'Given worsening funding pressures from higher demand and demographic changes, the NHS can ill afford to sacrifice resources for a higher drugs bill in the short term.' Eric Yang, Senior Economist at the Health Foundation

Following the US-UK drug pricing agreement, changes to the way the cost effectiveness of new medicines are assessed will drive up the NHS drugs bill.

In this new blog, Eric Yang argues that the higher bill means difficult decisions lie ahead for the government.

Read more ⬇️
https://bit.ly/3QrzvpX

An image promoting a webinar about productivity lessons from the NHS, with a pink arrow graphic pointing upward on a puzzle background.

WEBINAR: What can we learn about productivity from the NHS?
Chaired by Anita Charlesworth from our #NHSProductivityCommission, this event will hear from an expert panel on what we can learn from experiences of and within the health service.

Register now ⬇️
https://bit.ly/4rlNOcx

Really looking forward to this event - do sign up if interested

Helen Salisbury: Whole system thinking The widely predicted collapse of the NHS due to resident doctors’ industrial action just before Christmas didn’t materialise.1 There was little change to the new normal, with too many sick people spen...

Great comment by @helensalisbury.bsky.social in this week's BMJ and one that far too many NHS managers, leaders and politicians miss entirely: doi.org/10.1136/bmj....
...

The image shows an online event advertisement for a webinar on what can be learned about NHS productivity from health systems in other countries, scheduled for Monday, January 26, 2025 from 14:00-15:00.

WEBINAR: As part of evidence-gathering work by the NHS #ProductivityCommission, this event will hear from an expert panel on what we can learn from international evidence and best practice.

Register ⬇️
https://bit.ly/45dbZ4O

Interesting article by @policyskeptic.bsky.social on what could best improve productivity. Agree that an understanding of flow and patient pathways is critical; coordination is also an important challenge in a system as complex as the NHS

This feels like an important finding (albeit from one US study):

GLP-1 medications (Ozempic, Mounjaro etc) *do not* pay for themselves by reducing other types of medical spending, at least in the first five years. If anything, GLP-1s increase other forms of medical spending.

and the failure to implement solutions right in front of our eyes because of the fixation with "innovation" and digital for its own sake

Examples from my daily practice which have got worse by far recently

1. Endless (discharge) transport delays
2. Endless (discharge) equipment delivery delays

What's going on? Could productivity in individual trusts really be bouncing around so much? Definitely raises questions about how informative this measure is - we've always found it surprising how high and low some of the changes are
[2/2]

An interesting nugget buried in Treasury evidence to the Pay Review Bodies:

In recent years, the NHS and other departments have (with HMT permission) raided capital budgets to fund unexpectedly high pay awards. Updated guidance explicitly rules this out.

Closing soon The Health Foundation NHS Productivity Commission Call for evidence Share your views on how productivity in the NHS can be improved over the next decade Deadline: Friday 12 December

CLOSING SOON: The #NHSProductivity Commission want to hear from NHS leaders, front-line staff, business and industry experts, patients and the public.

Submit your ideas on how productivity could be improved across hospital, primary and community care, and mental health ⬇️

https://bit.ly/4oHG9UY

Abolished to perfection? Building a better centre for the NHS | Institute for Government The abolition of NHS England creates both risks and opportunities.

NEW REPORT: abolishing NHS England could help simplify accountability, improve prioritisation and create savings. But the change could also lead to increases in policy incoherence and blame culture, as well as the loss of skills, capacity and focus on areas outside the day-to-day NHS.

'The overall NHS financial position remains precarious, with no additional funding to absorb new cost pressures – including higher drug expenditure, the costs of redundancies, industrial action and other unavoidable pressures on the service.' Hiba Sameen, Lead Economist at the Health Foundation

This week's Budget provided a modest funding boost to NHS capital for digital infrastructure, which could help unlock some productivity gains.

However, with no substantive increase to day-to-day spending, Hiba Sameen says the NHS's financial position remains precarious⬇️

https://bit.ly/4irRvun

Sounds great. Is that approach typical of other places @craig.nikolic.co.uk ? And if not, what led you to do it?

Why has #NHS #productivity underperformed? Same as the broader economy: lack of productive capital to support workers. Capital per worker declined by a massive 36% to 2020, probably more since.
#dataisbeautiful
#NHSProductivityCommission report: bit.ly/3WPxu76
UK's capital gap: bit.ly/455vGwe

More striking stats from our #NHSProductivityCommission report (bit.ly/3WPxu76). UK hospital length of stay (a key #productivity indicator) increased hugely from 2019 to 2023. Hospital employment jumped by >15%. No wonder £ spent are not translating into better health outcomes. #dataisbeautiful

Got evidence or examples? Our Call for Evidence is open now 📩

www.health.org.uk/funding-and-...

This is the debate we want: focussed on practical fixes that join up drivers with real world experience of the health system - discharge, estates, data, incentives, performance

On tech: technology fails when it isn’t applied to redesigned operations or only fixes one silo. We’re clear that innovation will only meaningfully improve productivity when implemented within redesigned pathways that remove bottlenecks - not bolted onto old processes

On capacity: Steve compares the NHS to a restaurant hiring more chefs without more cookers or tables

This analogy fits our depiction of the pandemic shock. In our report we show the NHS added more hospital staff into a constrained system, helping explain the NHS's bigger productivity hit than peers

On four drivers: the NHS is a complex system. As we say in our report, the causes of the NHS productivity slowdown are multifaceted and interdependent; they must be tackled together, not with isolated fixes

@policyskeptic.bsky.social latest @hsj.co.uk column makes significant points about NHS productivity policy

@healthfoundation.bsky.social NHS Productivity Commission last week published our first report which makes many of the points Steve makes. A few examples 👇

www.health.org.uk/reports-and-...

Interesting piece from @policyskeptic.bsky.social

Notable that recovery plans on the 4-hour A&E standard fall short of the constitutional target, unlike the commitment on elective waits

Health Foundation NHS Productivity Commission Call for evidence Share your views on how productivity in the NHS can be improved over the next decade Deadline: Friday 12 December

NOW OPEN: The #NHSProductivityCommission Call for Evidence is a chance for you to share your ideas about how productivity could be improved across hospital care, primary care, community care and mental health.

More information and guidance for responding ⬇️

https://bit.ly/4oHG9UY

(Should say that is capped at a minimum of 50,000 admissions per year, so not very small specialties)

If you are interested in the drop in emergency admissions, here's the 10 conditions that are lowest vs pre pandemic trend

NHS hospital activity and resources - actual and compared to pre covid trend.

Planned care is at or above trend, but emergency care is below. Drop in emergency admissions is most stark, but this could reflect more use of same day emergency care (SDEC). Jump in workforce explains productivity hit.

And here's roughly same for the 4-hour A&E constitutional standard. This looks more plausible (although let's see what happens this winter). One big question is why the target is only 85% rather than the 95% standard - perhaps less ambition for emergency care than electives, or just more realism

Not a problem; I enjoy your general critique of productivity policy. I was only keen to defend this exercise. (I do think a forecast provides value independent of an analysis of ideal policies, albeit we did also explore some of those enabling factors)

Don't blame the experts, blame the task! This was a specific exercise with tightly constrained questions - at the heart of which was 'what will happen' to productivity, rather than what should happen. The blog is necessarily brief and doesn't do justice to the richness of the conversation.