This is exactly the question our new report Improving NHS productivity: More with the same not more of the same sets out to answer.
In contrast to other public services the NHS is not facing cuts to its budget so its challenge is not to cut services, but to simply deliver a little more to meet rising demand from the same resources. As the title of the report implies the NHS will not be able to deliver 'more with the same' if it does 'more of the same'. So what does it need to do differently? Currently it is a system designed for growth, focused on growth and solving its problems with cash-growth. Without this growth the focus needs to turn to scrutinising all NHS expenditure and activity.
Doing this reveals that the greatest potential to improve productivity and quality will come from focusing on clinical decision-making and reducing the large variations in clinical practice across the NHS. It is at the clinical front line where the bulk of NHS resources are committed on a daily basis by clinical teams prescribing, referring and admitting. And it is the unjustified variations in these practices that wastes NHS resources and can contribute to poor-quality care.
As decisions on resources are taken by these frontline clinical microsystems, it is with these teams that action to release resources has to start. Releasing this potential will require leaders and managers at all levels of the system to challenge doctors, nurses, and other health professionals to reduce variations in care and support them to improve productivity.
Read the report: Improving NHS productivity: More with the same not more of the same