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By Alice Donovan Hart, Director of Consulting, NHS Shared Business Services |
The Health Foundation and NHS Productivity Commission’s new report Breaking the Cycle is an important and timely contribution to the debate about how the NHS can achieve sustained productivity improvement.
The report looks at productivity in terms of what the NHS can achieve for patients with the time, people and resources it has available. It is not simply about cutting costs or asking already stretched staff to work harder.
From our perspective, an important part of improving productivity is giving time back to staff, so they have more capacity to focus on providing better care for patients. That means looking not just at what happens on the frontline, but also at the systems and processes that support it.
Breaking the Cycle highlights how short-term planning, fragmented accountability and an overly complex operating environment can make lasting improvements difficult. We also see these challenges across the NHS within our work.
Our Futureproofing the NHS report, published over the summer, argued that clinical decisions should remain local, while finance, workforce, procurement and operational data systems are stronger when common foundations are shared.There is a strong connection here with the Breaking the Cycle report, which identifies four conditions for sustained productivity improvement: stable direction, focused accountability, freedom to deliver and the capability to improve. Those conditions matter to the operational layer. Sustainable improvement needs the stability to invest for the long term, clear accountability for delivery, the freedom to improve how work is done and the capability to keep learning.
The experience of NHS staff matters too. In our commissioned NHS SBS Healthcare Professionals Omnibus June 2026 by YouGov, among 1,049 NHS staff surveyed, 71% said they spent more than an hour in a typical week dealing with inefficient processes or duplicated steps, while 67% identified more joined-up operational systems and processes as one of the changes that would make the biggest positive difference to their work.
This isn’t centralisation for its own sake. It is freedom within a shared framework: standardising repeatable operational services where there is value in doing so, while keeping care design and decisions close to patients, communities and local leaders.
The Breaking the Cycle report is also clear that technology alone will not solve the productivity challenge. The greatest benefits come when organisations redesign workflows, involve staff, build implementation capability and use reliable, comparable data to support decisions. Shared services can help the NHS test, learn and scale what works, rather than repeatedly solving the same operational problems organisation by organisation.
Practical evidence shows this approach can create value. NHS SBS’s latest Impact Report records £432 million in procurement savings in 2025 and highlights examples ranging from referral automation that reduced processing time from 40 minutes to under five, to unified finance and procurement arrangements that improve visibility and automate routine work.
Ultimately, productivity is not an end in itself. The real measure of success is whether we create more capacity for care – by improving the experience of staff, we will deliver better outcomes for patients. The challenge set out in Breaking the Cycle is not simply about finding new efficiencies, but about creating the conditions for sustained improvement. By reducing avoidable complexity, investing in capability and building stronger operational foundations, the NHS can release valuable time and resources back to where it matters most: supporting frontline teams so they can deliver for patients.
