Strategies to improve NHS productivity

©The King’s Fund 2010

Strategies to improve productivity

Mark JenningsJuly 2010

©The King’s Fund 2010

©The King’s Fund 2010

National cost and demand drivers

©The King’s Fund 2010

£15 to £20 billion

“All bets are off. We need to move away from the NHS being built for growth to being able to sustain itself in a prolonged limitation of resources...The NHS will need to make efficiency savings of £15–20bn from 2011–14.”

©The King’s Fund 2010

TimeTime

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2001/2 to 2010/112001/2 to 2010/11

2011/12 to 2013/14 on2011/12 to 2013/14 on

The GapThe Gap

More with the same

COST & DEMAND PRESSURES

COST & DEMAND PRESSURES

PRODUCTIVITY IMPROVEMENTSPRODUCTIVITY IMPROVEMENTS

£105bn£105bn

©The King’s Fund 2010

How we see the gap

Financial gap? – The same with less

Care gap? – More with the same

©The King’s Fund 2010

Focus

Trusts – new

income focus

PCTs – cash-growth focus

©The King’s Fund 2010

Focus on how and what we do…

Technical efficiency is doing things right, eg, reducing unit costs by reducing lengths of stay or shifting care to more cost-effective settings out of hospital.

Allocative efficiency is doing the right things, eg, allocating resources to achieve the most health gain for the population served and preventing future hospital admissions.

©The King’s Fund 2010

©The King’s Fund 2010

Variations in clinical care

“Variations in care are often idiosyncratic and unscientific with local medical opinion and local supply of resources appearing more important than science in determining how medical care is delivered.”

[J.Wennberg, BMJ, October 2002]

©The King’s Fund 2010

Unjustified variations in health care cause…

Increased cost

Reduced quality

©The King’s Fund 2010

©The King’s Fund 2009

£64m

Prescribing

[Source: NHS Better Care, Better Value Indicators][Source: NHS Better Care, Better Value Indicators]

©The King’s Fund 2010

©The King’s Fund 2010

A new NHS paradigm

‘Quality costs’

Health care can only be considered high quality if it is also effective and efficient.

Health care can only be considered high quality if it is also effective and efficient.

©The King’s Fund 2010

Visit: www.kingsfund.org.uk/quality