overall reduction in Government expenditure and borrowing. Health Secretary at the time, Alan Johnson, said:"Better quality, safe health care goes hand in hand with better value for money" and NHS Chief Executive David Nicholls has written to the NHS stating that "the value-for-money challenge will be met through delivering on our quality agenda, not instead of it." However, several reports are already suggesting that there will inevitably be cuts in frontline services, training budgets, and investment in new facilities. The RCN is constantly alerted to the impact of external financial factors on patient care in the NHS. In order to better understand how the NHS was using its resources in these uncertain economic times, the RCN wrote to over 550 NHS organisations across the UK under the Freedom of Information Act and asked for a breakdown of their expenditure on external consultants.