Press Story

Restoring NHS productivity to pre-pandemic levels would have freed £19 billion more in 2023/24, enough to build a new health centre in almost every neighbourhood

NHS could unlock £3.8 billion a year if it meets 2 per cent productivity target, enough to triple the number of scanners

Huge impact of staff leaving, with IPPR estimating more than 150,000 could have been retained since last Labour government

Giving workers a greater say, including new NHS staff boards, is key to boost productivity and increase retention, IPPR says

Billions worth of extra care could be unlocked if NHS productivity problems and high staff turnover are addressed, according to new IPPR research.

In 2023/24, the NHS in England had a budget of £171 billion, but productivity was 11 per cent lower than before the pandemic according to NHS England estimates. If productivity had matched 2019/20 levels, the NHS could have delivered an extra £19 billion worth of care. This would’ve been enough to build 900 new health centres — almost enough to deliver the Labour Party manifesto promise to build ‘Neighbourhood NHS’ in one year alone.

The new Labour government have now announced a major uplift to NHS spending in the 2024 autumn budget, taking the planned daily expenditure budget to £192 billion by 2025/26. Increasing productivity will be crucial to ensuring maximum benefit for patients. The NHS has a target to improve productivity growth to 2 per cent per year by 2029/30. Achieving this goal next year could deliver an additional £3.8 billion worth of care – enough to more than triple the numbers of MRI and CT scanners in the NHS.

Alongside poor productivity, the NHS is facing a parallel crisis of staff frustration and departure. The report notes that between 2010 and 2023, the average annual NHS leaver rate was 11.2 per cent, meaning one in nine staff members left each year. This is compared to 2009/10, when the rate was 9.5 per cent, just over one in 11 staff.

If the leaver rate had been kept down at 9.5 per cent, IPPR estimates that an average of 12,000 NHS staff could have been retained each year since 2010. Holding the number of new entrants constant, this would equate to around 150,000 additional staff retained cumulatively.

IPPR argues that the two major crises facing the NHS—low productivity and poor staff retention— reinforce each other. High staff turnover increases costs and impacts care delivery, while inefficiencies, such as outdated equipment, deepen staff dissatisfaction and lower productivity levels.

Low autonomy for NHS workers is a key underlying issue, the report finds. Decision-making in the NHS often lacks information and insights from frontline staff, leading to the wrong priorities and missed improvements. Money may be spent on hiring locum doctors when staff feel new computers are what is needed, or on top-up winter crisis funding rather than community services to keep people well.

IPPR argues for a new approach to NHS reform. Unlocking staff insights and giving them a greater voice could lead to meaningful changes at every level, the report says.

IPPR calls for reforms to incorporate staff voices in clinical service design and national policymaking including:

Empowering frontline staff by establishing channels for service improvement led by Trust-level specialists, with protected time for all staff to participate

Setting up representative staff boards in each NHS trust to put forward ideas from the wider workforce and consult on all matters affecting staff wellbeing, with a duty on main NHS trust boards to consult them

Giving a staff voice in national workforce policy by reforming pay review bodies to include negotiation or embed a formal duty to consult with staff

Dr Annie Williamson, IPPR research fellow and a current NHS doctor, said:

“After years of mounting pressures, the NHS is facing two major challenges: high levels of frustration among staff, and low productivity which is taking a toll on patients.

“By addressing these issues, we could unlock billions worth of better healthcare. More importantly, this would create a more efficient and sustainable health service, where staff voice is central to improving the quality of decisions throughout the NHS.”

Dr Parth Patel, associate director of democracy and politics said:

“We all know the NHS needs reform, but we keep getting distracted by the same red herring debates. The real issue is that we’re struggling to get the NHS firing on all cylinders again.

“Too many decisions are made at the top, while those on the front lines—who truly understand what’s needed—are left with little say. The status quo isn’t working. We need to empower NHS staff with a genuine voice and a real stake in the decisions that affect them. Only then can we unlock the NHS’s full potential again.”

ENDS

Dr Parth Patel and Dr Annie Williamson, the report’s authors, are available for interview

CONTACT

Liam Evans, Senior Digital and Media Officer: 07419 365334 l.evans@ippr.org

Georgia Horsfall, Digital and Media Officer: 07931 605737 g.horsfall@ippr.org

NOTES TO EDITORS

The IPPR paper, ‘From the Frontline: empowering staff to drive the NHS agenda’ by Dr Annie Williamson and Dr Parth Patel, will be published at 00:01 on Friday 22nd November 2024. It will be available for download at: http://www.ippr.org/articles/from-the-frontline
Advance copies of the report are available under embargo on request
Estimates of NHS productivity in 2023/24 are from Kelly J (2024) ‘NHS productivity’. NHS England. https://www.england.nhs.uk/long-read/nhs-productivity/. The budget for NHS England Resource Departmental Expenditure Limits in 2023/24 and 2025/26 are from OBR (2024) Economic and fiscal outlook – October 2024. https://obr.uk/efo/economic-and-fiscal-outlook-october-2024/#chapter-3. NHS leaver rates are from NHS Digital (2024) NHS workforce statistics. https://digital.nhs.uk/data-andinformation/publications/statistical/nhs-workforce-statistics/