Surviving the squeeze – delivering excellence in corporate functions with diminishing resources

The publication of the government’s Fit for the Future: 10-Year Health Plan for England has created both opportunity and pressure for NHS corporate functions. With ambitious goals for transformation and constrained budgets, the traditional approach to middle and back-office services faces unprecedented scrutiny. In the next decade, how can corporate functions deliver genuine excellence that enables frontline transformation?

Throughout the Summer and Autumn of 2025, and following the publication of the 10-Year Health Plan, NHS Shared Business Services (NHS SBS) is running a series of webinars titled ‘Futureproofing the NHS.’ The series has been developed to support the role of NHS SBS and our partners in modernising the operational foundations of the NHS.

In an environment of constrained budgets, ambitious reform, and rising demand, the way the NHS runs its corporate and support services is under closer scrutiny than ever. NHS SBS brings a distinctive and proven perspective to that conversation, occupying a rare operational vantage point. We are close enough to understand the day-to-day yet wide-ranging enough to spot cross-system patterns and solutions.

This series provides a forum to surface these insights and those of senior stakeholders from across the health service and beyond. We aim to convene a discussion on practical solutions to the immediate challenges highlighted in the 10-Year Health Plan. We will gather all of the information and ideas into a white paper to be published in early 2026.

To bring coherence to the series, each topic is explored through five consistent themes: workforce, procurement, digitalisation, organisational transformation, and data.

The inaugural session explored how to deliver excellence in corporate functions with limited resources, revealing practical strategies that transform constraints into competitive advantages and challenge budgets to drive innovation. This session was hosted by NHS SBS Managing Director, Erika Bannerman, who was joined by Danny Mortimer, the Chief Executive of NHS Employers,  David Furness Managing Director of the Shelford Group, Alice Donovan-Hart, NHS SBS’s Director of Consulting and
Mark Jennings, the Chief Solutions and Services Officer of Strasys.

Theme One –  workforce – upgrading staff experience with better systems

When resources are tight, investing in workforce systems might seem counterintuitive. Yet the panel agreed that strategic workforce investments deliver both efficiency and excellence, directly addressing the 10-Year Health Plan’s emphasis on improving staff experience.

Danny Mortimer identified the fundamental shift required: “What the plan says is that our people systems are fundamentally there to improve the experience of our people. And if you start with that in mind, then your design is better. Whereas, at the moment, particularly our core system, I recall it was introduced 25 years ago…and the big selling point was that it would create a data warehouse. Well, that doesn’t help a new employee sign on. It doesn’t help them manage their life….change their shifts or check their data.” [edited for clarity].

David Furness from the Shelford Group illustrated the daily cost of poor workforce systems: “I suspect the experience of everybody across the NHS is of multiple frictions in your daily life that take up your bandwidth and are slightly frustrating because they take a bit of time to overcome. They feel like small things, but they’re not, because if we want people to be energised, to be encouraged and innovative, then you’ve got to give them a working environment that enables them to do that. Not one where it feels like you’re wading through treacle just to get the simple things done” [edited for clarity].

There’s an excellent opportunity, agreed Danny,  in recognising that better workforce systems reduce rather than increase costs: “Some of our systems are really old and can’t support the kind of experience that David outlined. Secondly, people have tried to find workarounds….their solution to the fact we have a very old core system is to buy lots of other bolt-ons, which isn’t an ideal solution” [edited for clarity].

There are already great examples of improvements to workforce systems that are delivering benefits to staff. As Erika Bannerman pointed out, in Sussex, changing from a monthly payroll cut-off date to an “anytime” three-day change turnaround both improved accuracy and boosted staff morale.

