Our response to the final report of Lord Carter’s review of productivity in NHS providers

Nigel Edwards responds to the final report of Lord Carter’s review of productivity in NHS providers.

Press release

Published: 05/02/2016

Responding to the final report of Lord Carter's review of productivity in NHS providers, Nigel Edwards, Chief Executive at the Nuffield Trust said:

We agree with many of the problems and issues listed in today’s report, and Lord Carter has spotted some real opportunities for future savings. But plans to impose these benchmarks from the top down risk turning into another round of the kneejerk centralisation that has served the NHS badly in recent years. 

Nigel Edwards, Nuffield Trust


“We agree with many of the problems and issues listed in today’s report, and Lord Carter has spotted some real opportunities for future savings. But plans to impose these benchmarks from the top down risk turning into another round of the kneejerk centralisation that has served the NHS badly in recent years.

“Some of these goals and standards have had to be based on unreliable data. Given the variety that exists in the health service, they may not be flexible enough to provide safe, appropriate targets for all hospitals. Pushing them out from the centre risks creating perverse incentives and encouraging manipulation of the system.

“Between 2011-12 and 2015-16 NHS trusts in England made average cost improvements of around 3.5 per cent a year – significantly higher than the 2.3 per cent implied by Lord Carter’s £5 billion. They achieved this without Whitehall diktats.

“The fundamental concern about the headline figures is not that there is £5bn of ‘waste’ by NHS hospitals, but that we need to find so much more. The savings needed from this sector by the Department of Health will be nearer £10bn. We need a credible picture of where the rest of this is supposed to come from.”

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