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Improving NHS productivity is a key national priority. But what’s behind the slowdown and can it be reversed? 

Over the past few years, amid the turmoil of COVID-19, the NHS has seen substantial growth in funding and clinical staffing levels. Yet the numbers of patients treated haven’t risen in step – suggesting services, particularly NHS acute hospitals, have become less productive. 

Government has announced a wide-ranging review of public sector productivity and asked services to develop plans to recover productivity performance. At the Spring Budget 2024, £3.4bn in capital funding was announced to support digital and technology projects intended to boost NHS productivity. 

So why have activity levels not been keeping pace with recent increases in NHS funding and staffing, what can be done, and is implementing new technologies a solution worth banking on? 

To discuss, our Chief Executive Jennifer Dixon is joined by:





Anita Charlesworth, Chief Economist and Director of the REAL Centre at the Health Foundation.
Neil Sebire, Professor of Pathology and Chief Research Information Officer at Great Ormond Street Hospital for Children NHS Foundation Trust. 


Show notes

Institute for Government (2023). The NHS productivity puzzle. 

Institute for Fiscal Studies (2023). Is there really an NHS productivity crisis? 

Health Foundation (2023). The unsustainable is not sustained: why productivity is fundamental to the future of the NHS. 

Bennett Institute (2021). Productivity in UK healthcare during and after COVID-19 pandemic.

Chancellor’s speech on productivity growth (2023). 

Centre for Health Economics (2024). Productivity of the English National Health Service: 2021/22 update. 

What's happened to our economy and what does it mean for our health?

Many developed economies have been growing more slowly since around 2008, but the UK economy has been struggling more than most. Wages haven't risen since 2008 leaving the average worker £14,000 worse off. Productivity growth – vital to rising living standards – has stalled. Regional inequalities are unusually large, and economic hardship is widespread with 2.8 million people reporting not working because of long-term sickness.

So what’s driving this economic stagnation, how is it connected to our health, and what can politicians do to address the challenges?

To discuss, our Chief Executive Jennifer Dixon is joined by:






Diane Coyle, Bennett Professor of Public Policy at the University of Cambridge and Co-Director of the Bennett Institute.

Torsten Bell, Chief Executive of the Resolution Foundation.



Show notes

The Health Foundation (2023). The unsustainable is not sustained: why productivity is fundamental to the future of the NHS. 

The Resolution Foundation (2023). Ending stagnation: a new economic strategy for Britain. 

The Health Foundation (2023). What we know about the UK’s working-age health challenge.

Coyle D and Muhtar A (2022). Contemporary Social Science. Levelling up policies and the failure to learn.

Bennett Institute for Public Policy (2023). A Universal Basic Infrastructure for the UK. 

The Resolution Foundation (2024) (funded by the Health Foundation). We’ve only just begun: action to improve young people’s mental health, education and employment.

Given the huge pressures on the NHS it's perhaps inevitable people ask, what's the future of it?

The NHS and social care are struggling to deliver care and support to people who need it. With services so stretched, waiting times at record highs, public satisfaction falling and a demoralised workforce, is now the time to ask some fundamental questions about the NHS?

In the past month, two independent commissions on the future of the NHS have reported – the Times Commission in early February, and the first of several papers from the BMJ Commission at the end of January.

We speak to the commission chairs about what they found out and what they’d like to see future governments prioritise on health. And given the tight squeeze on public funds, what will it take to truly put the NHS on a sustainable footing?

To discuss, our Chief Executive Jennifer Dixon is joined by:





Rachel Sylvester, political columnist at The Times, and chair of the Times Health Commission.
Parveen Kumar, Emeritus Professor of Medicine and Education at Queen Mary, University of London, and co-chair of the BMJ Commission on the Future of the NHS. 

About a fifth of us of working age – just under 9 million people in the UK – are not looking for or are not able to work. Recently the biggest growth has been among those reporting long-term illness, now at a record high of around 2.7 million.

This decline in working-age health is causing concern among employers, politicians and policymakers. Earlier this month the Health Foundation launched an independent Commission for Healthier Working Lives to build consensus around the kind of action needed. So what’s going on, and what do the solutions look like both at a local and national level? 

To discuss, our Chief Executive Jennifer Dixon is joined by:






Sacha Romanovitch, Chief Executive of Fair4All Finance. Sacha is a member of the government’s levelling up Advisory Council, and Chair of the Commission for Healthier Working Lives, which is supported by the Health Foundation.

Oliver Coppard, Mayor of South Yorkshire. Oliver was elected as the Labour Co-op mayoral candidate in May 2022. Oliver sits on a commission led by Alan Milburn, former Secretary of State for Health, investigating economic activity in Barnsley. 

Join us as we look back at the pick of the pod in 2023. 

It's been a turbulent year: the NHS under pressure, the health of the population not improving as fast as we’d like and economic inactivity remaining stubbornly high, especially among working-age people. 

But it's not all gloom. To some surprise, we saw government ditch its nanny state objections and take bold action on tobacco. And there have been breath-taking advances in technology, not least in artificial intelligence. A reminder that innovation and politics can open up new possibilities and hope for the future. 

Join our Chief Executive Dr Jennifer Dixon as we reflect with guests who appeared on the podcast in 2023.

Show notes





Jeanelle de Gruchy and Kevin Fenton, Our health in 2040: are we getting sicker? 
Alice Wiseman and Clare Bambra, Low life expectancy in the north east, and what to do about it

Michelle Kelly-Irving and Nish Chaturvedi, How chronic stress weathers our health 
Sarah Neville and Hettie O’Brien, Going private: what’s happening and is it a bad thing? 
Rachel Wolf and Stephen Bush, What do the main political parties really have in store for health?

Jagjit Chadha and Anita Charlesworth, NHS at 75: What are we up against?

John Bell and Axel Heitmueller, AI in health care: hope or hype?

Ashish Jha, Keeping up with AI in health care: what we need to do next

Navina Evans and Penny Pereira, NHS at 75: The huge promise of technology

Jane Dacre, Nikita Kanani and Gabrielle Mathews, International Women’s Day: Voices in health care

Rachel Wolf and Stephen Bush, What do the main political parties really have in store for health? 
Alan Milburn and Stephen Dorrell, NHS at 75: Is political leadership up to the challenge?

AI technologies are advancing rapidly. Yet when it comes to AI in health care we're still in the early stages. The prize could be big – the question is what will it take to realise the benefits?

The applications of AI in health care will be far-reaching and profound, from high-quality personalised treatment advice made instantly available to automated systems that can cut bureaucracy, free up staff time and reduce costs. 

All this is exciting and could help with some of the big challenges ahead. But what of the risks? The current emphasis among policymakers is on AI safety – but a range of other considerations will need attention like serving the public interest, inclusion, cost, accountability, autonomy, privacy and more. And how can the NHS and social care rapidly get up to speed with all these developments? 

Join our Chief Executive Jennifer Dixon on location with expert guests including: Effy Vayena (Professor of Bioethics at the Swiss Institute of Technology); Alastair Denniston (Consultant Ophthalmologist and Honorary Professor at the University of Birmingham); Ashish Jha (Dean of Public Health at Brown University) and David Cutler (Professor of Applied Economics at Harvard University).

Show notes

The Health Foundation (2023). What do technology and AI mean for the future of work in health care?

House of Commons Science, Innovation and Technology Select Committee (2023). The governance of artificial intelligence: interim report. 

UK government (2023). UK's AI Safety Summit 2023.

Institute for Government (2023). How is the UK government approaching regulation of AI?

Financial Times (2023). How will AI be regulated?

Air Street Capital (2023). State of AI report.

OECD. OECD Artificial Intelligence Papers.

The White House (2023). Fact Sheet: President Biden Issues Executive Order on Safe, Secure, and Trustworthy Artificial Intelligence.