By using publicly available data, HSJ has been able to closely match the methodology used by Lord Carter to produce trusts’ headline “savings opportunity” figures. Here we list the least and most efficient trusts according to the headline measure, as well as data for all trusts.

As revealed today, the main savings estimates issued to hospital trusts as part of Lord Carter’s review of NHS efficiency are based solely on reference costs, which are a long running national collection.

HSJ was able to arrive at very close figures using the publicly available reference costs collection. The potential savings figures are not precisely correct, because a small part of the Carter methodology is not known.

Our calculation of every trusts’ savings opportunity was checked against the actual figures given by the Carter team to 10 trusts, and were very close to them. Another 10 trusts were then contacted for comment and did not dispute HSJ’s figures. See table at the bottom of the article for data on all trusts.

See below for an explanation of how the figures were reached. Trusts are currently in discussion with the Carter review team to negotiate and finalise their savings targets.

Least efficient hospital trusts according to headline measure

OrganisationHeadline efficiency measure (ATC/RCI)Potential savingsTotal reference cost collectionSavings opportunity  (% of clinical expenditure)
King’s College Hopsital FT 116 £154,017,560 £836,309,588 18
Hinchingbrooke Health Care 114 £20,510,432 £110,978,422 18
University Hospitals Birmingham FT 114 £91,188,135 £579,726,334 16
North Hospital 113 £72,324,845 £463,154,646 16
Guy’s and St Thomas’ FT 112 £124,154,219 £777,502,869 16
North Cumbria University Hospitals 112 £37,333,877 £246,550,063 15
Southport and Ormskirk Hospital 110 £29,817,076 £179,166,230 17
Gateshead Health FT 109 £28,458,322 £187,275,343 15
Wrightington, Wigan and Leigh FT 109 £37,787,496 £247,521,306 15
Central Manchester University Hospitals FT 109 £111,455,011 £752,681,327 15

 

Most efficient hospital trusts according to headline measure

OrganisationHeadline efficiency measure (ATC/RCI)Potential savings Total reference cost collectionSavings opportunity  (% of clinical expenditure)
Kingston Hospital FT 88 £10,215,720 £165,598,399 6
Surrey and Sussex Healthcare 88 £15,812,899 £204,411,988 8
West Suffolk FT 89 £11,900,095 £159,895,416 7
Luton and Dunstable University Hospital FT 89 £9,392,678 £221,171,755 4
Chelsea and Westminster Hospital FT 89 £15,673,740 £248,278,669 6
Royal Free London FT 89 £67,977,414 £635,346,026 11
Southend University Hospital FT 90 £8,122,013 £256,763,405 3
Royal United Hospital Bath Trust 90 £16,980,907 £240,201,161 7
Gloucestershire Hospitals FT 90 £21,811,896 £397,231,446 5
The Dudley Group FT 90 £31,036,459 £308,821,590 10

Lord Carter’s adjusted treatment cost for each trust, intended to provide an indicator of overall trust efficiency, appears to broadly match the figure provided in the reference costs index. This is the headline efficiency measure. An ATC/RCI below 100 suggests the trust is more efficient than average, with trusts above 100 less efficient than average.

Trusts’ potential savings, as calculated by HSJ, were reached by using the reference costs by department and service code. As with the Carter review methodology, it was assumed that trusts can bring down their actual costs to the national average in areas where they spend more than average, without increasing costs in other areas.

Trusts’ headline efficiency score does not necessarily correlate to their potential savings figure. The headline scores take into account services where trusts are more efficient than average, whereas the potential savings figures discount these services.

A 50 per cent cap on potential savings was used at service code level. Lord Carter’s team also used a 50 per cent cap, but it is not clear at which level this was applied. The figures above were also calculated using a market forces factor, as used in the reference costs. It is unclear exactly how this was applied by Lord Carter.

The final column shows the savings opportunity as a percentage of the total reference costs collection, with the market forces factor applied.

