Skip to content

This content is more than five years old


Quality in a Cold Climate

The NHS is facing the biggest financial challenge in its history. Following real-terms increases averaging 7 per cent since the turn of the century, the NHS budget will grow by just 0.1 per cent a year until 2014/15.

The Spending Review also committed the NHS to delivering up to £20 billion a year in efficiency savings by the end of this period. It must achieve this while grappling with rising demand for services from an ageing population and cost pressures that are squeezing local budgets.

Our Quality in a Cold Climate project aimed to support the NHS in delivering productivity improvements required to meet this challenge.

About the programme

Project reports and briefings

  • Reconfiguring hospital services

    Reconfiguring hospital services offers a timely and sobering contribution to the emerging debate on how service and organisational change should be taken forward across the NHS in Englan...

  • Mental health and the productivity challenge: improving quality and value for money

    The King's Fund worked with Centre for Mental Health, Royal College of Psychiatrists and NHS Confederation's Mental Health Network to explore how mental health services could be delivere...

  • Avoiding hospital admissions

    In order to successfully reduce avoidable emergency admissions, we need to fully understand which interventions are the most effective. The King's Fund commissioned this review of resear...

  • Referral management: lessons for success

    Our report provides practical advice to those seeking to influence GP referrals. It draws on the current literature and new qualitative and quantitative research.

  • Approaches to demand management: commissioning in a cold climate

    This write-up summarises presentations made at a seminar, which brought together commissioners, policy-makers, providers and others to consider some of the available evidence about deman...

  • Avoiding hospital admissions: lessons from evidence and experience

    This paper summarises presentations made at a seminar that brought together case studies from the NHS in England, Kaiser Permanente and the independent sector.

  • Windmill 2009: NHS response to the financial storm

    The era of unprecedented investment in health care is over, and prospects for future funding now look bleak. But how will the NHS respond? We used a behavioural simultation to test the p...

  • How cold will it be?

Mental health and the productivity challenge

Improving productivity is one of the greatest challenges now facing the NHS, and our report examines how developments in mental health care can help to deliver the necessary productivity savings. This video explores some of the work currently being done to improve productivity and patient care in mental health services. We hear from Chris Naylor, project lead, and a number of the case studies featured in the final report from our publication on mental health and the productivity challenge.

Improving NHS productivity

Lord Howe, Parliamentary Under Secretary of State for Quality, outlines the productivity challenges facing the NHS.

Jim Easton, Director for Improvement and Efficiency, Department of Health, discusses how the QIPP health agenda has been working so far and how quality of care can be improved whilst implementing substantial efficiency savings.

John Appleby, Chief Economist at The King's Fund, looks at why we need to improve NHS productivity and by how much at our Improving NHS productivity conference.

Unwarranted variations

We get an American perspective on unwarranted variations in care from Jack Wennberg and Al Mulley. How can we compare this to variations in NHS care in England?