NHS needs to gear up in terms of productivity, say statisticians

By Dr. Ananya Mandal, MDMar 25 2010

Steady fall

In an alarming new revelation, the productivity of National Health Service NHS, has dropped steadily from 2001 by 0.4% each year and a total of 3%. 2008 has seen the largest fall, 0.7% according to the Office for National Statistics, ONS.

This fall has been estimated to be due to the increase in patient load compared to workforce and services. The ONS adjudged this drop after adjustments of service quality measurements including survival rates, shorter waiting time, health benefits and measures of primary care like blood pressure and cholesterol. Without these adjustments the figures are more dismal at 7.8% drop since 2001.

The ONS said yesterday that the quality measures were "the best we have at the moment but measuring quality [in the NHS] is very difficult".

Andrew Lansley, the Shadow Health Secretary, said: “This is further evidence that the Government has failed to deliver reform and value for money in the NHS ... Too much money in the NHS has been wasted, there is too much bureaucracy and the resources have not got to the front line.”

Mike O'Brien, the health minister, said: "Most economists, and HM Treasury, accept it is difficult to grow capacity and productivity at the same time, yet the NHS maintained virtually flat productivity [a 0.3 per cent a year decline] over the longest period of sustained growth in its history."

Paradox

Some of the reasons for this drop remain hidden and paradoxical. For example longer consultation time that improves patient care and satisfaction results in a fall of productivity. Cancer therapy improvement also shows up as a fall in productivity due to shorter life span in such patients.

Plan & way forward

The Department of Health yesterday laid out a plan for the achievement of £4.35 billion of savings annually by 2012-13 by the NHS. The success of this plan will still not ensure the target of £20bn cumulative savings by 2013-14 that can support NHS through the coming years feels NHS chief executive David Nicholson.

The Chancellor yesterday pledged to raise frontline NHS funding in line with inflation in 2011-12 and 2012-13. Cuts in some services however are inevitable mainly due to the rising demands from aging populations and advances of medical care. It is estimated that the funding gap of £20bn needs to be met by productivity gains of 3-4% per year according to the Kings Fund.

Professor John Appleby, chief economist at the Kings Fund, said: "Improving productivity has to be the top priority if the NHS is to maintain quality and avoid having to cut services. Politicians will need to be honest about the scale of the challenge ahead and help the public to understand that some of their services may need to change in order to improve efficiency and maintain quality."

Health secretary Andy Burnham said: "The NHS budget is in a strong position after a decade of record investment. I am pleased that the Budget locks in that growth. As a result of this funding, the NHS is today more resilient, has more capacity and provides better care than ever before." "We have already challenged the NHS to deliver efficiency savings of £15-20bn by 2013/14. By making tough efficiency savings, this will mean we can continue to increase real terms resources available for patient care year by year."