Organisation nameHeadline efficiency measure (ATC/RCI)Potential savings Total reference cost collectionSavings opportunity  (% of clinical expenditure)
KING’S COLLEGE HOSPITAL NHS FOUNDATION TRUST 116 £154,017,560 £836,309,588 18
HINCHINGBROOKE HEALTH CARE NHS TRUST 114 £20,510,432 £110,978,422 18
UNIVERSITY HOSPITALS BIRMINGHAM NHS FOUNDATION TRUST 114 £91,188,135 £579,726,334 16
NORTH BRISTOL NHS TRUST 113 £72,324,845 £463,154,646 16
GUY’S AND ST THOMAS’ NHS FOUNDATION TRUST 112 £124,154,219 £777,502,869 16
NORTH CUMBRIA UNIVERSITY HOSPITALS NHS TRUST 112 £37,333,877 £246,550,063 15
SOUTHPORT AND ORMSKIRK HOSPITAL NHS TRUST 110 £29,817,076 £179,166,230 17
GATESHEAD HEALTH NHS FOUNDATION TRUST 109 £28,458,322 £187,275,343 15
WRIGHTINGTON, WIGAN AND LEIGH NHS FOUNDATION TRUST 109 £37,787,496 £247,521,306 15
CENTRAL MANCHESTER UNIVERSITY HOSPITALS NHS FOUNDATION TRUST 109 £111,455,011 £752,681,327 15
MID ESSEX HOSPITAL SERVICES NHS TRUST 108 £42,352,362 £289,012,032 15
WESTON AREA HEALTH NHS TRUST 108 £11,743,763 £95,236,504 12
THE WHITTINGTON HOSPITAL NHS TRUST 108 £42,430,050 £226,599,855 19
UNIVERSITY COLLEGE LONDON HOSPITALS NHS FOUNDATION TRUST 108 £71,218,031 £587,974,879 12
THE LONDON NORTH WEST HEALTHCARE NHS TRUST  107 £67,184,103 £557,554,546 12
BRADFORD TEACHING HOSPITALS NHS FOUNDATION TRUST 107 £54,448,122 £323,275,899 17
BARKING, HAVERING AND REDBRIDGE UNIVERSITY HOSPITALS NHS TRUST 107 £53,265,078 £433,372,256 12
UNITED LINCOLNSHIRE HOSPITALS NHS TRUST 106 £61,359,110 £421,533,085 15
WYE VALLEY NHS TRUST 106 £16,395,486 £155,163,469 11
MEDWAY NHS FOUNDATION TRUST 106 £39,895,895 £240,006,082 17
THE ROTHERHAM NHS FOUNDATION TRUST 106 £29,183,468 £222,717,737 13
CAMBRIDGE UNIVERSITY HOSPITALS NHS FOUNDATION TRUST 106 £60,517,822 £519,240,137 12
BLACKPOOL TEACHING HOSPITALS NHS FOUNDATION TRUST 105 £55,193,658 £359,639,768 15
SOUTH TYNESIDE NHS FOUNDATION TRUST 105 £24,887,706 £192,626,296 13
PETERBOROUGH AND STAMFORD HOSPITALS NHS FOUNDATION TRUST 105 £33,840,471 £251,139,585 13
THE QUEEN ELIZABETH HOSPITAL, KING’S LYNN, NHS FOUNDATION TRUST 105 £22,254,180 £168,047,328 13
NORTHERN DEVON HEALTHCARE NHS TRUST 105 £26,928,700 £215,798,730 12
ROYAL LIVERPOOL AND BROADGREEN UNIVERSITY HOSPITALS NHS TRUST 104 £48,879,152 £358,361,723 14
TAMESIDE HOSPITAL NHS FOUNDATION TRUST 104 £19,948,017 £167,365,343 12
SHERWOOD FOREST HOSPITALS NHS FOUNDATION TRUST 104 £29,639,047 £261,523,783 11
LEWISHAM AND GREENWICH NHS TRUST 104 £42,391,605 £369,459,048 11
THE HILLINGDON HOSPITALS NHS FOUNDATION TRUST 104 £23,146,918 £177,447,797 13
