Improving the productivity of the NHS in England
Posted on 14 October 2010
Professor Andrew Street and colleagues assessed the amount and quality of hospital and community care provided to patients in each Strategic Health Authority in relation to resource use. Their methodology is consistent with how NHS productivity is measured in the national accounts and exploits routine data sets including the hospital episode statistics, reference cost returns and financial information for all NHS organisations.Productivity is 5 per cent higher than the national average in South West SHA and 6.5 per cent lower than the national average in East Midlands SHA. By implication, if it were as productive as South West, East Midlands could deliver the current amount of hospital and community care for £4.7billion rather than the £5.3billion actually spent.Even though the budget is ring-fenced the NHS has to make substantial efficiency improvements over the next five years
Professor Andrew Street
The geographical variations in productivity are not due to differences in the types of patients treated; nor to differences in quality of care as captured by inpatient and outpatient waiting times and hospital survival rates; nor to regional differences in the prices that organisations pay for staff, buildings and capital. All of these are taken into account.
Part of the explanation may lie in where patients seek treatment. Fifteen per cent of patients who live in the East Midlands are treated in hospitals outside their own region. This is the case for only two per cent of patients living in the South West. Of the 2.4m patients treated in London, 12 per cent are from other parts of the country.
South West may also benefit from a more stable workforce, vacancy rates for non-medical staff being well below the national average. Lower productivity in the hospital and community sectors may be because more work is undertaken in primary care. The absence of comprehensive data about the activities undertaken in general practice makes it difficult to establish what GPs are doing in different parts of the country.
Professor Street says: “Even though the budget is ring-fenced the NHS has to make substantial efficiency improvements over the next five years. Our analysis indicates in which parts of the country there may be greatest scope for improvement.”
Notes to editors:
- Centre for Health Economics. Regional variation in the productivity of the English National Health Service. CHE Research Paper 57, York: University of York. Available at: www.york.ac.uk/media/che/documents/papers/researchpapers/rp57.pdf
- The authors of this report are Chris Bojke, Adriana Castelli, Mauro Laudicella, Andrew Street, Padraic Ward, from the Centre for Health Economics at the University of York.
- Relative productivity of each SHA is shown below
- The project was funded by the Department of Health in England as part of a programme of policy research at the Centre for Health Economics, University of York. The views expressed are those of the authors and may not reflect those of the funder.
- The Centre for Health Economics at the University of York aims to undertake high quality research that is capable of influencing health policy decisions. The Centre is one of the largest health economics research units in the world and its research aims to influence the way decision makers think about the determinants of health and wellbeing, and the organization and delivery of health and social care.
- Further information can be obtained from Professor Andrew Street, Tel: 01904 321401; Email andrew.street@york.ac.uk
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