Why Hunt’s Productivity Plan Misses the Mark

In the wake of the government's announcement of a nearly ￡6 billion infusion into the NHS over the next five years, I find myself pondering the broader implications of this strategy?. As someone deeply invested in the future of the NHS, I can't help but question whether the focus on clinical services technology sufficiently addresses the myriad of challenges facing our health service today, or if this is indeed a missed opportunity.

While promising a modernization of IT systems and the integration of cutting-edge artificial intelligence (AI) capabilities into patient care, the announcement seems to overlook the critical backbone of the NHS: its 120,000 staff across central functions, including Finance, HR, IT, Communications, and Corporate Governance. These roles are pivotal in supporting the entire NHS workforce, which totals 1.45 million, not just the 750,000 medically qualified staff. This gap in the budget's focus raises concerns about whether enough is being invested in these essential services that ensure the NHS operates smoothly and efficiently.

Why I believe the budget strategy must change:

The NHS is grappling with significant staff welfare issues, highlighted by some 27 million days of sickness and absence across 2022. This staggering figure equates to the absence of approximately 74,500 full-time equivalent staff, including 20,400 nurses and 2,900 doctors, on any given day—a likely underestimate due to under-recording. Mental health and well-being-related reasons accounted for 6 million of these days, with reported absences due to anxiety, stress, depression, and other psychiatric illnesses increasing by 26% between 2019 and 2022.

The high rate of sickness absence not only disrupts patient care and adds to the operational costs but also has a demoralizing effect on the workforce. It signals deeper systemic issues within the NHS that need urgent attention. Such a pervasive problem cannot be solved by clinical services technology alone; it requires a holistic approach that includes significant investment in technology that supports better outcomes for all NHS staff, not just those in clinical roles.

Leaders of NHS People Services functions that I speak with regularly outline positive change they are striving for through robust support systems for mental health and well-being.? This in turn creates a more resilient and supported workforce capable of delivering high-quality care without the burden of excessive stress and burnout. But it does not resolve some of the long-standing underlying issues that back-office staff face when performing their duties – namely poor access to modern systems, complex legacy processes, and low-quality data.

Investing in central functions is not just about improving efficiency; it is about valuing and supporting the people who form the heart of the NHS. In turn, front line services receive better support and attention – after all, eliminating unnecessary issues surrounding on-boarding staff, running an effective payroll, and delivering effective job planning (to name a few) should not be an either/or decision.? These are fundamental issues that should have been addressed many years ago and could have as big of an impact on overall NHS efficiency over the next five years as Hunt’s plan demands.

It's time for the government to broaden its perspective and consider a more inclusive approach to investment and tackle the long-standing under investment in central functions. I believe then we will see a significant improvement in tackling the issues of staff sickness and absence across the whole NHS, fostering a healthier, more sustainable working environment for all employees.

Trusts should balance investment moving forward:

In preparing the Productivity Plan, the Government may have missed an opportunity to rebalance investment and create a more equal baseline between clinical services and central functions, based on local digital and technology assessments.? This would have allowed executive teams to prioritise investment based on local needs and existing programmes of work.

As we look toward the future, I will continue to advocate for a balanced investment strategy that embraces technology in clinical services but also prioritizes advancements that support the entire NHS workforce. After all, a healthier, happier staff is essential for the delivery of exceptional patient care and the overall success of the NHS.

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About Russ Boreham:?

Over the past twelve years, my career has been deeply rooted in the healthcare sector, where I've had the privilege of making significant contributions to the NHS. I discovered my passion for the NHS while working with a digital transformation consultancy. It was there that I was involved in a groundbreaking digital transformation programme at NHS Blood and Transplant. This project, which spanned over three years, marked a milestone by achieving the world's first cloud-enabled heart transplant. Inspired by this experience, I dedicated myself to driving innovation within the NHS, focusing on leveraging Automation & AI. Subsequent work has not only led to substantial cost savings for the NHS but also provided crucial support to its workforce during the challenging times of Covid. Building on this foundation, I established the NHS industry practice at Automation Anywhere in 2018, where I continue to advocate for and implement transformative solutions. While the views I express are solely my own, my commitment to enhancing healthcare through technology remains unwavering.