NHS Procurement Champion and Labour Peer Lord Carter of Coles has published an interim report setting out findings from his review of NHS procurement and standards.
Announced in 2014, the review’s goal is to help the NHS identify £22bn of efficiency savings required in the next five years. Carter’s team analysed cost data across four broad categories of expenditure: hospital pharmacy and medicines optimisation, estates management, procurement and workforce.
Despite being ‘reluctant’ to set detailed targets, Carter believes that his recommendations can save the NHS up to £5bn a year by 2019-20. Recommendations include:
- adopting an “adjusted treatment index” measuring and comparing efficiency across the provider sectorto allow peer review of performance
- developing a “model NHS hospital” to help NHS providers improve productivity
- developing workforce standards for making best use of staff time, staff rostering, one to one care, and skill range
- and designing a model approach to hospital pharmacy services.
This, of course, sounds like good news. We know the NHS is struggling in the face of mounting financial pressures, and the changes proposed by Carter’s review will save much needed cash which can be reinvested into the health service.
But looking at the wider context it is alarming that a report discussing how the service can save pennies and pounds is being relied upon to save the NHS. Even if the £5 billion identified in the report can be saved in practice, it stills leave a shortfall of £17bn for the NHS to find down the back of the sofa.
While the Carter review is focused on realising short term cost savings, in parallel George Freeman’s Accelerated Access review is looking at how the health service can invest in the innovative new medicines that are being brought to market.
It is hard to avoid the conclusion that the Carter and Freeman reviews are happening in silos, with the former engaging with the NHS and the latter with industry. No one is joining the dots, and this week’s announcement that CMO Sally Davies is calling for a third independent review on the safety and efficacy of medicines adds yet another dimension to an already fragmented picture.
The health service is facing huge challenges as it copes with the dual pressures of a growing and ageing population. The development of a range of fantastic and innovative medicines which bring great promise for patients, are coming to market at a time of ever dwindling budgets. If real change is to take place, the NHS must be allowed to break free from the chains of short-term cost-containment, and instead work with industry and providers to think long-term. Only then will we be able to deliver both quality and sustainability in the NHS.
It is in everyone’s interests to work together and make sure that the NHS can free up the money needed to invest in the things that matter most to patients and their families.