Alice Donovan-Hart from NHS SBS highlighted the value of taking a strategic approach: “The customers that tend to come to us tend to be people that are, of their own volition, interested in this area of work. So they might be a HR leader, or they might be a finance leader…..They’re coming at it from their professional interest in how they might advance some of their services. I think it’s probably really hard for any of them to get excited about just taking headcount out. So there has to be something more…and that’s where automations can be really successful”

She went on to give onboarding as an example: “because it’s not just about making that quicker or less error prone, which is, of course, a benefit….but it also has a direct correlation with your retention rates, so you’re then hitting out some of your key strategic priorities, which is a much bigger win.”

Key takeaways

1. Design systems for user experience, not just data collection – a focus on creating data warehouses hasn’t helped staff with daily tasks like signing on or checking shifts.
2. Better workforce systems reduce costs by eliminating workarounds – old systems force expensive bolt-on solutions that create more complexity rather than solving core problems.
3. Strategic automation delivers retention benefits beyond efficiency – improving processes like onboarding correlate directly with retention rates, delivering wins beyond just saving time.

Theme Two – digitisation – automating the tasks that hold frontline workers back

The panel was asked to consider where automation might be able to return meaningful time to staff today, and what the barriers could be to scaling that more broadly. Panellists discussed how to maximise digital impact while minimising resource requirements and implementation risks.

Mark Jennings offered a pragmatic perspective, saying: “I don’t think that the NHS or any other institution will get anywhere by always pitching AI versus humans…I think you have to think about applying technology, but AI in particular, perhaps from the back to the front [office]. So if you decide we can’t do the boring stuff, such as routing paper and mapping invoices to purchase orders through AI, then please stay away from the patients. I think organisations have to learn to build trust from the back to the front, but build that sense within the organisation of one team being entirely focused on how you improve patient care.”[edited for clarity].

This approach recognises the critical enabling role of corporate functions. Mark explained: “Corporate functions have a really tough job because they can’t make the front line love their work, but they absolutely can make them hate it” [edited for clarity].

The “back to front office” approach has the potential to build confidence through administrative success: “There’s an enormous enabling function at the back office phase… If it becomes a sign of expanding job roles, expanding possibilities, and better care, I think it will be embraced” [edited for clarity].

NHS SBS’s Ada bot, used in Cambridgeshire, exemplifies this approach, reducing referral processing time from 40 minutes to five minutes while saving over 100 staff hours monthly. The automation investment has delivered immediate efficiency returns that funded further digital initiatives.

Mark warned against making common assumptions about the reduction in resources required when automations are introduced: “I’m a big believer in technology, but I know that we continually underestimate what humans do, and we think it is easier to replace them than it is. That’s why it’s very important to look at the augmentation side, but also not to make simplistic assumptions in business cases around how many humans can be taken out by automation or AI. The world is going to be different. We’re not looking at the same world as today, but with fewer people, we’re looking at a different world. In the 10-Year Health Plan, there’s not enough about what that different world will be like” [edited for clarity].

In a similar vein, Alice Donovan-Hart made the point that simply digitising an analogue process is rarely enough. Instead, successful implementation requires a deep and detailed understanding of the workflow and integrating automations in a way that improves delivery and reduces friction.

Key Takeaways:

1. Build AI trust from ‘hidden’ back office services, such as finance and procurement, to those that are patient-facing, like bookings for appointments and transport, for example.
2. Never automate a bad process – simply making an analogue process digital will fail to achieve the benefits of automation, and most projects require a redesign in underlying processes before implementation, making it more work than anticipated.
3. Be realistic and focused about what AI and automation can and should achieve – this means avoiding underestimating human roles and over-promising automation savings. The future will be different, not just the same but with fewer people and more AI.

Theme Three – procurement – putting procurement on the patient safety agenda

The panel discussed how excellence in procurement requires shifting from cost-only thinking to value-based approaches that deliver safety, quality, and efficiency simultaneously. The 10-Year Health Plan’s emphasis on procurement as a strategic tool creates the framework for this transformation.

Alice set the scene, saying: “Safety and savings – I think they’re two critical priorities for any system, and it’s fair to say the potential is there for procurement. So why aren’t we seeing more impact? Procurement has a historical reputation as a transactional, rules-based support function, rather than a strategic one. Procurement tends not to be on the board, so progress is probably not as fast as it could be”.

