The NHS in England could prevent 20,000 deaths and save £33bn a year by cutting red tape and boosting productivity, a report says.
Research by the Health Foundation found the health service has been held back for decades by excessive regulation, short-term planning and insufficient capability to deliver major change.
But rewiring the NHS, the world’s largest single healthcare system, by harnessing new technology, empowering staff and increasing capital investment could save both lives and money, it found.
There is “substantial scope to improve outcomes within the funding already available to the NHS”, which could result in up to four extra years of good health for people on average, the report said.
In terms of where deaths could be prevented, focusing on diagnosing cancer earlier and finding people with high blood pressure or conditions such as diabetes quicker would be key, it added.
The report called for a series of changes, such as releasing the NHS from unnecessary regulation, reporting and compliance tasks, as well as launching a “test-and-learn” approach to scaling up things that could improve productivity, such as use of artificial intelligence.
“Our analysis suggests that if the NHS in England achieved outcomes closer to the best-performing comparable health systems, without spending more each year, it could potentially result in 18,500–20,600 fewer deaths each year from treatable causes and 2.5 to 4.5 additional years that people spend in good health on average,” the report said.
Increasing NHS productivity is “sometimes … seen as exhorting hard-working staff to work even harder, in a system already under considerable strain” but this view must be challenged, it added. “At its heart, productivity means achieving better health outcomes from the resources available.”
The biggest issues affecting productivity included the “constant churn”, too many targets, and not enough focus on health outcomes.
Researchers also heard from staff how poor IT wasted clinical time, how limited estate and equipment constrained healthcare and how gaps in administrative support shifted additional work to clinicians.
While AI offered opportunities, the “NHS has repeatedly struggled to take advantage of the potential”, the report said.
Anita Charlesworth, report author and senior economic adviser at the Health Foundation, said: “This is mission critical for the NHS, which cannot simply keep doing more of the same.
“The problem is not a lack of committed and talented people or an absence of ideas; it is that the NHS is not set up to deliver sustained productivity growth.
“Our research points to a fundamental redesign of the operating conditions – not another disruptive reorganisation, but a reset to make improving productivity a defining focus for the NHS over the next decade and beyond.”
Sir Ciarán Devane, chief executive of the NHS Alliance, which represents and supports the health and care system in England, Wales and Northern Ireland, said he agreed more could be done to deliver further productivity gains but there were “big barriers” that would need to be addressed.
“Lack of capital investment has been a long-running drag on NHS productivity. More must be done to turn the tide on years of neglect … We also agree that a more streamlined, supportive regulatory system which encourages local autonomy and innovation will be vital for future progress.”
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