The NHS across the UK does not deserve more money because it wastes so much on poor care, an expert leading a wide-ranging efficiency review has warned.
After visiting every hospital in the country and finding huge variations in cost and the quality of common treatments, Tim Briggs says the NHS needs to “put our house in order” before asking for extra taxpayers’ cash.
The consultant orthopaedic surgeon has already helped Scotland compare how different hospitals look after patients with joint and limb problems to help improve treatment and save cash. He is now leading a programme in England looking across a wide range of surgical procedures.
“I’ve now been to every single trust in England, Wales, Scotland and Northern Ireland and there is significant waste out there,” Professor Briggs told The Times.
“I do not think at the moment we deserve more money until we put our house in order and we actually make the changes that will improve the quality of care.”
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It is understood the orthopaedic community in Scotland has saved millions of pounds by looking at variations between different health board areas — such as higher infection rates or more frequent emergency admissions — and learning from those which are the most efficient.
Money has also been saved by negotiating contracts to buy medical items for Scotland as a whole, rather than individual health boards arranging their own procurement.
However, there is still concern about significant differences between hospitals around the country.
An investigation by NHS Greater Glasgow and Clyde has uncovered higher hospital admission rates in their region compared to other areas.
One surgeon, who did not wish to be named, said questions should be asked about why other hospital departments in Scotland were not undertaking similar work to improve efficiency — “particularly those jamming all the beds”.
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The Briggs report is backed by Simon Stevens, head of NHS England, and Jeremy Hunt, the UK health secretary, who last night urged hospitals to act on the findings.
On the back of its work in England, Professor Briggs’s team reports today that more than 300,000 patients a year are needlessly admitted to emergency surgery beds when they do not actually need an operation.
If everyone copied the best units by getting a consultant to run tests quickly, many of these patients would be sent home immediately, freeing up a ward in each hospital and saving the NHS £108 million a year.
In bowel cancer surgery alone, death rates vary from zero in some places to 14 per cent elsewhere, while hospitals are spending £23 million too much by keeping in patients for ten days when the best have them home in five.
Some hospitals are paying 350 times more for basic surgical equipment than others for no clear reason, while there is no consensus about the best way to carry out some common procedures.
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The general surgery report is one of the first instalments in a project looking at 34 specialisms covering 90 per cent of hospital activity south of the border, and Professor Briggs said there were “huge gains to be made”. For example infection rates in hip replacements are 25 times higher in some hospitals than others, he found.
“If you could get the infection rate across the country down to 0.2 per cent just in hip and knee replacements, you’d save the NHS every year £250-300 million, just by improving the quality of care,” he said.
Blunders in childbirth cost the NHS more than £400 million a year in legal claims, yet some hospitals pay just £75 per birth while the best spends £6,980, Professor Briggs found.
While saying that social care was different, Professor Briggs insisted that the NHS had to make sure that “every pound of taxpayers money is spend to the best effect. Then, once we’ve got that, we can speak to the politicians as the population ages about whether the NHS needs more money. But at the moment there are significant changes we can make to improve our practice that will allow us to do a lot more work with the amount of money we have.”
Mr Hunt urged hospitals to act on the report’s findings, saying: “As this excellent work led by Professor Tim Briggs shows, some hospitals are already working smarter with their money to save time and get better outcomes — but there’s more to be done.”