Guidance map / NHS value and efficiency map

The HFMA and NHS England NHS value and efficiency map has been updated. The map is a tool that promotes best practice in the efficient and effective use of resources to deliver high-quality sustainable healthcare. It includes resources which also recognise the importance of a value-based approach to enabling the delivery of high-quality sustainable healthcare services.

The challenge of using limited resources to effectively deliver high quality healthcare remains constant against the ever evolving political and economic landscape that NHS organisations operate within. Prior to the Covid-19 pandemic the National Audit Office (NAO) issued a series of reports on the financial sustainability of the NHS in which they stated ‘To be sustainable, the NHS needs to manage patient demand (including how long patients wait) and the quality and safety of services within the resources given to it.’

There is inconsistency in the language used to describe these challenges, with terms such as sustainability, productivity and value used interchangeably. But regardless of language, what is clear is that sustainability requires finance, clinical teams and informatics to work collaboratively both within individual organisations and across health and social care partnerships. Provision of high-quality services to improve population health and wellbeing is synonymous with efficient and sustainable use of resources and the moral imperative to reduce health inequalities is backed by growing evidence that there is a ‘cost of doing nothing’ which must be addressed. This approach is embedded in law by the Health and Care Act 2022 via a new duty for organisations to deliver against the ‘triple aim’ of improving (a) health and wellbeing, (b) the quality of services, and (c) efficiency and sustainable use of resources.

Establishment of integrated care boards (ICBs) in July 2022 signalled the start of formal working partnership to meet system-wide financial duties but this is being embedded at a time when systems continue to feel the impact of the Covid-19 pandemic plus the cost of living crisis, with significant challenges to financial sustainability at the same time as increasing operational pressures.

This map is a reference document for those involved in influencing the use of resources and ensuring delivery of the sustainable healthcare services. The intended audience is wide-ranging including finance staff, informatics teams, clinical staff, service managers and both executive and non-executive board members.

The map is split into four sections:
• explanation of terms
• strategic agenda
• enablers for value and efficiency
• opportunities to improve value and efficiency.

The map will be regularly updated. Please email [email protected] if you have suggestions for additions to the map.

Find out more about HFMA’s Healthcare Costing for Value Institute here.