Welcome to Providers Deliver: achieving value for money. This is the tenth report in the publication series where we celebrate and share the work of NHS trusts and foundation trusts, as they continually strive to improve services for patients and service users, despite facing challenging operational and financial pressures. The 2024/25 NHS operational planning guidance positioned improving the productivity of the NHS as one of its core priorities (NHS England, 2024a). This report will explore how trusts across all sectors have been identifying innovative solutions to improve their productivity and continue delivering on the priorities of their local populations.
In July last year, we published Stretched to the Limit: tackling the NHS productivity challenge, which examined the various barriers trust leaders identified as stalling the NHS' return to pre-pandemic levels of productivity growth (NHS Providers, 2023). As we continue our recovery from the Covid-19 pandemic, trusts are working flat out to tackle record-high care backlogs and long waiting lists, at the same time as identifying significant efficiency savings and delivering more activity within existing resources while maintaining high quality patient care.
The aim of this report is to move the conversation on from 'diagnosing' the NHS' productivity challenges and highlight a variety of the 'treatment' plans trusts have identified which have had a material impact on their productivity levels. Trusts are at the heart of many of the innovative solutions across health and care and are best placed to lead the NHS' efforts to improve delivery models, streamline internal processes, adopt new technologies and allocate resources most efficiently and effectively to deliver results for the populations they serve.
Trust leaders are committed to doing all that they can to achieve the best value for money for taxpayers. As a result, the provider sector wants to ensure productivity is viewed through a much wider lens of improvement and the concept of 'value'. When measuring NHS productivity, there is a risk that government and national bodies focus on the technical definition of productivity as a formula comprised of examining the total number of 'inputs' (NHS funding, number of staff ) for the total number of 'outputs' (the amount of activity delivered). Instead, through the conversations I have with trust leaders, there is a clear focus on striving to improve outcomes for patients, which will simultaneously help the NHS to be more productive. The NHS needs a vision to unite behind and I believe that vision should focus on the priorities of patients. Our Picture of health briefing outlines five shared commitments that will help realise the next generation NHS, driving greater national productivity and delivering clinical excellence (NHS Providers, 2024).
As this report highlights, there are a variety of factors which can help improve productivity across the health service – some of these are within the capacity of trusts to influence and control. However, if we are serious about improving the sustainability of the health service and want to enable it to be as productive as possible, then the efforts of trusts to improve productivity have to be matched by efforts across government to tackle some of the long-term enablers of productivity growth, such as capital investment to improve the NHS' infrastructure. Recent analysis by the Health Foundation explores the potential benefits of technology freeing up additional time for staff, to not only increase patient care volumes, but also dedicate more time to training and research – all producing a tangible benefit to productivity (Horton & Moulds, 2024). As the following report shows, trusts are committed to do their part to improve productivity; but they need support from government and national bodies to unlock their full potential.
Sir Julian Hartley
Chief Executive, NHS Providers