Productivity prescription: giving the NHS space to breathe

In the recent budget, the Chancellor announced that technology, among other things, would be the route forward to £35billion of cumulative savings in the period to 2029/30. That £35billion is at the upper end of the ambition. 

Technology, data and AI all have valuable roles to play in the NHS and delivering that challenge. In that context, anything that seeks to further the modernize the system and improve its “offer” to both staff and patients should be welcomed.

The problem with big numbers is they’re often a generalization. Most people would agree technology, data and AI all have a valuable role in delivering savings, but it’s also a generalization.

Suppliers frequently favour generalisation, and its close friend “hype”, to simplify complex solutions and promote technologies without fully addressing the NHS’s underlying challenges. Within the NHS landscape, there’s a prevalence of point solutions and pilot programmes that haven’t delivered on their promises. Beyond the financial implications, these initiatives often fail to provide practical benefits for clinicians, patients, or overall healthcare outcomes. For example, the deployment of virtual wards. In one hospital alone, eight different virtual ward platforms coexist, sometimes requiring patients to navigate multiple systems simultaneously. Aside from the value to the public purse, such solutions often make little sense for clinicians, patients, or outcomes. Virtual wards are an excellent initiative, but they will likely struggle to have true impact if a technology-centric view persists, and if such technology is layered onto overworked staff and often unchanged models of care. 

Integrating solutions within the NHS

The problem for the NHS is not whether technology has an important role, but what role it plays and how that fits in with an integrated approach to complex issues.

It’s about aligning these solutions with the specific, real-world challenges that local healthcare systems are trying to solve. With the £35billion savings goal in sight, it’s essential to focus on addressing the factors that hinder productivity.

At Capita, we‘re not health economists. As such, we don’t have an economists view on how to measure NHS productivity, or if something is the right measure, or if it needs to be adjusted for quality, case mix or demographics. As a solutions-oriented company, we focus on delivering impactful and proven services, against real benefits cases, in partnership with the NHS every day.

When we consider a challenge like productivity, we focus on understanding the barriers to performance and the real-world intricacies of delivering quality service. We adopt this perspective as our framework, primarily because the term productivity broadly generalises a complex array of issues. As an example, on behalf of a London Integrated Care System (ICS) we led the procurement transformation of 150 FTEs across eight NHS Trusts and one Clinical Commissioning Group (CCG) into a single shared service procurement function to drive value and efficiency. Under a self-funded model we delivered over £8m in Cost Improvement Programme (CIP) savings against contractual guarantee.

Tackling productivity and innovation head-on

In terms of NHS productivity and budget ambitions, committed and invested partnerships are needed to help the NHS deliver. As an NHS partner, we’re aware of the difficulties in realising ambitious goals within a service that’s facing genuine challenges.

1. Identify core issues: What are the underlying factors that are diluting the impact of the system inputs such as funding and staffing? We need a focus on identifying those factors as targets before solutioning.
   
   These may range from visibility gaps, unplanned or obscured activities, and escalating complexities to insufficient investment, poor service integration, inefficient interfaces, staff morale issues, capacity demands, management limitations, skills deficits, lack of automation, unwarranted variations, and outdated IT infrastructures. While this list is not exhaustive, these significant challenges require careful consideration to prevent them from undermining straightforward solutions. Understanding these issues is the first step towards unlocking the full potential of change and innovation.
2. Space to breathe: The two primary obstacles that could prevent the NHS from fulfilling its ambitions are limited management capacity and inadequate investment. Put simply time and money. 
   
   The NHS leaders we speak with daily largely know what they need to do but are hindered by not having very much (or any room) for manoeuvre. 
   Partners must, therefore, provide solutions that offer the NHS the necessary flexibility, facilitating tangible savings and enhancing agility meaningfully. This involves taking risks and investing in the success of initiatives.
   
   As a partner, we believe we have to offer solutions which deliver headroom in these areas and doing so in a meaningful way. Meaningful - in the context of headroom - means, in part at least, helping the NHS save money in real-terms, not economic and helping it be more agile. Meeting the productive challenge will likely require the NHS to consider how it delivers change and improvement. 
    

Healthcare is complex, with no easy solutions. The NHS faces significant challenges that will become even more difficult without targeted support for the key agenda identified. Suppliers must offer more than just innovative ideas; they need to stand by the NHS daily, helping it to overcome both big and small challenges, even if they are more mundane than the “hype of the day”. 

Achieving the NHS’s £35bn savings target is ambitious. Many support this goal because they value what the NHS represents and its vital role. At Capita, we are fully committed to supporting the NHS in reaching this target - sharing its core values and recognising its paramount importance.

Explore our NHS solutions and take the first step towards better healthcare outcomes by contacting us today: