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There are huge opportunities to do this but under the current adversarial contracting model of purchaser vs. provider there are no incentives for change to happen.
Providers find every way they can to record and be paid for as much activity as possible and commissioners try to evade payment for anything they can claim is someone else's responsibility.
The transactional costs of this system are mind-boggling and the negotiation of contracts for one provider take literally 1000's of man hours to conclude. We just agreed our main 15-16 contract for Apr15-Mar16 in November. Still haven't signed the other £300m worth.
dubtap
Chalfie
While achieving £22 billion in efficiency savings by 2020 is hugely ambitious, there are significant opportunities to improve productivity, and the NHS must engage staff at all levels in a new mission to deliver better value at lower cost by changing the way that clinical care is delivered (Alderwick et al 2015). The 1.4 million staff who work in the NHS must be supported to achieve this.