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Roadmap to better efficiency

by Elizabeth O’Mahony

16 January 2017


In many ways, productivity improvement is a good news story for the NHS. At the half-way mark for 2016/17, NHS providers (although slightly behind planned levels) were forecasting that they will achieve £346m more cost improvements by the year-end than in 2015/16. Achieving this would mean cost improvements would amount to 3.9% of spend compared with 3.6% achieved last year.

Contributing to these efforts, providers are also on target to take out almost £1bn from their agency staffing bill.

However nobody is under the illusion that this is a job done. Achieving the month six forecast for 2016/17 while maintaining our focus on quality – with much of the winter still to come – remains an unrelenting challenge. And beyond the immediate challenges of the current year, the service faces a sustained financial challenge to combat significant challenges relating to population growth and changing disease patterns.

Meeting current demand in better ways – making better use of technology and ensuring care is delivered in the best setting and at the right time – is how we will meet the long-term sustainability challenge. But it is not all about new models of care. We need to tackle variation in services and eliminate it where it is unwarranted – often adding unnecessary cost. And we need to push harder to improve our productivity in both frontline and support services, making full use of Lord Carter’s pioneering work in this area.

There is already good work underway, but there is also significant scope for improvement. Even the most efficient provider has services that are seriously inefficient. We need to get better at spreading good practice and make the most of existing tools and proven approaches to accelerate our efficiency drive.

With this goal in mind, NHS Improvement and the Provider Cost Improvement Group have worked with the HFMA to update the NHS efficiency map. Published recently, it’s an easy way for provider finance teams to look for new efficiency ideas and to test whether what they are already doing is effective.

The map brings together efficiency guidance, tools and examples to help produce cost improvement plans – quick links to information on the Getting it right first time  programme or Lean-based ‘productive series’ of specific setting improvement methodologies .

It provides links to best practice on how to lead, manage and report on efficiency programmes. And we hope it will become a gateway to help managers find the resources they need to support local improvement drives – a living document that is updated regularly with real-life examples where trusts are realising savings.

You can already find great examples of how providers are driving improvements in care and reducing costs with a more structured approach to enhanced nursing care or specialling. Other studies look at real improvements in procurement and operating theatre management and at how one trust is taking a very structured approach to its medically-led cost improvement programme.

The map may offer some new ideas on how to drive improvement locally or it may simply act as a check list of the support and improvement tools that are already out there for providers to use. Either way, we hope it will give providers some support as they continue to tackle variation and drive productivity.

The key to success is taking improvement methodologies and tools, such as those signposted in the map, and using them to deliver actual better, more cost-effective services. So if you’ve got a story to share that might help others in their pursuit of better value, let us know.

Have a look at the map here