New Frontiers in NHS Efficiency

The NHS is facing one of the most significant financial challenges in its history.  NHS Chief Executive David Nicholson has said that the health service must look to save £15–20 billion by 2014. In this new financial climate, the NHS will have to make even more difficult decisions about what it will, and will not, offer.

To help the NHS respond to this challenge, the Nuffield Trust is launching a major new programme of research and policy analysis that will examine how the NHS can become more efficient as it enters a period of significant financial restraint.

New Frontiers in NHS Efficiency will set out practical recommendations for managers, clinicians and policy makers on how the NHS can improve its productivity and deliver more value for less. There are two broad ways in which the NHS can do this: providers can cut their costs and improve productivity and value, getting more for less; and funders (primary care trusts and practice-based commissioners) can focus on investing (and disinvesting) their money where it really adds value, through robust and evidence-based processes of setting priorities in a way that shapes new forms of service provision.

The Nuffield Trust programme, led by Head of Policy Dr Judith Smith, will examine the scope for greater efficiencies by providers and commissioners of care. It will be informed by rigorous analysis of existing UK and international research evidence. The following set of linked projects will draw upon this research evidence in making policy recommendations about how the NHS can sustain and improve quality of care during the economic downturn:

• whether the NHS should be explicit about what is in (and out) of the ‘NHS offer’;
• international experience of priority setting in health;
• how PCTs make (and could make) difficult decisions about funding;
• lessons from past experience of making savings whilst improving quality in health care;
• the potential or otherwise of integrated care to improve efficiency. Integrated care is when both health and social care services work together to ensure individuals get the right treatment and care that they need;
• the ways in which commissioners might use their influence to bring about better integrated and more cost-effective care;
• the potential of analysis of patient level costing data in exposing variation in clinical practice and pointing the way to greater efficiency; and
• the implications of all of this for the future of provider and commissioner services in the NHS, as well as reform more generally.

The findings will be published in a series of reports in September 2010, culminating in a final report in spring 2011. Seminars will be held with clinicians, managers and policy makers to inform the recommendations. The project will be overseen by a steering group chaired by Nuffield Trust trustee Andy McKeon, Managing Director of Health at the Audit Commission. The group will include NHS chief executives, Nuffield Trust trustees and senior associates, and UK and international academics with expertise in health economics and health policy.

New Frontiers in NHS Efficiency is part of a wider programme of work on efficiency from the Nuffield Trust. This new phase builds on the findings from our recent report, Health in a Cold Climate: Developing an Intelligent Response to the Financial Challenges Facing the NHS. The report drew on discussions at a series of four seminars, which examined ways in which the NHS could use its resources more efficiently.

Further details of individual projects and their progress will be announced on our website. If you would like to receive regular updates on the programme and invitations to the seminars please click here to register your interest.  You can also contact Dr Judith Smith, Head of Policy, via email.

Related articles:

Smith J, Wide angle needed on NHS efficiency Healthcare Finance, November 2009.