Health Foundation’s Productivity Commission Risks Repeating Familiar Mistakes

The Health Foundation’s new Commission on NHS Productivity is seeking evidence on how the health service can improve performance, use technology effectively, and deliver long-term reform. One of its first activities was to convene a group of experts to discuss whether the NHS can achieve the government’s target of two per cent annual productivity growth.

The commission’s stated aim is to identify which productivity levers matter most, how technology can contribute, and what types of reform might yield improvement. However, some observers believe its approach so far risks repeating long-standing policy assumptions rather than challenging them.

NHS productivity remains around ten per cent lower than before the pandemic. Yet the framing of the commission’s debate has been described as limited, focusing on targets rather than on the practical barriers that make improvement difficult.

A blog summarising the discussion suggested that effective use of technology could reduce administrative burdens or enable virtual care. Critics argue that these claims oversimplify the problem, as administrative work is not a major cause of poor productivity. Similarly, efforts to “streamline discharge” may help accident and emergency flow, but only if linked to wider capacity planning across hospitals and community services.

The Health Foundation’s framework identifies four main “levers” of productivity: workforce, technology, capital and transformation. Analysts caution that these areas are interdependent and cannot be improved in isolation. For example, adding staff without the necessary capital investment or infrastructure is unlikely to increase output.

Some commentators also note that the debate continues to overemphasise innovation and new technology, when many of the most effective productivity gains could come from consistently applying well-established operational methods. The lack of system-wide thinking, they argue, is a key reason why technology projects and reform programmes often fail to deliver the expected impact.

The Health Foundation’s commission will report in 2026. Its findings will help inform future government and NHS policy on efficiency and reform. The challenge will be to move beyond theoretical levers and consider how the system’s structure, capacity and leadership can enable sustainable productivity growth.