Frugal innovation in the NHS

During our webinar the point was acknowledged – just as it was during our NHS non-executive directors’ event earlier in March – that in the face of increased demand and dwindling resources the only way to make ends meet is to improve productivity.

But where our recent events have focused on achieving this through greater leanness of governance, there is a limit to how much this can achieve. Most public sector boards would freely admit that they could find some fat to trim in the way they operate – but there is only so much that can be trimmed. In the NHS, growth in demand will inevitably outstrip any organisation’s ability to make itself leaner.

There’s another factor too – efficiency improvements take time. As Rob Whiteman, chief executive of CIPFA, said in an interview with GGI CEO Andrew Corbett-Nolan that was aired during the webinar: “Productivity is clearly an opportunity, but it has to be realistic. It takes a while to deliver – it comes through medium-term planning and the fruits come down the line. Productivity can’t be seen as short-term balancing item.”

But there are other ways to achieve the same end. The first is better patient engagement. Better engagement leads to fewer misunderstandings and miscommunications and less delay. It results in improved effectiveness, more efficiency and better quality of care.

Andrew Corbett-Nolan highlights a second area to explore: “We should look more closely at the way different patient groups receive services – there’s not enough differentiation at the moment. Someone needing emergency treatment has very different needs to someone with long-term chronic conditions, for example, or someone receiving specialist care for a rare cancer. We don’t currently vary service offerings enough and there could be enormous efficiency gains to be had if we did.”

Driving efficiency and productivity gains in the NHS is complex and difficult – and it’s a task that’s fraught with the danger of creating disharmony. The last thing any hard-pressed NHS manager or clinician wants to hear at this time of great stress is that they’re not productive enough. Sensitive engagement will be needed to avoid this.

But ultimately, faced with the unavoidable trends of shrinking resources and growing demand, improvements must be found. And the sooner the better.