A year after their first publication, the NHS Better Care, Better Value indicators are starting to reflect efforts to improve the efficiency of NHS care.
From quarter 1 2006-07 to Q1 2007-08, the total English NHS productivity opportunity (money that could be released if all organisations performed at the level of the top quartile) has fallen by£346m, from£2,287m to£1,941m, with the largest improvements in length of stay, emergency admissions and low-cost prescribing, reducing by£151m,£78m and£60m respectively.
Low-cost prescribing has seen the greatest improvement in percentage terms with the productivity opportunity falling by 72 per cent. The indicator measures the number of prescriptions for simvastatin and pravastatin (used for high cholesterol, and which can be prescribed generically) as a percentage of the total volume of statin prescribing. A 28-day course of a branded statin is about six times more costly than a generic one.
The productivity opportunity of this indicator suggests the money that would be saved if every primary care trust achieved the upper quartile rate of low-cost statin prescribing. For Q1 2006-07 the upper quartile performance level for PCTs' use of lower-cost statins was 69 per cent, increasing to 77 per cent this year - a significant achievement for PCTs. If those with below 77 per cent use of lower-cost statins increased to this level, over£24m would be saved in a year.
Underlying this improvement is a wide variation in the performance at strategic health authority level, ranging from an improvement of 9.9 per cent to 25.6 per cent. Generally, the lower an SHA's percentage of low-cost statins at Q1 last year, the greater the improvements they have made during the year. NHS East of England's improvements have exceeded the trend, moving from an average of 59.02 per cent to 74.15 per cent. However, NHS North West could have been expected to make more progress than it has.
To help the NHS build on this progress, the NHS Institute for Innovation and Improvement is developing further prescribing indicators, to include low-cost proton pump inhibitors, ACE inhibitors and common generic drug savings.
For more value indicator figures visit www.productivity.nhs.uk.