NHS is almost a fifth less productive than before the Covid pandemic, figures reveal

The NHS is almost a fifth less productive since before the pandemic, a damning report has revealed.

It means taxpayers are getting poorer value for money, with every pound spent on the likes of staff, buildings and equipment delivering fewer services, the Office for National Statistics said.

Campaigners last night warned the ‘catastrophic collapse’ in efficiency is most likely to blame for the ‘appalling level of service’ patients have experienced in recent years.

They called on the Government to ‘light a fire under NHS bosses’, tackle wasteful bureaucracy and deliver significant improvements.

In the autumn Budget, Chancellor Rachel Reeves announced a £22.6billion increase in NHS day-to-day spending over two years and a £3.1billion increase in its capital budget.

But the ONS said healthcare productivity fell by 2.4 per cent in the third quarter of 2024, compared with the same period a year earlier.

This was 18.5 per cent below its pre-pandemic peak in the final quarter of 2019, it added. Meanwhile, overall public service productivity fell by 8.4 per cent.

Health leaders blamed the worsening productivity on crumbling buildings, outdated technology and bed-blockers, which limit the speed at which staff can admit new patients and deliver care.

John O’Connell, chief executive of the TaxPayers’ Alliance, said: ‘The catastrophic collapse in the health service’s productivity is surely the primary reason behind its appalling level of service for its patients in recent years.

‘While politicians rightly praise the efforts of part of the workforce, huge swathes of the NHS simply aren’t delivering with the problem particularly acute in the bureaucracy.

‘Health Secretary Wes Streeting needs to light a fire under NHS bosses and demand a significant improvement in productivity.’

It is the first time the ONS has released quarterly productivity figures for the NHS and said it chose to focus on healthcare over other sectors because it is the largest public service area by share of expenditure.

Healthcare accounted for approximately 39 per cent of the total public expenditure in the third quarter of 2024.

The analysis includes several activities, including elective and non-elective services, GP appointments, prescription drugs, outpatient, mental health, community health, and A&E.

Saffron Cordery, interim chief executive of NHS Providers, which represents health bosses, said trusts ‘work hard to make the most of every pound’.

She added: ‘Many factors hamper better productivity, including an eye-watering near-£14billion backlog of essential repairs to ageing NHS buildings and equipment as well as thousands of patients stuck in hospital every day who can’t be discharged often due to a lack of community NHS or social care capacity.

‘At the same time the number of people accessing mental health services and undergoing diagnostic tests and cancer screening has never been higher.

‘To make the NHS more productive requires long-term, cross-government support including for digital technology which can free staff from time-consuming admin.’

Max Warner, research economist at the Institute for Fiscal Studies, said: ‘The government and NHS England are right to focus on improving NHS productivity, as lower productivity is bad for those needing care, bad for NHS staff and bad for the public finances.’

Charlotte Wickens, policy adviser at The King’s Fund, said: ‘Reasons behind the stalling of healthcare productivity may include outdated kit and buildings, low levels of managers to overall staff, high levels of staff burnout, the impact of industrial action, patients stuck in hospitals because other services are not able to support them, and patients having more complex care needs than pre-pandemic.

‘It is clearly going to be difficult to run an efficient service when the lift to the operating theatre is consistently broken and clunky laptops take 10 minutes to switch on.’

Matthew Taylor, chief executive of the NHS Confederation, said: ‘NHS leaders and their teams are working hard to boost productivity and ensure the healthcare system can meet the needs of an ageing population, often with multiple or more complex conditions.

‘There are very differing measures of NHS productivity, but what matters is people’s health, preventing worsening ill health to reduce the pressure on hospitals and deliver better value for money. But this is often not captured in measures of activity in hospitals alone.’

An NHS spokesperson said: ‘The NHS recognises that there are different methods for working out public sector productivity and we will continue to work with the ONS to ensure all figures used are as accurate as possible.

‘While our latest estimates show acute productivity has reached 2.4 per cent in the first seven months of 2024/25 compared to the same period last year, there is a lot more work to do to make further improvements – we will be ruthlessly focused on this over the next year, including by having a sharp focus on slashing agency spend, improving retention of staff and using the latest technology to be more efficient.’

The Department of Health and Social Care last night admitted patients are ‘paying more but getting less’ as it vowed to deliver better value for taxpayers.

A Department of Health and Social Care spokesperson said: ‘This government inherited a broken NHS. Today’s ONS report confirms that patients are paying more but getting less. We need to get back to basics and start focusing on what matters most to patients.

‘Our reforms will squeeze better value out of every penny going into the NHS.

‘We have set an extremely tough productivity and efficiency target for the NHS next year, and we are giving them the tools to hit it.

‘We are bringing our analogue NHS into the digital age, cutting out millions of pointless and missed appointments, and holding the NHS to account through league tables.

‘Through our Plan for Change, we will get the NHS back on its feet, delivering better value for taxpayers and a better service for patients.’