Take out waste, bring in innovation | Nigel Edwards
There is a consensus that savings of around 20% will be needed in the NHS in the three years from 2011, and this represents an unprecedented need for change and innovation. At the same time, it is vital to hold on to the gains in quality that have already been made and not indulge in slash-and-burn cuts that are poorly thought-through. The variation in performance in the NHS shows that there is scope for improvement, but achieving the best will mean removing waste, duplication, unnecessary steps, and delay.
Action will be required across the whole system, not just in the back office. Many of the savings available from this remain on paper until they reach a scale where fewer staff, buildings and other fixed costs are needed. This may mean radical change in the way care is organised, and perhaps some hospital closures. If this is not enough to bridge the gap, then choices about whole lines of service will need to be taken.
It may also be necessary to look at asset sales and staff pay to create some headroom, which will be difficult as the sort of change that is required needs the full engagement and imagination of NHS staff. Hopefully, the squeeze will produce unprecedented innovation and creativity- it will need to.
Nigel Edwards, director of policy, NHS Confederation