7. EFFICIENCY AND PRODUCTIVITY
7.1.8 In his third annual report to the NHS
Chief Executives Conference, on 20 May 2009, the Chief Executive
of the NHS said: "We should plan on the assumption that we
will need to make unprecedented efficiency savings between 2011 and
2014—between £15 billion and £20 billion
across the service over three years." How does the Department
anticipate those savings will be achieved without compromising
the service provided? Please give concrete examples. (Q87)
Answer
1. HM Treasury has not yet set Departmental
allocations beyond 2011, so the scale of any efficiency savings
is not yet known, but health is a key Government priority—as
it always has been.
2. In order to prepare for every eventuality,
David Nicholson has asked staff to be ready for a wide range of
future funding scenarios. This includes the challenge of £15 to
£20 billion efficiency savings during the period from
2011-14 with the focus firmly on improving quality and efficiency
simultaneously because getting it right first time for patients
is both efficient and delivers better quality of care.
3. This is a challenge for the whole NHS
system and cannot be addressed through a national programme or
top-down initiatives. Playing an enabling role, the Department
will work together with the NHS regionally and locally and with
other delivery partners to identify and prioritise detailed actions
required to meet the challenge by focusing simultaneously on quality,
innovation, productivity and prevention, not on compromising services.
To support this, Jim Easton has been appointed as NHS National
Director for Improvement and Efficiency.
4. Specific actions and initiatives are
subject to detailed work with the NHS over the coming months,
but there are a variety of concrete examples where savings are
being achieved without compromising service quality or, indeed,
of efficiency and quality being improved simultaneously. For example:
— The success there has been in reducing
healthcare-acquired infections which the National Audit Office
estimates has saved up to £143 million so far, as well
as improving the quality and safety of patient care.
— Significant savings have been made by
reducing average length of elective hospital stay (over 20 per
cent since 2004), emergency bed days (more than 3 million
fewer since 2004) and increasing day case rates (now at 73%),
helping to save money as well as enabling patients to return to
their own homes and daily lives more quickly.
— The recent NHS Improvement report on
transforming in-patient cancer care which highlights a set of
simple improvements which could save up to 1 million bed
days if implemented across the NHS, while at the same time improving
services.
— The Productive Ward initiative which
has helped staff across the acute sector to significantly increase
the proportion of their time spent on direct patient care. Programmes
of this kind help to improve the efficiency of clinical teams
while improving quality and patient experience.
— Improvements in procurement, coupled
with technology, have not only delivered savings of hundreds of
millions of pounds but can also help improve patient safety. For
example, robotic medicine dispensing systems can cut not only
costs but also dispensing errors. Bar codes and similar technologies
can both improve efficiency and reduce errors when giving patients
drugs, blood and other treatments.
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