NHS productivity
This briefing focuses on productivity in the NHS in England, which has become an issue of increasing importance for policy makers and NHS leaders. It details the methods used to measure NHS productivity, recent trends, and proposed strategies to increase productivity.
The 10 Year Health Plan for England, Fit for the Future, published on 3 July 2025, states that “we will need to urgently resolve the NHS productivity crisis”. A central element of recent NHS financial strategy in England has been a target of 2% annual productivity growth. This is intended to reverse the reported decline in NHS productivity seen during the COVID-19 pandemic. While there have been recent increases in productivity in the English NHS, it has not yet recovered to the level it was at prior to the pandemic. This decline is persistent across the differing methods used to measure productivity, with the range of estimates finding NHS productivity is 5 – 11% lower now than it was in 2019/20.
Changes in productivity can have an impact on NHS fundings needs. The Health Foundation have projected that with 1% a year productivity growth, the NHS needs funding of £211bn by 2028/29, while with 2% per year productivity growth, the NHS would need £198bn.
There are a number of reasons why NHS productivity may be lower than it was previously. These include changes in infrastructure and resilience, patient complexity, hospital flow, staff morale and experience and organisational incentives.
This briefing sets out how and why healthcare productivity is measured, reflecting different views on what should be measured and what different measures mean. It also lays out recent trends in NHS productivity, the explanations given for these trends, and outlines the potential changes that have been proposed to increase productivity.