How we can work together to help deliver the NHS productivity target

Key insights from Stuart Saw, Director of Financial Strategy, NHS England, on how we can work together to help deliver the NHS productivity target.

The last two years during the pandemic has shown how much we can achieve in very difficult and frightening circumstances. Two years ago, at the start of lockdown, we needed to put into operation very speedily a London procurement and distribution hub for PPE which I set up and chaired for about nine months. Now that intense and chaotic period has passed, it’s worth reflecting on what everyone has achieved and how that can inform us collectively on what the role of the procurement community could be going forward.

Now that we appear to be over the worst of the pandemic, how do we bring the best of what we achieved into our current work? And how do we link that to the operational requirements of the NHS and to Finance? 

Where are we financially?

We have significant financial challenges with all sorts of ‘known unknowns’. Waiting lists are higher than ever and we have a huge task to restore elective activity and to restore outpatient activity. The NHS’s key tasks over the next 18 months are to bring waiting lists down and to restore activity back to previous levels – whilst increasing activity by around 4%-5%. This is over and above what we delivered two years ago. So we have a huge task to pull that back and everyone’s job is to bear down on that issue – and as you know, all trusts have been asked to deliver a minimum 3% efficiency in the next financial year.

What can we do?
So how do we make these improvements when we know there are already challenges such as the rise of inflation? The Consumer Price Index (CPI) is forecast to hit 8%. There are other clear markers: the price of oil and the huge hike in energy prices.

1. Pulling together within ICBs

If you are involved in how your organisation puts your plans in for the financial year 2022/2023, please consider the following questions:

• What are the productivity assumptions for your trust?
• How do those link up at an ICS/ICB level?
• How do we start to deliver that?

Integrated Care Boards (ICBs) as of 1 July 2022 will be how organisationally we bring all of our activity and financial and efficiency assumptions into one place with a central governance route - and how we start to make them happen. It is clear that for ICBs to work, the collective organisations within the ICB, which include all our NHS trusts, have to be pulling together to deliver efficiencies.

2. Collaboration in procurement

I would encourage all of us to look at how we collaborate and how we move outside organisational boundaries to scale up what we do. That will take time as there are still cultural and of course legislative issues. What I’d ask everyone to consider in their activities is:

• How do we collaborate at scale?
• How do we deliver value at scale by stepping outside organisational boundaries to do things on a wider footprint?
• How do we ensure we don’t retreat into organisational silos?

We’ve proven that we can achieve much in difficult circumstances and delivering in the NHS will be challenging in a different way during this financial year. However, the way in which procurement colleagues have come together over the past two years and even before that has been wonderful to see and very heart-warming. I’m sure we can collectively work together to face our new challenges and achieve more great things.