The Health Foundation’s response to Lord Carter’s review on NHS spending

Lord Carter of Coles, Chairman of the NHS Procurement and Efficiency Board, has published his report on NHS spending today.

Commenting on the report, Dr Jennifer Dixon, Chief Executive of the Health Foundation, said:

“We welcome Lord Carter’s report, which usefully identifies the scope for around £5bn of efficiency savings by 2019/20 across NHS hospitals from improving workflow, managing workforce costs, better procurement, and improved estates and medicine management.

“This is a significant contribution to the £22bn estimated efficiency requirement facing the NHS by 2020. The emphasis on getting better data and metrics to show hospitals how they compare with others is sound. This data will need to be recognised as meaningful and valid at a local level and then used and interpreted intelligently to identify and support improvement. We agree that regulation should not be the primary route to prompting change. 

“Lord Carter's work is a stark reminder both of the size of the challenge and the scale of the leadership task. His report reminds us that there is no silver bullet and unlocking these efficiencies will require sustained work across the service. Crucially the report identifies the need for funding to achieve these efficiencies. We and the King’s Fund have argued that to meet the challenges the NHS faces it will need dedicated investment to provide the support for transformative change. This is over and above the additional £8bn to sustain NHS services.  

“We agree that workflow and discharge arrangements are key areas needing further exploration in his final report in the autumn. Flow Cost Quality, a Health Foundation programme, also found that improving workflow – how patients move through the system – can make significant improvements to the quality and safety of care patients receive.

“For example, when Sheffield NHS Foundation Trust first implemented improvements to patient flow this led to a 37% increase in the number of frail older patients who could be discharged on the day of admission or the following day. The Trust also saw a 15% decrease in in-hospital mortality for geriatric medicine. But all this took a lot of frontline clinical involvement, specialist expertise and time – it’s not a quick fix.

“The focus on out of hospital support to prevent avoidable admission and support early discharge is also welcome. To achieve this we will need much better working across health and social care. Again this will take time and careful management to achieve.

“The approach taken by Lord Carter, if implemented well, should help to improve the efficiency of our hospitals over the coming years. But there is still the unresolved short term question of how our hospitals are to balance their books this year. In 2014/15 they reported a deficit of approaching £1bn. This year it is forecast to be even larger.”

Media Contact

Thais Portilho, Senior Public Affairs Manager
T: 020 7257 8027
M: 07584 995681
E: thais.portilho@health.org.uk

Notes to editors:

Read more about the Flow Cost Quality programme here and here

Read the Health Foundation’s Improving Patient Flow report here

The Health Foundation is an independent charity working to improve the quality of health care in the UK. We are here to support people working in health care practice and policy to make lasting improvements to health services. We carry out research and in-depth policy analysis, run improvement programmes to put ideas into practice in the NHS, support and develop leaders and share evidence to encourage wider change.  We want the UK to have a health care system of the highest possible quality – safe, effective, person-centred, timely, efficient and equitable.