Alice identified how resource constraints have also, historically, limited procurement excellence: “We have some quite under-resourced procurement teams across the system…They tend not to be embedded early enough in strategic priority settings. So they can’t have that level of influence” [edited for clarity].

Therefore, excellence will be achieved by having a more strategic focus, rather than increasing spending. Alice explained the data imperative: “You’ve got to get after your data. If we can’t be really clear on our contracting and spend data, then we can’t make some of those decisions” [edited for clarity].

Without this clarity, procurement cannot deliver value at scale, Alice continued: “Without clarification, you can’t get the value… you can’t pull on that national procurement muscle” [edited for clarity].

In Norfolk & Waveney, efforts to shift toward a more strategic, system-wide approach, including unified procurement across five trusts, have identified potential long-term savings of £7.3 million. These projected efficiencies stem from coordinated purchasing and shared decision-making, not increased budgets.

Cultural transformation remains essential alongside process improvement. Alice emphasised: “We’ve obviously got the Procurement Act that’s aiming to address some of that. I think it can, but ultimately, legislation can’t shift your culture” [edited for clarity].

Key takeaways:

1. Good data is essential for strategic procurement decisions – without clear contracting and spend data, teams cannot determine what should be procured nationally, regionally, or locally.
2. Procurement teams need earlier strategic involvement and a seat on the board – teams embedded late in the process get trapped in rules-based activities rather than driving strategic value.
3. Cultural transformation ultimately matters more than legislation – the Procurement Act can help, but legislation alone cannot shift organisational culture around procurement’s strategic role.

Theme Four – organisational transformation – doing corporate services properly, not just structurally

The discussion revealed a counterintuitive finding about organisational transformation and resource allocation. Excellence in corporate functions may require a shift in thinking regarding the relationship between investment and outcomes.

Mark cited Strasys’ research that has challenged conventional wisdom, and which suggests that excellence isn’t always about spending more on clinical care and less on operational activities; it’s about doing the right things more effectively. Mark warned against the temptation to solve budget pressures through cutting corporate services, saying: “Non-patient facing staffing costs have been at 13 pence in the pound for acute trusts every year since 2018… Could they be 10 pence? Perhaps. But I’d much rather focus on the 83 to 87 pence. There is a real risk that the NHS could be somewhat undone by really going after corporate functions. They’re not going to save it. We have to support corporate functions to enable the system adaptation that hasn’t happened so far” [edited for clarity].

Danny Mortimer added: “We’re seeing growing evidence that the scaling of corporate services brings real benefits to colleagues delivering clinical services….I think we are at something of a tipping point now” [edited for clarity].

David Furness talked about how constraint can often drive innovation: “What we’ve got is what the country can afford to spend on health care at the moment, and that is generating ideas and innovation among front-line teams. One of our chief executives talked to me the other day about their cost improvement challenge. The response to a request to staff to ‘tell us the ideas that you think will help us save money and improve care’ has gone far beyond anything they ever expected. If you engage people in the problem and give them the information to improve services, they will do it” [edited for clarity].

​​NHS SBS’s experience demonstrates this principle in practice. Erika Bannerman noted how the organisation approaches transformation challenges: “Capital funding is going to be essential for the ten-year plan to be realised. NHS SBS is a 20-year-old joint venture with a 10-year strategic plan, which comes with funding that enables us to invest in the long term around technology. What needs to happen is we need to have a very clear pipeline of what’s required so that we can get the best value for money for the taxpayer and ensure that it realises a return” [edited for clarity].

Mark emphasised the need for system-wide thinking: “Every silo thinks they’re special and to some extent they are. But they are 20% special and 80% standard… take booking systems. Fundamentally, everyone has working hours, and a certain number of people need to see certain others. There are so many commonalities. Let’s stop all the different booking systems within hospitals for different specialities and find a way that works for everybody” [edited for clarity].

