NHS faces annual £14bn productivity gap

In a report, Improving NHS Productivity , the charity says that the most significant opportunities for avoiding the £14bn productivity gap "lie in changing clinical practice among front line staff". "This is less than previous assessments as it is based on reduced estimates for costs that may not be required or could be reduced in light of changing priorities," says the report, published on 22 July 2010. "It equates to a need to find productivity improvements of 3 to 4% a year if the NHS is to maintain quality and avoid cutting services." The report also identifies "real opportunities" for the NHS to tackle inefficiencies in support services and back office practice. It says that the NHS needs to "share back office functions and strengthen the procurement of goods and services". "As this happens, it will be essential to ensure that there is a continuing investment in developing leadership and change management capabilities at all levels of the NHS. This includes the development of both clinical and managerial leaders, together with the analytical and data management skills they will need to reduce waste and increase efficiency," the report says. But the restructuring of the NHS, including the abolition of primary care trusts and strategic health authorities, could be a major distraction for NHS leaders, the report warns. "This risk must be managed to ensure that the work on quality and productivity already under way in many parts of the NHS is not sidetracked," it adds. The document also stresses the need for integration between health and social care services and cites their combined working at Torbay Care Trust as a good example. The Devon trust has has established five integrated health and social care teams for older people, organised in localities aligned with doctors' general practices. "To maintain quality and avoid cutting services, the NHS must focus on delivering more value from the same amount of money, not delivering the same value for less money," said Chris Ham, chief executive of the King's Fund. "This means focusing on the front line teams who provide care to patients and hold the key to delivering the productivity gains needed."