John Appleby: the NHS productivity challenge

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  • Posted:Thursday 01 May 2014

With a financial crisis in the NHS looming in 2015/16, John Appleby looks at the financial pressures currently facing the health system, how local organisations are coping, and how the funding gap could be met in future.

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David Sandbach

Retired NHS CEO,
Comment date
11 May 2014
We need to stop concetrating on supply side issues which usually focus on the centralised repair shops aka hospitals.

We should go hell for leather to transfer care into people's homes thus shifting the cost of accomodation and 24 hr staffing onto the patient and their kin folk.

The capital cost and fixed cost savings at the hospital will more than compensate the additional cost in primary care. In reality hospitals will shrink in bed numbers. Oddly enough the citizenry say they want to be treated at home if at all possible. Sounds like a win win to me!

To achive this level of shift we will need to use technology e.g. body worn monitors and AAL equipment etc.

Fortunately the tech cupboard is full of kit we can use and rely on from a safety / efficacy point of view. The only problem we have is lack of experience in using the technology - too many people of a certain age are in charge of the system may be?

Money saved can be reinvested into demand reduction facilities. Stopping and or delaying people getting sick or acquiring long term conditions is the only show in town in my opinion if we want:

A. Happy healthy citizens who can enjoy an active health ageing process and work for longer.

B. Reduce the size of the Health and Social care realestate and if we are really lucky the H&S care labour force.

Julie Ann Racino

ASPA, Budget and Finance Section,
American Society for Public Administration
Comment date
15 December 2014
In the US, the 2000s marked the first citywide bankruptcy in our nation (i.e., Detroit in Michigan) and the world saw the first nation bankruptcy in Greece. We support your initiatives on responsible cost improvement targets, investment funding, and income generating activities in a broad sense. Look forward to working with you in the 2014-2015 period on the use of health care financing in the community.

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