Key takeaways:

1. More frontline spending doesn’t automatically improve clinical productivity – research shows sometimes low correlation between frontline investment and clinical productivity gains.
2. Cutting corporate functions poses risks to NHS transformation – at less than 20p per pound spent, every penny spent on corporate services must work as hard as possible.
3. Constraints can drive innovation when people are engaged – financial pressure can generate ideas when staff are asked to help solve cost and care challenges.

Theme Five – data – a single source of truth that enables the NHS to run better

The panel agreed that excellence in data management, including maximising the full value of data in the health service, requires a fundamental shift from data collection to data utilisation, precisely what the 10-Year Plan emphasises through its commitment to simplified reporting.

David Furness highlighted the transformation opportunity: “One of the clear commitments that comes out of the 10-year plan is a simplified operating model with rather few data requirements coming down from the top… Too often in the NHS, we think a lot about data as being a tool for reporting rather than a tool for transformation and improvement” [edited for clarity].

​​The potential for this shift is already visible in leading organisations. David continued: “In the best of our trusts, we see a kind of virtuous circle where you get really good corporate services departments helping to generate really good data that drives improvement, which then drives improved data collection and use of data” [edited for clarity].

Mark identified the integration framework that maximises data value: “Clinical, operational and workforce data is a ‘holy trinity’ of data…..You understand patient needs and behaviours more from operational data than you do from clinical data. Yes, every treatment has to be grounded in clinical data. But if we’re talking about a reimagined NHS, we should be talking about one that’s reimagined around what the patients need, how they behave, what motivates them, and what outcomes we need to achieve for them. And that is largely in the operational data. Putting that with the clinical data, I think that is where the real unlock comes for what’s next for the NHS” [edited for clarity].

Mark noted a cultural paradox that needs to be addressed: “It’s really strange to me that in health care, you have on the clinician side the absolute belief in the scientific method, in using data to guide diagnosis and to drive better care decisions. And yet, corporately, there is incredibly little of that” [edited for clarity].

Key takeaways:

1. Shift from data for reporting to data for transformation – the 10-Year Plan’s simplified reporting creates an opportunity to use data for improvement rather than just accountability.
2. Operational data combined with clinical data describes patient needs better than clinical data alone – understanding patient behaviours and needs requires combining the “holy trinity” of clinical, operational, and workforce data.
3. Create virtuous circles through good corporate services – leading trusts show how excellent corporate services generate good data that drives improvement and better data collection.

Delivering excellence through strategic integration

The panel’s insights revealed that delivering excellence in corporate functions with diminishing resources isn’t about doing less; it’s about doing things differently. The solution lies in recognising how the five themes in the discussion interconnect. Better workforce systems create the conditions for successful digital adoption. Strategic procurement reduces costs that fund better systems. Organisational transformation creates the conditions to deliver integrated value.

David emphasised the need for change: “It’s important to recognise that we won’t achieve our goals if we don’t change what we do. We need to tell a story of radical transformation. Where I think corporate services play a role is through the intelligent use of data to change patient flow and processes. To achieve this, you require a corporate infrastructure that provides the data necessary to implement those changes, equipping clinical teams with the tools they need to make adjustments. The second thing to say is that it’s all about people – bringing people along with you. Encouraging and enabling people to change” [edited for clarity].

The evidence from NHS SBS implementations – from Sussex’s ‘anytime’ payroll solution that improved accuracy and staff morale to Norfolk & Waveney’s unified procurement that saved millions while reducing duplication, and automation tools that have condensed 240 years of work into the past four – proves that excellence is achievable with constrained resources when corporate functions focus on strategic integration.

Join the conversation

Our next session, “Digital transformation under pressure: Sustaining momentum amid NHS reorganisation”, explores how to maintain digital excellence during structural change.

Register now to continue this vital discussion about achieving operational excellence that enables the transformative vision of the 10-Year Health Plan.