Productivity of the English National Health Service: 2019/20 update

This report updates the Centre for Health Economics’ time-series of National Health Service (NHS) productivity growth for the period 2018/19 to 2019/20.

NHS productivity growth is measured by comparing the growth in NHS outputs produced to the growth in inputs used to produce them. Outputs include all the activities undertaken for NHS patients wherever they are treated in England. It also accounts for changes in the quality of care provided to those patients. Inputs include the number of doctors, nurses and support staff providing care; the equipment and clinical supplies used; and the facilities of hospitals and other premises where care is provided.

The COVID-19 pandemic only marginally affected the period covered in this update, as the first positive cases in England were recorded at the end of January 2020, with the UK government introducing lockdown measures only at the end of March 2020. We have considered the possibility of an “early” impact of the COVID-19 pandemic on the delivery of healthcare goods and services in some NHS settings (hospital inpatient and outpatient, primary care, and community prescribing) as the English NHS prepared to free up capacity to deal with the pandemic. 

In general, our analyses highlighted a dramatic difference in growth rates between the months of April-February and March alone for hospital inpatient, outpatient, primary care, and community prescribing. For all of these settings, except community prescribing, the winding down of activity due to the COVID-19 pandemic was concentrated within the month of March 2020. For example, the quality-adjusted Laspeyres output growth rate for hospital inpatient activity was equal to 1.96% when comparing the period April 2019-February 2020 with April 2018-February 2019, but -22.56% when comparing March 2020 with March 2019. For community prescribing, the Laspeyres output growth rate was substantially higher when comparing March 2020 with March 2019, than when comparing April 2019-February 2020 with April 2018-February 2019. This might be due to a larger number of prescriptions being issued in anticipation of an imminent lockdown in early March, a shift to increasing the rate of prescriptions made during lockdown, or some combination of these. 

Full Report: CHE Research Paper 185 (PDF , 3,536kb)

Other papers in the CHE Research paper series can be found at: CHE Research Papers