Recommendation 3

NHSE displays a remarkable complacency about the realisation of future NHS productivity improvements, which, if achieved, would be unprecedented. According to official ONS measures, long-term productivity gains in the NHS averaged 0.6% a year over the period 1996–97 to 2018–19. But productivity subsequently fell and has yet to recover fully. The NHS has 19% more staff compared to before the pandemic but is only seeing 14% more patients. Workforce issues such as sickness and absence continue to impact productivity. NHSE is confident that the annual productivity gains that it has committed to of 2.0% by 2028–29 can be achieved because it contends the last two years have been affected by ongoing disruptions such as industrial action, and that further recovery is still possible, particularly through technology-enabled change. However, NHSE was unable to convince us that it has a detailed plan to achieve the promised productivity gains, and it does not yet fully measure and capture productivity in important areas, such as mental health and community services. recommendation NHSE should set out in detail which specific actions and initiatives it expects to contribute to the unprecedented increase in productivity it has committed to, and by how much. This should include specific measures to address poor staff retention and sickness rates, which contribute to low productivity.