Long-term plan must take new approach to efficiency

A report, Making the most of the money – efficiency and the long-term plan, said providers were ready to deliver the long-term plan. However, the success of the plan would depend on the levels of efficiency savings required and how they are realised.

It said that most of the readily available savings have already been delivered. NHS Providers warned that ‘unreasonable’ efficiency requirements were leading to greater provider deficits. Providers were increasingly forced to use non-recurrent measures to meet efficiency targets.

Instead, the long-term plan should focus on the efficiency gains to be made in greater collaboration across local systems. A survey of trust leaders found that 61% said improved system working represented the greatest opportunities for efficiencies over the next five years.

However, fewer than one in five (19%) were confident their trust could increase the level of efficiency savings in the next five years, while only 10% believed they would be set a reasonable efficiency target. And only 25% said they could safely continue to deliver the same levels of efficiency.

Financial incentives that promote short-term thinking were the biggest barrier to increasing efficiency, according to 69% of trust leaders. A similar proportion said operational pressures presented the biggest barrier.

While most trust leaders (71%) agreed there was waste in the NHS through inefficiency, many pointed out that it compared well with other health services internationally.

Chris Hopson (pictured), the chief executive of NHS Providers, called for trusts to be given a voice in the debate on efficiency ahead of the long-term plan being finalised. ‘The discussion on provider sector efficiency has often been conducted as a one-way, top down, debate with NHS national system leaders setting the overall requirement and outlining areas where they believe efficiencies can be made.’

He added: ‘It is clear from this report that there are opportunities for further efficiencies – trust leaders recognise that – but their confidence in being able to deliver them is low. We cannot continue as we are, setting an unrealistic target and hoping that will deliver more savings. It just leads to increased provider deficits.

‘Taking forward these ideas to make the most of the money in the NHS will require new thinking and a different approach from all of us. However, it is clear that NHS trusts are ready to meet that challenge.’

Speaking at the opening of NHS Providers’ annual conference, Mr Hopson said that the long-term plan must be a reset moment for NHS performance and finances. The long-term plan must allow the provider sector to return to sustainable success ‘to enable frontline staff and trust leaders to feel, once again, that their efforts are being properly reflected in a positive public narrative about how well the NHS is doing’, he added.

The patience deficit (blog): 10-year plan must set credible expectations for how quickly change can be achieved.