Money vs mindset: How the NHS can make the most of extra investment

It was the day we’d all been waiting for. Rachel Reeves’ Autumn Budget felt like it had been on the horizon for a while. And it was great to see a commitment to the NHS, with an extra £22.6 billion for day-to-day spending, but how will this be spent? Having extra money is one thing - but it requires a focused and considered approach to spending it.

There are three areas I believe the much loved organisation should be investing money into to get the NHS back on track. And they’re centred around efficiency and effectiveness of the resources we already have.

Focus on management

There’s this perception that anyone who's not contributing at the front line of the NHS is surplus to requirements. There’s been a culture of stripping out middle management in particular, but the data shows that the NHS has far fewer managers than other international health systems - all this does is place more of the administrative burden on clinical staff.

The NHS needs to rejig spending towards increasing headcount at managerial level and to attract strong candidates with the right skill set. It’s not a case of simply needing more doctors, more nurses, more surgeons. It’s not that easy. They need to use them smarter and that’s where investing in managerial decision making, process, and function structure within the organisation will help. Managers - be prepared to be agile in your thinking. Often, people enter discussions with a fixed idea of how they want something done, but being flexible is key to innovation.

We know money and resources are tight, so embracing technologies like artificial intelligence (AI) and machine learning (ML) could unlock the potential of an existing resource: data. Managers can look at what’s working, what’s not, and inform the balance of resources, making sure every pound spent on improving the NHS is impacting the maximum number of patients.

Use the data

The NHS is getting used to electronic health records (EHRs) and more and more systems are being adopted that make it easier to record information about healthcare interactions with greater accuracy. Now we have this information, it’s time to start using it. We are sitting on a goldmine of data that can be interrogated to identify trends and anomalies, to reveal insights into disease pathologies, to case find, to flag health inequalities, to monitor interventions, to track adverse events – the list goes on. We can use this information to tweak and redefine our processes and pathways to optimise the patient experience and improve outcomes of care.

But, to do this to the best effect, we need to invest in data tools capable of analysing information from a wide range of organisations that work towards our better health, including local authorities, schools, primary, and secondary care. We need tools that can harmonise and crunch all that data. This will show us the levers to pull and where the system needs adjusting to optimise and tune up the NHS so it becomes a more efficient, higher functioning operation.

Focus on answering the key questions. Always think "why" you need that data. Consider the burden on staff when asking for a particularly complicated data field. You'd be surprised what's possible with just simple data points. We hear all the time about digital solutions, data, and reports, but actually these are used far less often than you’d think in NHS day-to-day decision making. So, often decisions are made by habit or heuristics and what works anecdotally, rather than getting into the data to see what’s working.

Reams and reams of data are available. Yes, it can be a bit daunting, but, as a first step, what all NHS organisations can start with is the data that’s easily available to them, such as census data and deprivation data. Using data well also includes getting your measures right and your KPIs right, looking at outliers and performance, and really diving in deep.

Connecting data sets will transform productivity and that’s absolutely key right now. It will give the NHS vital oversight into how decisions in one area impact another. So, combining general ledger/finance department data that talks about cost centres and workforce numbers with activity, referral, admission, and clinical data, etc., and organising these datasets longitudinally to give insights into productivity, variation, and those outliers we talked about. With the right data analysis it becomes clearer why one team is seeing 10,000 people and another 20,000.

You can then look at putting in place the systems and processes to balance this out and to deliver the care and attention everyone wants and needs from the NHS. Connecting data will help the NHS to better understand pathways and allow for hypothesis testing of problems and solutions and actually putting data behind anecdotes. With effective use of data it becomes possible to predict health issues and triage them better. It’s all about working smarter, not harder!

Think operational not capital spending

Typically, tech investment has fallen under capital spending, a major focus for the NHS that also includes building infrastructure, purchasing equipment, and maintaining physical assets. However, in the new era of cloud computing and digital services, we need to shift this thinking and consider technology as an operational investment.

Cloud computing allows NHS organisations to reduce the need for expensive on-premises servers and IT infrastructure, enabling them to access advanced computing power, storage, and applications as a service, often with lower upfront costs and far more agility to keep up with new developments. This shift enables the NHS to focus more on service delivery, data accessibility, and innovation in patient care, rather than on heavy capital investments in physical assets, which can quickly become obsolete. Consequently, capital spending is becoming less central to NHS modernisation efforts compared to investing in adaptable, cloud-based solutions that can be scaled in response to changing needs.

For me, transformation is about delivering improved patient outcomes through meaningful and tangible interventions. We hear a lot about digital transformation, but its true potential lies in how we leverage this toolset to enhance the patient experience. And that’s where how we work matters.

These are simple tweaks with a powerful impact, that just require a mindset shift. More money is just one aspect of this.