News and Comment

Why empowering the public service workforce is key to improving quality and efficiency

Thursday 4 July 2013


As is well known, the NHS is facing one of the most significant financial challenges in its history, with the need to secure £20 billion of cash releasing efficiency savings by 2014/15. Against this backdrop of austerity, there is a risk that resourcing decisions will be taken purely on the basis of driving down cost without due consideration of how this affects ‘value’. Not all cuts will lead to savings. Cuts to specialist nursing aimed at helping patients stay at home for example, can lead to greater demands on hospitals. There is an urgent need to be clearer about how we measure the social and economic value of health services as a means to justify or rationalise their actual financial cost.

There is a further risk that austerity can stifle innovation. It has been calculated that innovations designed and implemented by clinicians could have a value of £9 billion per year in the UK. Through the Royal College of Nursing’s (RCN) Frontline First campaign, for instance, we have been made aware of the numerous ways through which nurses add value to patient care while generating efficiencies through new and innovative ways of working. They, and others, have a key role to play in realising the cash-releasing efficiency savings in the NHS.

To empower the health service workforce to understand how they can contribute to realising cash-releasing savings while maintaining high quality care, OPM designed a programme of training and support in the use of a bespoke and accessible Economic Assessment Tool (EAT).

Thanks to funding from the Burdett Trust for Nursing, this two-year programme has started to be delivered to nurses in Scotland,Wales and Northern Ireland since 2012.

This programme equips nurses with the relevant skills to assess the social and economic value of nursing services and to use those skills to guide the development, improvement and delivery of services. More critically, the programme can help unleash the potential of the health service workforce to contribute proactively to the quality and efficiency agenda, by demonstrating where real efficiency savings are being made as well as highlighting areas where there is further potential for savings. If this is scaled up, it could make a significant contribution to national efforts.

For example, one nurse stated that:

In the course of conducting my economic assessment, I also came to realise that an understanding of these economic benefits can influence the way we plan for future activities and developments to improve the service.

Another nurse remarked that:

The OPM programme offered a unique opportunity to engage in a process that not only sought to identify the economic value of the service model but also empowered practicing clinicians to develop new skills that were sustainable. This has laid the foundations for thorough assessment of cost, value and worth to be incorporated into future service design and delivery. There has been a real culture change that supports a systematic and consistent approach in clarifying costs, value and quality.

We firmly believe that workforce-led quality and efficiency drives are more likely to be both sustainable and successful, and therefore that it is important to invest in the workforce sufficiently.

It is with this in mind that we are convening our next seminar in our Valuing Public Services breakfast seminar series in partnership with the Royal College of Nursing, and with participation from the MS Trust. This event, on 5th July 2013, showcases two innovative programmes aimed at developing the capability of the nursing workforce to demonstrate their impact, and their social and economic value. Frontline nurses, who have undergone the programmes, will be sharing their experiences and learning, as well as discussing the impact of their work. Although the case studies originate from the nursing profession, the lessons learned also have wider applications across the public services workforce.

For those unable to make the event in person, we will be tweeting throughout the seminar using the #valuingps hashtag. There will also be a live Twitter chat led by the RCN (@thercn) following the event this Friday at 12.45pm, which uses the hashtag #RCNchat.