Nurses among those praised for boosting NHS productivity

The research, by the University of York’s Centre for Health Economics, found NHS productivity in England has grown almost two and a half times as fast as the wider economy over the last 12 years.

“This is a huge tribute to the work of NHS staff, and the intrinsic efficiency of this country’s health service”

Simon Stevens

According to the study, NHS staff provided 16.5% more care pound for pound in 2016-17 than they did in 2004-05 compared with growth of only 6.7% in the economy as a whole.

Meanwhile, productivity increased by 2.86% between 2015-16 and 2016-17, the report said.

Increases in NHS productivity are measured by comparing the growth in “outputs” such as the number of treatments provided with “inputs” – the number of nurses, doctors and support staff providing care, equipment and clinical supplies used and the cost of hospitals and other facilities.

The study – titled Productivity of the English National Health Service: 2016-17 Update – shows NHS outputs have continued to increase since they started being measured by researchers in 2004-05.

For example, it shows over 5.2 million more patients received planned or emergency hospital treatment in 2016-17 than in 2004-05 – an increase of about 42%.

“Is the purpose of healthcare ‘improved productivity’ or the alleviation of human suffering?”

Alison Leary

In addition, outpatient activity shot up by about 131% with over 60 million more attendances in 2016-17, compared with 2007-08.

In calculating the growth in productivity, the researchers also took into account the quality of care provided.

The study found there have been year-on-year improvements in hospital survival rates.

However, waiting times have been getting longer since 2009-10, although they are shorter than they were in 2004-05.

Overall NHS output – with quality taken into account – has increased by 60% between 2004-05 to 2016-17, said the report.

This has been mirrored by increases in “inputs” such as staffing with spending on NHS staff increasing by 57.4% in the same period, the report found.

It revealed spending on agency staff, such as nurses, had fluctuated “erratically” over time, with “periods of increased use followed by periods of restraint”.

Overall, spending on agency staff has increased 88.5% since 2004-05, but the figures show spending dropped for the first time in years in 2015-16 – following the introduction of a spending cap.

Spending on supplies increased by more than 202%, while spending on buildings and facilities increased by more than 189% over the 12 years from 2004-05 to 2016-17, found the report.

Altogether spending on NHS “inputs” increased by 79.5% over that period and by 3% between 2015-16 and 2016-17.

NHS chief executive Simon Stevens hailed the increase in overall productivity as a major achievement.

NHS England

Simon Stevens

Simon Stevens

“This independent research confirms that NHS productivity has been growing at more than double that achieved by the rest of the UK economy including the private sector,” he said.

“This is a huge tribute to the work of NHS staff, and the intrinsic efficiency of this country’s health service,” said Mr Stevens.

He added: “It represents further welcome proof that taxpayers’ investment in our health services is money well spent.”

However, some nursing experts raised concerns about whether enhanced productivity was necessarily a good thing, given current staffing shortages and pressures on nurses and others.

“If the NHS is more efficient but the workforce is over-stretched and the care is not person-centred then what is the price of efficiency?” said Professor Alison Leary, chair of healthcare and workforce modelling at London Southbank University and a member of he Nursing Times editorial advisory board.

“Is the purpose of healthcare ‘improved productivity’ or the alleviation of human suffering?” she tweeted in response to the report.

Work to boost the efficiency of the health service even further is ongoing, according to NHS England, which said the NHS delivered more than £6bn in quality and cost improvements last year.

alison leary

alison leary

Alison Leary

Recent steps taken by NHS England and NHS Improvement to improve efficiency included the agency cap introduced in November 2015, plus efforts to stop unnecessary prescribing and halt ineffective procedures, helping save millions each year.

Meanwhile, further efficiency savings set out in the long-term plan for the NHS in England include reducing spending on everyday items, drugs and admin costs.

New ways of delivering care are also expected to help boost efficiency and achieve better results, said NHS England.

These include including doing more tests and treatments in the community rather than in hospital, bringing together physical and mental health services to provide more preventative care, and increased use of technology and data.