In Spring 2016, working with Wales Public Services 2025, the Public Policy Institute for Wales (PPIW) ran a series of facilitated workshops exploring how further ‘technical’ efficiency could help close the projected long-term NHS ‘funding gap’ in Wales. This was linked to new modelling work by the Health Foundation on NHS Wales fiscal sustainability and research by the Wales Institute for Health and Social Care on possible impacts of Prudent Healthcare.
We found that, although health boards and trusts in Wales have cost reduction plans, the decline in the level of savings reported annually suggested that achieving gains was becoming more difficult.
NHS Wales has a strong record in achieving efficiency through improved procurement and shared services, and there is scope for further gains. There is also significant potential, for example, in optimising the deployment of staff; managing estates and facilities; electronic health records, patient-focussed digital applications and streamlining business systems.
But for these opportunities to be realised, and for the required level of efficiencies to be delivered, there needs to be a more strategic and sustained all-Wales programme.
NHS Wales should draw on the work of Lord Carter of Coles in England on tackling unwarranted efficiency variations between acute hospitals. Crucial to this will be the development of better efficiency metrics for Wales.
Health boards and trusts would also benefit from stronger national support, for example, in translating examples of local good practice and high-potential innovation into service-wide change. Such national support needs to address concerns about the change capacity across the system and align funding with change priorities through transformation funding or equivalent.