The productivity paradox – how doing less might be the secret to achieving more

If you work in the NHS, my guess is that you’ve heard a lot of the P-word recently. Not patients – productivity. It’s become a buzzword in Whitehall and Westminster, with organisations across the NHS landscape seeking to unravel the NHS’s productivity puzzle. The puzzle being that, when compared with pre-pandemic times, the NHS has more staff but is achieving less.

But is it?

My brother and sister in law are both NHS consultants, so I know a little of how it feels on the front line. It feels fraught, with unrelenting patient needs, high levels of stress and an infrastructure that can feel like it’s being held together by an elderly gerbil. Talk of “increased productivity” feels like a slap in the face to front-line colleagues who are already working incredibly hard.

Paradoxically, I believe that the NHS might be more productive if it actually did less.

For example, although I’m a huge fan of data, and the need to base decisions on it, the amount of reporting required is onerous, particularly when replicated across every trust via manual processes.
Another area is training – again, hugely necessary. But NHS organisations having multiple different systems and processes, all of which require specialist training is, frankly, a waste of time. People should be able to move between jobs in the NHS without the need for retraining in some of the commonest finance and procurement procedures, for example.

I could go on, but the point is that productivity is a factor of giving the right people the right tools to do the right job. I appreciate that’s much easier to say than do, particularly when even the first part – the “right people” is fraught with controversy. For example, all the data shows that, far from being stuffed with bloated management bureaucrats as some newspapers would have you believe, the NHS actually lacks skilled managers. Yet no Secretary of State will risk ridicule in the court of public opinion by embarking on a recruitment drive to get more managers into the health service. Even when – according to the NHS Confederation – every £1 spent on the NHS has an approximate corresponding economic benefit of £4.

So the uneasy balancing act continues, where sometimes the right people are given some of the right tools to do a job that may or may not need doing.

Although the puzzle is as intricate as a Eldredge tie knot (the mindbogglingly complex knot that was a shortlived craze back in the day when ties were still a thing), it can be solved. Or, at least, it can be assuaged.

Collaboration, consistency and commitment are the ingredients. Collaboration to stop money, people and time falling between the cracks of NHS organisations. Consistency to ensure both interoperability on the tech side, but also the portability of skills and experience. And commitment is the willingness to put aside the parochial mindset that pervades many NHS organisations and work together for the good of the whole.

It can be done, and I believe that the new shared services we’re introducing are a significant step forward. Our new finance and accounting service, for example, connects people, organisations and systems on a single platform to help buyers, suppliers, clinicians, administrators and finance teams get things right first time, 24 hours a day, from anywhere, with the data they need to make informed decisions.

Most importantly, it enables teams to spend less time on back-office processes and more on their patients and colleagues.

We’ve recently released a podcast about the NHS’s productivity puzzle, which features my dulcet voice! If you’d like to listen, click here.