Closing the NHS performance gap

This article was originally published in 2017.

The financial pressures facing the NHS are no secret. The challenges and economic arguments are well documented, as is the critical task of “balancing the books” by 2023, which calls for system-wide savings of around £27 billion.

Regardless of future financial settlements, factors such as an ageing population, new treatment options, rising consumer expectations, and increasing clinical complexity mean the NHS will need to deliver more and improve care outcomes within ever-tightening resource constraints.

For years, a primary approach to addressing financial shortfalls has been implementing provider Cost Improvement Programmes (CIPs), aiming for 2%–6% annual savings. These plans generally rely on various interventions to manage cost pressures, investment choices, and non-recurring savings.

CIPs are often labelled as “financial improvement programmes,” “productivity initiatives,” or “efficiency plans,” yet the fundamentals remain consistent. Recently, there has been an increased reliance on these productivity initiatives, with significant provider CIPs forming a key component of Sustainability and Transformation Plans (STPs).

But how effective are these initiatives? Are they a solution to enhancing the sustainability of NHS providers? Strasys analysed NHS acute providers from 2012 to 2017, examining their financial, regulatory, quality, and operational performance in light of CIPs to understand how their performance has evolved.

The authors, Naeem Younis and David Meikle, discuss the findings and solutions for healthcare leaders.

Our findings reveal that while NHS cost improvement programs may deliver short-term benefits, they often fall short in the long run, potentially leading to increased costs. More significantly, we discovered a correlation between quality and financial performance.

Through interviews, observations, and extensive work with NHS Trusts, we have assessed current practices and proposed an improved path toward long-term sustainability. This path has been tested and proven to deliver value and productivity improvements.