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Feature Data Briefing

A productivity challenge too far?

BMJ 2012; 344 doi: (Published 19 June 2012) Cite this as: BMJ 2012;344:e2416
  1. John Appleby, chief economist
  1. 1King’s Fund, London W1G 0AN, UK
  1. j.appleby{at}

The NHS in England is already embroiled in a barely achievable productivity challenge. But if the government pushes this policy goal for a further four years beyond 2015, is the NHS setting itself up for failure? John Appleby looks at the figures

Richard Douglas, Department of Health director general of policy, strategy, and finance, has reportedly said that the drive to find further efficiency savings in the NHS will continue after 2015,1 with the total savings rising from £20bn (€24.6bn; $31bn) to a possible £50bn by 2019-20. His comments are a startling admission of the long term impact on public services of the global financial crisis and ensuing recession.

But perhaps it should come as no surprise. Firstly, economic recovery has been slow to the point of stagnation. According to the National Institute for Economic and Social Research’s “recession tracker” (, the UK economy is still four percentage points below the last peak in the economy—over four years ago—and …

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