Lord Carter’s Review: The Recommendations
Lord Carter’s long awaited review of hospital productivity has today published 15 recommendations aimed at saving the NHS £5bn a year by 2020.
The recommendations touch on almost every aspect of spending in the hospital sector – from clinical workforce management and hospital pharmacy, to procurement and imaging services.
Their broad theme is improved and standardised use of data to identify and drive out unnecessary expenditure. Lord Carter has set out what is likely to be a gruelling timetable of work for acute trusts and NHS Improvement.
The report’s recommendations are:
1. NHS Improvement should develop a national people strategy
This and the implementation plan should be complete by October to set a timetable for simplifying system structures; raising people management capacity; building greater engagement; and creating an engaged and inclusive environment for all staff by significantly improving leadership.
This will include every trust chief executive leading a “sustained campaign” to reduce the NHS’s high levels of bullying and harassment.
It will also mandate succession planning and the initial use of NHS Executive Search to develop candidate shortlists for director roles, to drive down spending on headhunters.
It will require improved collection and management of sickness absence data, to help drive down high rates of sick leave.
3. Trust plans by April 2017 to ensure hospital pharmacies achieve their benchmarks
Targets include increasing pharmacist prescribers; e-prescribing and administration; accurate cost coding of medicines; and consolidating stockholding by April 2020, in agreement with NHS Improvement and NHS England so their pharmacists and clinical pharmacy technicians spend more time on medicines optimisation with patients.
This will involve “ensuring that more than 80 per cent of trusts’ pharmacist resource” is used for direct medicines optimisation, medicines governance and safety, and reviewing the provision of all local infrastructure services, which could be delivered collaboratively with another trust or third party provider.
4. Ensure pathology and imaging departments achieve benchmarks by April 2017
These will be agreed with NHS Improvement, so there is a consistent approach to the quality and cost of diagnostic services across the NHS. If benchmarks for pathology are unlikely to be achieved, trusts should have agreed plans for consolidation with, or outsourcing to, other providers by January.
5. Trusts to report procurement information monthly to NHS Improvement
This will create an NHS Purchasing Price Index from April. Trusts will collaborate with other trusts and NHS Supply Chain with immediate effect, and commit to the Department of Health’s NHS Procurement Transformation Programme, so there is an increase in transparency and a reduction of at least 10 per cent in non-pay costs is delivered across the NHS by April 2018.
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