Productivity in the NHS

Why it matters and what to do next

1 November 2018

Title

Productivity in the NHS: why it matters and what to do next

Published journal

The BMJ

Abstract

Earlier this year, the prime minister announced a financial settlement for the NHS over the next five years of 3.4% real terms growth, or £20.5bn (€23bn; $27bn) a year by 2023-24.

Although greater than the 1.5% growth over the past eight years, the settlement is less than the long term average of 3.7% and the 4% recommended after recent detailed analyses. It will not be enough to modernise the service or head off difficult decisions about what services and treatments to provide. These decisions will be easier if the NHS is able to get more out of the funding it receives, which requires a focus on productivity.

Productivity is not normally a centrepiece of reforms to the NHS, but it should be. Paul Krugman, the distinguished US economist, put the issue starkly: “Productivity isn’t everything, but in the long run it is almost everything. A country’s ability to improve its standard of living over time depends almost entirely on its ability to raise output per worker.”

However, productivity is a subject guaranteed to kill the attention of clinicians and patients. Clinicians associate it with working harder—something viewed with derision in today’s resource squeezed stressful working environment—and patients with cutting costs. Policy makers highlight new technologies that “disrupt” usual working practices as being the key to higher productivity—a narrative that can easily alienate staff and often omits the need to support staff to introduce and adapt new innovations, without which diffusion is slow. It is true but a cliché that increasing productivity means working more effectively not necessarily harder, reducing waste not sacrificing quality.

Read full article

You might also like...

Blog

Taking a long-term view

How can our new programme, Shaping Health Futures, help the long-term sustainability of health and social care services?

Press release

The NHS has a new long-term plan but this is not 'job done'

The Health Foundation has responded to the publication of the NAO's annual report on the financial sustainability of the NHS.

Press release

NHS long term plan launch: pragmatic and ambitious, but making it a reality will be tough

Health Foundation response to launch of new long term plan for the NHS in England

Citation

BMJ 2018; 363  doi: https://doi.org/10.1136/bmj.k4301 (Published 26 October 2018) 
Cite this as: BMJ 2018;363:k4301

Kjell-bubble-diagramArtboard 101

Work with us

We look for talented and passionate individuals as everyone at the Health Foundation has an important role to play.

View current vacancies
Artboard 101 copy 2

The Q Community

Q is an initiative connecting people with improvement expertise across the UK.

Find out more