Hospital Productivity Drops 11 Percent Since Lockdown: NHS

A general view of staff on a NHS hospital ward on Jan. 18, 2023. Jeff Moore/PA

Productivity in hospitals “is still lower than it was pre-pandemic” with productivity in acute care 11 percent lower than before the lockdown, NHS England has said.

The health service noted in its report published on Thursday that before COVID-19, the NHS “typically delivered productivity growth at a faster pace than the rest of the public sector and the wider economy,” but that in line with health systems around the world, the effects of the pandemic “caused significant and long-lasting disruption to NHS services, and consequently productivity.”

The health service conducted analysis of productivity in the acute hospital care sector, which relates to short–term treatment for patients with any kind of illness or injury, and found that productivity last year was “around 11 percent lower than before the pandemic.”

The report noted that 2023/2024 was also “significantly impacted” from strikes by NHS staff, costing around £1.2 billion and reducing aggregate activity.

Even adjusting for the impact of industrial action, the analysis would still be 8 percent lower than before lockdown.

Other factors behind this were found to include the length of stay for patients increasing “during and since the height of the pandemic” which had a number of causes including constraints on out-of-hospital capacity, particularly in relation to social care where capacity for care at home “has been recovering since 2022.”

“Temporary staffing costs are still higher than pre-covid,” the report said, “partially to cover higher sickness and absence rate among staff, in addition to covering for industrial action.”

‘Staff Burnout’

The report also collated research performed by local NHS organisations, NHS England, and other bodies to understand what happened to productivity during and since the lockdown. Some of the drivers of decline report authors found included “post-pandemic turnover of experienced leadership and management,” as well as “staff burnout and lower engagement.”

“Sickness absence rates have reduced from the high point during covid, but are still higher than 2019 levels with an increasing proportion with stress related absences,” the report said.

A poll of NHS staff from April found that more than three quarters (76 percent) have experienced mental health issues in the past year.

The survey, commissioned by NHS Charities Together, found that 52 percent said they had struggled with anxiety, 51 percent had had low moods, and 42 percent had experienced exhaustion.

Another survey by trade union UNISON had shown 31 percent of NHS staff had taken time off work in the last year because they were experiencing mental health issues.

The productivity report said it would seek to implement the NHS Long Term Workforce Plan, which includes mental health support for staff, and use the National Retention Programme to improve staff engagement and retention.

Aging NHS Estate

Other factors cited by the report impacting productivity include a population getting older and requiring more complex and longer care, an aging NHS estate—“which had meant a growing backlog of maintenance”—and “increasing technology debt.”

Freedom of Information (FOI) requests made by the Liberal Democrat party in recent months revealed the condition of the NHS’s estate, with one set of data analysis finding that more than 2,000 NHS hospital buildings in England predate 1948, making them older than the health service itself.

Another set of FOI data published by the party revealed there had been 18,000 reports of pest problems at NHS hospitals in England in the past three years.

In March’s budget, Chancellor of the Exchequer Jeremy Hunt announced NHS England would receive a £2.5 billion day-to-day funding boost for fiscal year 2024/2025.

A medical professional in PPE pushes a patient inside St. Thomas's Hospital in north London, on April 1, 2020, Daniel Leal-Olivas/AFP via Getty Images

The NHS will also receive £3.4 billion in capital investment, with Mr. Hunt saying this would double investment in “digital transformation, significantly reducing the 13 million hours lost by doctors every year because of old IT and delivering test results faster for 130,000 patients a year thanks to AI-fitted MRI scanners that help doctors read results more quickly and accurately.”

A Department of Health and Social Care spokesperson has also previously said the government was investing “record sums to upgrade and modernise NHS buildings, with £4.2 billion invested last year alone” on top of expected investment of over £20 billion for the New Hospital Programme.

According to government guidance on public spending, the largest taxpayer expense is health care, at 19.8 percent of a person’s income tax, followed by welfare (19.6 percent) and national debt interest (12.0 percent).