Dr John Øvretveit
This report reviews the evidence of whether improving quality can also save money for health service providers. It explores the cost saving potential of initiatives to improve quality and the barriers to success.
For most of the last decade, organisations have become accustomed to times of plenty. But the impending public sector spending crisis changes this context utterly. There are many ways in which savings can be made. The report sets out to answer whether improving quality can also help to address the need for costs to be saved.
The evidence suggests that improving quality could have an important if limited contribution to addressing financial pressures. At a local level, clinicians and managers can increase their likelihood of success by: working together to meet the challenge, using tested improvements that are adapted to local circumstances, using reported experiential evidence; measuring and monitoring the improvement, including how much it has cost and how much it has saved; and above all by managing implementation skilfully.
At a national level, the evidence suggests that the Department of Health and strategic health authorities could improve chances of success by providing NHS organisations with the expert support, supporting the development of skills and addressing the barriers created by the financial and performance management systems.
The Health Foundation is also supporting the NHS through our new award programme, Shine, which launched on 1st September 2009. Shine will support clinical teams to implement innovative ideas to save money while maintaining or improving quality. We are pleased that the review of the evidence supported our view that focusing on small scale changes has significant potential to lead to cost savings. Our award is about helping people test their ideas and establish the evidence base for their changes in order to encourage others to adopt the ideas.
This report will be of interest to anyone in the NHS that is interested in improving quality and reducing costs especially, primary and secondary healthcare organisations, strategic health authorities, royal colleges, specialist medical societies and policy makers.