Health care productivity

The trouble with macroeconomic definitions of productivity (ie the
ones where we make arbitrary assumptions about the "value" of health
improvement) is that they are useless for making decisions about anything
and they give simpler definitions of productivity a bad name.

The NHS needs good local measures of productivity if it is ever going
to improve anything. If hospital A gets twice as many hip replacements per
operating theatre as hospital B (and the quality and casemix is the same)
then hospital B might want to work out why.

These differences exist between hospitals, between consultants,
between departments, and they are often large differences. Sometimes there
are good explanations (Consultant A only does complex cases) but often
there are no good reasons. Experts who understand the clinical processes
can readily identify those differences that can be emulated by the less
productive.

Real and significant improvements in the operational performance of
the NHS (as good practice is replicated) could be obtained if more
attention were paid to measuring and publishing these local productivity
metrics. We shouldn't let the macroeconomic gobbledygook blacken the name
of useful productivity metrics for operational improvement.

Competing interests:
Management consultant working in health