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NHS funding must be linked to a review of efficiency

The efficiency, not just the financial cost, of the NHS has come under increased scrutiny in recent weeks.

According to analysis of data by the Nuffield Trust, emergency hospital readmissions – within 30 days of a patient being discharged – have risen by a fifth in the past seven years. In many of these cases, patients required further treatment for conditions such as pneumonia and pressure sores. These preventable readmissions – often for conditions not diagnosed on the first visit – amounted to one per cent of the total and affected around 185,000 people, the Trust calculated.

Last month Professor Keith Willett, NHS England’s medical director for acute care, accused the NHS of a ‘ridiculous waste of resources’. Writing in The Telegraph, Professor Willett reported that surgeons are often left unable to operate because of a failure to tackle bed-blocking, caused by patients unable to be discharged due to a lack of support at home or in the community.

Meanwhile, as the NHS approaches its 70th anniversary, funding for the service has repeatedly come into question, with calls for increased healthcare budgets emerging from clinicians, thinktanks, and politicians, all eager to demonstrate their continued commitment to universal healthcare.

However, the question of efficiency and funding must be part of the same equation. The vast majority of NHS patients receive excellent care, delivered as efficiently as possible given current resource restraints within the service. But, as the largest employer in Europe with an annual budget of £124 billion, efficiency inside the NHS will inevitably be an issue and in every large, complex organisation there is always room for improvement.

Any marginal improvement in efficiency can have a huge impact, and the uptake of medical technology is a case in point, as the Medical Technology Group’s research has shown. The potential for medtech – such as hip replacements, compression bandages, or implantable cardioverter defibrillators – to reduce healthcare budgets by avoiding hospital admissions and reducing social care costs, while improving patients’ quality of life – is exponential to the investment needed. That’s why the NHS must avoid rationing and consider all of the evidence for each medical technology, taking into account not only immediate savings to the health service itself, but also the value of returning patients to work and living independently.

As the NHS approaches this year’s important milestone, it’s time to re-evaluate our relationship with the health service. We need to recognise that only by seeking efficiencies and longer-term solutions – alongside increased funding – will the NHS deliver better outcomes for patients and the taxpayer.

June 2018

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