Fear of service disruption and the risk of compromising service quality and availability are considered to be the main obstacles to improved efficiencies and savings according to the findings of a major survey of NHS organisations.
Despite three out of four organisations already rising to the challenging targets outlined in NHS England’s five year forward view, most believe that integrated care models, outsourcing and sharing services will be essential to deliver guaranteed year-on-year savings.
Efficiency Challenges in the NHS - an iGov 2015 Survey - targeted organisations from Acute Trusts, Mental Health and Community Trusts to Ambulance Services, Clinical Commissioning Groups and Commissioning Support Units. The survey looked at the issues arising from NHS England’s challenging target of generating efficiency and demand savings of between 2 - 3% each year for the rest of the decade. The respondents were quizzed on the actions they’re taking to meet this target - from prevention initiatives and new care models to steps taken to increase the sharing of back office services as proposed in the Dalton Review.
The survey shows that renegotiating contracts, rationalising the estate portfolio and the risks posed by new ways of working are seen to be the principal considerations when addressing efficiency challenges. Evidently, it’s in these areas where respondents consider the opportunities and real obstacles to organisational change lie. And the top priorities for dealing with such organisational challenges were improving the patient journey - 74% - and successfully delivering integrated care models (73%).
Most respondents (54%) consider procurement to be the business support area where the largest efficiency improvements can be achieved, with 45% of respondents also highlighting the same area for the quickest efficiency savings. Estates and property management and ICT services also featured prominently as areas where significant efficiencies can be achieved. In other areas, contract renegotiation was considered to be the most common factor (69%) that will help to maximise efficiencies over the next five years.
There was widespread agreement that the delivery of immediate savings in the first year is just the first - and, arguably, easiest - step to take. Most respondents agreed that it’s quite another matter to establish sustainable savings without risking service disruption or impacting adversely on service levels and availability. Just under half (41%) believed outsourcing and sharing services contributed toward achieving their current efficiency targets. However, there is a significant increase in respondents (62%) who believe outsourcing and sharing services will make an important contribution to successful delivery of the efficiency plan over the next five years.
“The survey has highlighted that many organisations are concerned about their ability and scope to deliver ongoing savings without compromising frontline resources, once the immediate opportunities for efficiency gains have been exhausted,” says Serco’s Dominic Durose. “Indeed, investment in new service developments and operational improvements must go hand in hand with efficiency savings in order to ensure all service and financial objectives are satisfied. The success already achieved by Serco ASP’s NHS partnership demonstrates how this can be achieved and the value of working with a like-minded partner to deliver high quality shared services and ongoing savings.”
The ‘Efficiency Challenges in the NHS’ iGov survey was commissioned by Serco and examined the success and obstacles as NHS organisations strive to meet their new efficiency targets and look to build on their initial progress in meeting NHS England’s target. Respondents comprised a broad cross section of managers, department heads and directors from more than 200 different NHS organisations.
Ian Gregory, marketing and business development director, Serco