Shrinking budgets, improving care: Cut administration and buy wisely

BMJ 2010; 340 doi: (Published 17 March 2010) Cite this as: BMJ 2010;340:c1258
  1. Phil Leonard, senior manager
  1. 1UK and Ireland Advisory Services, Ernst and Young, London SE1 2AF
  1. pleonard{at}

    All countries are facing the question of how to maintain the quality of care in the face of static or shrinking health budgets. In the NHS it’s estimated that savings of over £20bn need to be made in the next few years. Graham Rich (doi:10.1136/bmj.c1251) and Phil Leonard argue that the NHS can save money while maintaining and improving the quality of care and set out their views on how to do this. But Yair Zalmanovitch and Dana Vashdi (doi:10.1136/bmj.c1259) think that something will have to suffer

    In financial terms, the National Health Service has grown substantially in recent years but that growth is about to slow rapidly. This sounds like bad news for NHS managers because they need to think of ways to save quite a lot of money rather quickly. In fact, it is an opportunity not only for the managers but for doctors and their colleagues. With careful thought they can save the NHS billions of pounds and improve health care by refocusing investment in areas that deliver best value for patients and divert it from underperforming services and unnecessary administration.

    Deep cuts in administrative costs

    Across the NHS, administration costs £10bn-£15bn a year. Although many professionals in …

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