Value for money in the English NHS: summary of the evidence

The extent to which the English National Health Service secures value for money for taxpayers has become a central issue of political and public debate. Questions include: how much expenditure growth has been made available to the NHS? on what has that money been spent? what improvements in the volume and quality of health care have been secured? and what are the implications for productivity? There has been a flurry of research activity designed to address these and similar questions. This report seeks to bring together this research in a concise format and draws some tentative conclusions about recent productivity changes in the NHS.

It finds that there is considerable evidence of growth in both the volume and quality of NHS activity. However, this has not in general kept pace with the growth in expenditure. On most measures, therefore, NHS productivity is either static or declining. However, the report highlights a large number of unresolved methodological issues that make it hard to draw any definitive conclusions. We conclude that the measurement of NHS productivity change makes an important contribution to national debate. However, there remains considerable scope for improving both the data and the methods underlying current estimates.