Does the NHS need more money?

Article published in the King's Fund.

There is still scope to improve productivity in the NHS. Emerging evidence from the Getting It Right First Time programme – which aims to improve quality of care and increase productivity in more than 30 clinical specialties – underlines the opportunities to reduce waste, improve clinical practice and tackle unwarranted variations in care. However, the NHS can no longer maintain quality of care and meet performance standards within its current budget. In the short term, the government will need to find additional funding if the NHS is to be able to deliver the current range of services to existing standards of care. In the long term, as the OBR has made clear, NHS spending will need to increase as a proportion of GDP. As the Barker Commission argued, this is affordable if hard choices are made about taxation and public spending.

Connecting allied health professionals (AHPs)

NHS Improvement recently hosted four regional events for provider AHP leads on evidencing the quality and productivity of AHPs’ care.

The events provided an introductionopens in a new window to the Model Hospital, AHP job planning, and the early findings of a deployment tracker metric that some AHP leads are currently implementing.

Towards affordable healthcare: Why effective innovation is key

This major new report from the International Longevity Centre, and supported by EY has found that whilst the UK is well placed to innovate to improve health outcomes and reduce costs, the UK is often not doing enough with the tools at its disposal.

With the NHS committed to achieving efficiency savings of £22 billion through productivity gains of 2 to 3% between 2015 - 2020-202, ‘Towards affordable healthcare: Why effective innovation is key’ explores how health care innovations currently employed at home and abroad could increase productivity and reduce costs.

The report showcases seven outstanding global and UK-based innovations with a strong evidence base of demonstrable success, and calculates the savings that could be achieved by implementing them across the UK.

NHS efficiency map

This map is a tool that aims to promote best practice in identifying, delivering and monitoring cost improvement programmes in the NHS. It contains links to a range of tools and guidance to help NHS bodies improve their efficiency.

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Productivity Of The English NHS: 2014/15 Update

This report updates the Centre for Health Economics’ time-series of NHS productivity growth. It finds that the rate of NHS productivity growth since 2004/5 compares favourably with that achieved by the economy as a whole.

Updates to the Model Hospital

NHS Improvement has made some changes to the Model Hospital including new compartments, features and a self-registration function for providers.

It's added pathology and doctor productivity to the list of compartments, and refreshed data to the following compartments:

• pharmacy and medicines
• nursing and midwifery
• allied health professionals
• visitor cost recovery

Model Hospital expanding to ambulance, specialist acute, community and mental health trusts

As part of our work to implement Lord Carter’s hospital productivity recommendations, the Model Hospital online information system is expanding to include early benchmarking data for ambulance, specialist acute, community and mental health trusts.

The data will go live on Monday 17 April and you can access it via the Model Hospital website. This letter provides a full overview.

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A year of plenty?: an analysis of NHS finances and consultant productivity

This analysis from The Health Foundation show that NHS providers saw relatively little of the income growth for the NHS as a whole, and that productivity for consultants and the wider workforce in acute hospitals has been falling.

NHS efficiency map updated

The HFMA and NHS Improvement have worked in partnership to update and revise the NHS efficiency map. The map is a tool that promotes best practice in identifying, delivering and monitoring cost improvement programmes (CIPs) in the NHS. The map contains links to a range of tools and guidance to help NHS bodies improve their efficiency.

Monitoring progress of the NHS estates and facilities (E&F) productivity efficiency project

This letter to E&F leads at acute trusts is to commission information which will tell us how we are making progress against Lord Carter’s recommendation (No 6) and the key supporting actions by the E&F community.

Productivity, Technology And The NHS

This paper from Newchurch looks at the NHS in England approach to productivity improvement half-way through the implementation of NHS Engand's 'Five Year Forward View' (5YFV).

Operational productivity – expanding to community and mental health

NHS Improvement have now commenced a review into community and mental health trusts, building on the approach of the Carter report on operational productivity and performance in NHS acute hospitals.

Professor Kendall is taking up this post alongside his role under the same title at NHS England, where he has been in post since April 2016. He will join the nursing directorate as an expert advisor to the senior leadership team and help to continue supporting improvement in mental health services across England.

NHS machines: the utilisation of high-value capital equipment at NHS trusts

The note from the Taxpayers' Alliance looks at the utilisation of five different types of machines in NHS trusts in England. It feels that when it comes to the utilisation of expensive machines, many NHS trusts are not sweating their assets. If NHS Trusts are to achieve genuine efficiency, the management of machines must be improved as part of a greater efficiency drive:

• Computerised Tomography (CT) scanners which provide a detailed view of different tissue types not available with traditional x-rays.
• Magnetic Resonance Imaging (MRI) which are is a safe means of producing detailed internal scans useful in diagnosis and treatment. 
• Linear accelerators (LINACs) which play a critical role in cancer care
• Lithotripters which use ultrasound shock waves to break up kidney stones. 
• Positron Emission Tomography (PET) scanners which are useful in effectively diagnosing and treating cancer.

Priorities for the NHS and social care in 2017

The NHS five year forward view (Forward View) will be tested to its limits as leaders work to improve performance and transform care. The NHS locally has to deliver £15 billion of the £22 billion efficiency improvements required under the Forward View, with the remaining £7 billion to be delivered nationally. It also has to provide evidence that new care models are delivering benefits. Failure to do so will raise serious questions about the assumptions on which the Forward View was based and on the ability of leaders to deliver their plans.

Against this background, the King's Fund has identified five main priorities for 2017:

• Supporting new care models centred on the needs of patients
• Strengthening and implementing sustainability and transformation plans
• Improving productivity and delivering better value
• Developing and strengthening leadership at all levels
• Securing adequate funding for health and social care

New report shows the way ahead to tackle delays and duplication across health and social care

The Health Foundation and the Advancing Quality Alliance (AQuA) have published The challenge and potential of whole system flow, a guide to help local NHS and social care leaders to work together to improve productivity, patient experience and the quality of services.

The report says poor flow not only wastes time, energy and money, it can hurt patients and is deeply frustrating for people working in health and social care. The report cites common examples of poor flow: ambulances queuing outside hospitals; stretched emergency departments; problems getting a GP appointment; and mental health patients being transferred hundreds of miles for a bed.

The report argues that the current context for health and care providers – including significant financial pressures and the emergence of new local partnerships (the Sustainability and Transformation Plan partnerships in England) –present an opportunity for a serious focus on tackling flow across NHS and social care systems.

The State of the NHS Provider Sector: November 2016

This survey of NHS trust chairs and chief executives by NHS Providers has revealed rising concerns over the growing NHS workforce gap.

172 NHS leaders responded to the survey and only 27 per cent of these respondents reported confidence in having the right staff numbers, quality and skill mix to deliver high-quality care. The report provides examples of where trusts are improving quality of care and increasing productivity despite financial constraints and growing demand. The report highlights that trusts are able to deliver when given achievable tasks but warns that the sustainability of services is at risk.