MILTON KEYNES HOSPITAL NHS FOUNDATION TRUST 103 £19,488,874 £180,270,537 11
BRIGHTON AND SUSSEX UNIVERSITY HOSPITALS NHS TRUST 103 £46,916,131 £428,333,388 11
ISLE OF WIGHT NHS TRUST 103 £20,935,048 £148,369,536 14
OXFORD UNIVERSITY HOSPITALS NHS TRUST 103 £69,142,572 £691,372,849 10
IMPERIAL COLLEGE HEALTHCARE NHS TRUST 103 £84,269,309 £617,982,032 14
PENNINE ACUTE HOSPITALS NHS TRUST 103 £50,061,765 £539,726,430 9
SANDWELL AND WEST BIRMINGHAM HOSPITALS NHS TRUST 103 £53,144,325 £396,245,907 13
WORCESTERSHIRE ACUTE HOSPITALS NHS TRUST 103 £36,334,692 £365,525,621 10
JAMES PAGET UNIVERSITY HOSPITALS NHS FOUNDATION TRUST 103 £16,162,461 £175,237,381 9
UNIVERSITY HOSPITALS OF MORECAMBE BAY NHS FOUNDATION TRUST 102 £34,585,391 £281,036,335 12
EAST CHESHIRE NHS TRUST 102 £19,146,171 £155,509,531 12
UNIVERSITY HOSPITALS COVENTRY AND WARWICKSHIRE NHS TRUST 102 £51,702,968 £500,318,763 10
CALDERDALE AND HUDDERSFIELD NHS FOUNDATION TRUST 102 £31,005,687 £329,898,204 9
CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST 102 £39,715,057 £335,376,627 12
GEORGE ELIOT HOSPITAL NHS TRUST 102 £18,807,910 £121,757,550 15
EAST KENT HOSPITALS UNIVERSITY NHS FOUNDATION TRUST 102 £53,224,929 £490,316,730 11
MID YORKSHIRE HOSPITALS NHS TRUST 102 £39,437,196 £468,419,204 8
COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST 102 £52,164,918 £469,704,779 11
BARNSLEY HOSPITAL NHS FOUNDATION TRUST 102 £13,754,690 £165,165,571 8
CROYDON HEALTH SERVICES NHS TRUST 102 £25,388,686 £223,552,684 11
EAST SUSSEX HEALTHCARE NHS TRUST 101 £38,982,840 £349,140,432 11
COLCHESTER HOSPITAL UNIVERSITY NHS FOUNDATION TRUST 101 £21,266,682 £267,438,361 8
SHEFFIELD TEACHING HOSPITALS NHS FOUNDATION TRUST 101 £75,471,408 £784,544,223 10
MAIDSTONE AND TUNBRIDGE WELLS NHS TRUST 100 £43,132,443 £340,929,704 13
YEOVIL DISTRICT HOSPITAL NHS FOUNDATION TRUST 100 £10,427,901 £113,535,750 9
BASILDON AND THURROCK UNIVERSITY HOSPITALS NHS FOUNDATION TRUST 100 £20,376,021 £280,048,232 7
COUNTESS OF CHESTER HOSPITAL NHS FOUNDATION TRUST 100 £15,143,568 £167,331,043 9
SALFORD ROYAL NHS FOUNDATION TRUST 100 £36,816,912 £371,137,576 10
UNIVERSITY HOSPITAL OF NORTH STAFFORDSHIRE NHS TRUST 100 £71,326,890 £604,636,087 12
YORK TEACHING HOSPITAL NHS FOUNDATION TRUST 100 £33,676,116 £400,487,592 8
HARROGATE AND DISTRICT NHS FOUNDATION TRUST 99 £15,482,914 £165,773,753 9
WALSALL HEALTHCARE NHS TRUST 99 £24,159,115 £235,437,608 10
THE PRINCESS ALEXANDRA HOSPITAL NHS TRUST 99 £16,951,943 £178,706,338 9
ROYAL DEVON AND EXETER NHS FOUNDATION TRUST 99 £29,776,438 £343,747,076 9
BARTS HEALTH NHS TRUST 99 £119,714,728 £1,031,027,236 12
