Service Reconfiguration

10.10.18

Current NHS efficiency methods ‘no longer sustainable’ as 75% of trust leaders believe NHS 'wastes too much money'

The current way of driving efficiency in the NHS is “no longer sustainable” and the 10-year plan is an opportunity to provide a solution, according to a new report.

A new report from NHS Providers has said that the current way of driving efficiency in the NHS is “no longer sustainable” and that the 10-year plan and NHS funding settlement is a chance to provide a transformed and sustainable health service.

The report noted that trusts have delivered “impressive” efficiency savings year-on-year since austerity began in 2010-11. Providers delivered nearly £7bn of recurrent savings in the last three years alone.

However, the report found that trust leaders have “exhausted the 'easily realisable' savings from within their own organisations,” which leads them to be “increasingly reliant” on non-recurrent savings or on more ambitious, longer-term transformation plans which require central support and upfront investment.

During his opening speech at the NHS Providers annual conference yesterday, its chief executive Chris Hopson called for a performance and financial targets ‘reset’ within the 10-year plan.

Findings in the report suggested that trust leaders know where efficiency gains can be made, but that they need support from outside their organisations to achieve them. Just 20% of respondent to NHS Providers’ survey agreed that they had received enough support from central bodies, and just 19% said they had the resources available to make further progress on efficiency.

The report also states that 75% of trust leaders believe the NHS wastes too much money.

Echoing Hopson’s speech, the report recommended that the forthcoming long-term plan should identify “realistic and deliverable improvements that can be made and chart a credible path to realising them,” and added that placing trusts under financial pressure will not automatically lead to efficiency improvements.

Other recommendations from the report include drawing distinctions between cost reduction schemes, productivity improvements and system efficiencies; accepting that there will be some variations between organisations in how services are delivered and that the long-term plan should only describe variation as “unwarranted” where there is clear evidence that it can and should be removed; and that accountability must shift away from single-year efficiency programmes to provide incentives for both commissioners and providers to prioritise more sustainable efficiency schemes.

The report also called on NHS Improvement to not rely on organisational reconfigurations to save unsustainable services, that it should automate as many information collection processes as possible to reduce the reporting burden on trusts, and that it should identify top efficiency performers similar to the Global Digital Exemplars programme.

During his speech yesterday, Chris Hopson also called for a “reimagined” relationship between local and national leaders and for greater powers to be devolved to local system leaders.

 

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