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Can the NHS cut costs without substantially damaging the quality of health care? Yes

BMJ 2010; 340 doi: (Published 14 April 2010) Cite this as: BMJ 2010;340:c1967
  1. Rebecca Rosen, senior fellow
  1. 1The Nuffield Trust, London W1G 7LP
  1. rebecca.rosen{at}

    Rebecca Rosen and Paul Corrigan (doi: 10.1136/bmj.c1999) think that the NHS cost cutting that will occur over the next few years does not inevitably mean that the quality of care it provides will suffer. John Appleby (doi: 10.1136/bmj.c1959) and James Owen Drife (doi: 10.1136/bmj.c1966) are not so sure

    We face a tough financial climate. We don’t know exactly how much we’ll need to save across the NHS, although the amount will be substantial. But it is not inevitable that cost cutting will reduce quality for two reasons.

    Firstly, much activity has no value in the NHS so it can be cut without detriment to clinical outcomes or patient experience. NHS “better care better value” metrics highlight opportunities for this. Up to £0.5m (€0.56; $0.76) of savings are still available in most hospitals by reducing preoperative bed days.1 Potential to save millions of pounds exists, and more than 10% of …

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