‘Major productivity problem’ in NHS since pandemic
THE NHS has become less productive since the pandemic amid rising absenteeism and an increasing refusal by staff to work overtime, a report warns.
Government pledges to clear record backlogs are “at serious risk” even if unprecedented efficiency gains were achieved, according to the National Audit Office (NAO).
It cited an internal review by NHS England, which found that the health service was about 16 per cent less productive in 2021 than it was in 2019.
“This is a major problem and NHS England believes that reduced productivity has continued in 2022-23,” the NAO warns. Accusing health officials of having lost control of spending, the report highlights “a reduced management focus by NHS trusts and NHS England on cost control and operational rigour”.
The independent parliamentary body suggests inflationary pressures, problems with productivity and a reliance on GPS to absorb some work traditionally carried out in hospitals could mean key aims are not met and patient care could be put at risk.
NHS England’s plan assumed that services would recover to pre-pandemic levels of activity early in 2022-23, with an aim of about 30 per cent more treatments by 2024-25.
But today’s report said increasing activity to these levels would be “a historic feat” and would “require a rate of growth not seen in recent times”.
It comes as Steve Barclay, the Health Secretary, signalled he has won extra funding for the NHS, on top of planned increases. The report says extra investment is needed to keep pace with inflation, but the NHS is not expected to get the £7billion bosses had demanded.
Yesterday, Mr Barclay told the NHS Providers conference that hospitals need to play their part in tackling record numbers stuck on wards owing to delayed discharges into social care.
He urged hospitals to ask “what is in their control” as they seek to discharge bed blockers, adding: “Consultants at the weekend, what they can do?”
Recent NHS guidance has advised focusing on “seven-day working” to increase the weekend discharge rate.
On a weekday, more than 10,000 people are usually sent home from hospital but by the weekend the daily figure dips to an average of 6,800. Mr Barclay said: “What manifests as a problem in ambulances is often caused elsewhere in the system. If it’s the blockage in the pipe in terms of delayed discharge, that is creating pressure on the hospitals.
“In hospitals at the weekend, that discharge drops, so the question then is – what is within the trust’s own control?”
Meg Hillier MP, chairman of the Commons public accounts committee, said the Government faces a “monumental challenge” in tackling backlogs.
She added: “The NAO’S latest report shows that NHS England’s recovery programme for elective and cancer care is very ambitious, reliant on innovative but relatively untested approaches, and already falling short of expectations.
“Patients will continue to suffer the consequences if NHS England doesn’t act now to improve its management of the programme.”
An NHS spokesman said: “The NHS maintains strong control over where money allocated for recovery is spent, and of both financial and operational performance.”
He said services had been affected by staff absences and Covid but the NHS was delivering on its elective recovery milestones with 1.3million patients completing treatment in September.