BUCKINGHAMSHIRE HEALTHCARE NHS TRUST 99 £26,063,815 £314,452,706 8
UNIVERSITY HOSPITALS OF LEICESTER NHS TRUST 99 £63,707,744 £754,832,821 8
AIREDALE NHS FOUNDATION TRUST 99 £15,806,564 £142,586,490 11
NOTTINGHAM UNIVERSITY HOSPITALS NHS TRUST 99 £50,480,813 £722,857,214 7
EAST LANCASHIRE HOSPITALS NHS TRUST 99 £37,573,468 £417,044,871 9
ST GEORGE’S HEALTHCARE NHS TRUST 99 £50,643,928 £509,982,713 10
AINTREE UNIVERSITY HOSPITAL NHS FOUNDATION TRUST 98 £25,014,079 £259,559,517 10
KETTERING GENERAL HOSPITAL NHS FOUNDATION TRUST 98 £17,581,098 £195,113,425 9
SOUTH DEVON HEALTHCARE NHS FOUNDATION TRUST 98 £23,336,832 £215,615,868 11
WEST HERTFORDSHIRE HOSPITALS NHS TRUST 98 £15,920,826 £267,278,064 6
PLYMOUTH HOSPITALS NHS TRUST 98 £27,563,401 £393,447,085 7
UNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUST 98 £41,812,155 £440,481,661 9
HAMPSHIRE HOSPITALS NHS FOUNDATION TRUST 98 £27,985,448 £290,567,425 10
HEART OF ENGLAND NHS FOUNDATION TRUST 97 £62,388,529 £595,718,709 10
ST HELENS AND KNOWSLEY HOSPITALS NHS TRUST 97 £20,606,705 £267,082,243 8
CHESTERFIELD ROYAL HOSPITAL NHS FOUNDATION TRUST 97 £13,085,061 £189,988,486 7
LANCASHIRE TEACHING HOSPITALS NHS FOUNDATION TRUST 97 £58,894,939 £407,692,507 14
BURTON HOSPITALS NHS FOUNDATION TRUST 97 £12,189,702 £180,330,292 7
THE ROYAL WOLVERHAMPTON NHS TRUST 97 £29,453,064 £386,031,553 8
NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST 97 £27,536,188 £256,327,961 11
DARTFORD AND GRAVESHAM NHS TRUST 97 £14,143,027 £189,915,301 7
WARRINGTON AND HALTON HOSPITALS NHS FOUNDATION TRUST 97 £14,406,544 £206,392,554 7
HULL AND EAST YORKSHIRE HOSPITALS NHS TRUST 97 £35,395,254 £478,731,765 7
NORTHERN LINCOLNSHIRE AND GOOLE NHS FOUNDATION TRUST 97 £30,298,162 £324,396,379 9
POOLE HOSPITAL NHS FOUNDATION TRUST 96 £16,965,289 £190,150,119 9
NORTHAMPTON GENERAL HOSPITAL NHS TRUST 96 £22,118,071 £262,405,521 8
THE ROYAL BOURNEMOUTH AND CHRISTCHURCH HOSPITALS NHS FOUNDATION TRUST 96 £28,573,365 £239,555,859 12
EAST AND NORTH HERTFORDSHIRE NHS TRUST 96 £38,003,036 £326,654,826 12
UNIVERSITY HOSPITAL OF SOUTH MANCHESTER NHS FOUNDATION TRUST 96 £42,432,489 £350,343,301 12
DORSET COUNTY HOSPITAL NHS FOUNDATION TRUST 96 £8,969,288 £148,947,622 6
TAUNTON AND SOMERSET NHS FOUNDATION TRUST 96 £18,057,471 £228,199,757 8
LEEDS TEACHING HOSPITALS NHS TRUST 96 £99,240,913 £848,253,704 12
UNIVERSITY HOSPITAL SOUTHAMPTON NHS FOUNDATION TRUST 96 £42,828,967 £522,969,437 8
STOCKPORT NHS FOUNDATION TRUST 95 £14,532,422 £259,369,089 6
SOUTH TEES HOSPITALS NHS FOUNDATION TRUST 95 £47,502,665 £548,221,850 9
THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST 95 £55,686,000 £788,730,060 7
NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST 95 £31,970,023 £384,937,844 8
SHREWSBURY AND TELFORD HOSPITAL NHS TRUST 95 £28,348,525 £288,759,600 10
MID CHESHIRE HOSPITALS NHS FOUNDATION TRUST 95 £13,944,372 £170,604,320 8
ROYAL SURREY COUNTY HOSPITAL NHS FOUNDATION TRUST 95 £26,308,710 £232,193,572 11
ROYAL BERKSHIRE NHS FOUNDATION TRUST 94 £30,048,743 £311,287,644 10
WESTERN SUSSEX HOSPITALS NHS FOUNDATION TRUST 94 £25,134,286 £343,071,830 7
BEDFORD HOSPITAL NHS TRUST 94 £22,265,938 £155,979,672 14
ROYAL CORNWALL HOSPITALS NHS TRUST 94 £25,442,686 £311,796,810 8
BOLTON NHS FOUNDATION TRUST 94 £16,408,080 £259,796,421 6
SOUTH WARWICKSHIRE NHS FOUNDATION TRUST 94 £12,968,226 £208,485,391 6
NORTH MIDDLESEX UNIVERSITY HOSPITAL NHS TRUST 93 £17,997,521 £201,142,011 9
DERBY HOSPITALS NHS FOUNDATION TRUST 93 £27,158,549 £447,736,418 6
NORFOLK AND NORWICH UNIVERSITY HOSPITALS NHS FOUNDATION TRUST 93 £27,736,643 £448,993,603 6
PORTSMOUTH HOSPITALS NHS TRUST 93 £30,392,646 £417,200,474 7
HOMERTON UNIVERSITY HOSPITAL NHS FOUNDATION TRUST 93 £24,218,040 £200,857,852 12
EPSOM AND ST HELIER UNIVERSITY HOSPITALS NHS TRUST 92 £21,664,457 £297,144,866 7
FRIMLEY PARK HOSPITAL NHS FOUNDATION TRUST 92 £33,309,577 £457,687,890 7
GREAT WESTERN HOSPITALS NHS FOUNDATION TRUST 92 £26,970,568 £268,458,825 10
SALISBURY NHS FOUNDATION TRUST 92 £10,982,985 £168,675,236 7
WIRRAL UNIVERSITY TEACHING HOSPITAL NHS FOUNDATION TRUST 91 £19,655,010 £279,177,819 7
ASHFORD AND ST PETER’S HOSPITALS NHS FOUNDATION TRUST 91 £7,443,846 £214,236,861 3
IPSWICH HOSPITAL NHS TRUST 91 £29,008,723 £239,894,404 12
DONCASTER AND BASSETLAW HOSPITALS NHS FOUNDATION TRUST 91 £14,294,120 £311,923,029 5
THE DUDLEY GROUP NHS FOUNDATION TRUST 90 £31,036,459 £308,821,590 10
GLOUCESTERSHIRE HOSPITALS NHS FOUNDATION TRUST 90 £21,811,896 £397,231,446 5
ROYAL UNITED HOSPITAL BATH NHS TRUST 90 £16,980,907 £240,201,161 7
SOUTHEND UNIVERSITY HOSPITAL NHS FOUNDATION TRUST 90 £8,122,013 £256,763,405 3
ROYAL FREE LONDON NHS FOUNDATION TRUST 89 £67,977,414 £635,346,026 11
CHELSEA AND WESTMINSTER HOSPITAL NHS FOUNDATION TRUST 89 £15,673,740 £248,278,669 6
LUTON AND DUNSTABLE UNIVERSITY HOSPITAL NHS FOUNDATION TRUST 89 £9,392,678 £221,171,755 4
WEST SUFFOLK NHS FOUNDATION TRUST 89 £11,900,095 £159,895,416 7
SURREY AND SUSSEX HEALTHCARE NHS TRUST 88 £15,812,899 £204,411,988 8
KINGSTON HOSPITAL NHS FOUNDATION TRUST 88 £10,215,720 £165,598,399 6

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Exclusive: Carter savings estimates based on discredited data