System change hits activity records

From quarter 1 in 2006-07 to quarter 2 in 2007-08, the total English NHS productivity opportunity (the money that would potentially be released if all organisations performed at the level of the top quartile) has fallen by£334m, from£2.29bn to£1.95bn.

Efficiency improvement seems worse in the last quarter. As the productivity opportunity is calculated with reference to the volume of activity in the relevant quarter, possibly for some of the indicators the under-reporting of activity data by some trusts (which seems to be particularly prevalent in the last quarter of 2006-07 and the first quarter of 2007-08) will have exaggerated performance improvement.

The variation in volume was probably due to the changeover to the secondary uses service. The production of the Better Care, Better Value indicators has coincided with the introduction of this service, which replaced the NHS-wide clearing service. During this period the quality of the data extracts we have received has fluctuated.

Quarter 4 2006 was the first period where we used the data from the new service. Some organisations had problems sending their data to it so there were gaps in the data extract used to calculate the indicators. In quarter 1 2007 the secondary uses service was closed for a system upgrade. Trusts were advised to submit data by 27 July and we calculated the indicators using the data extract up to that date. By quarter 2 the data extract was back to the expected levels.

During the changeover a large acute trust experienced a significant fluctuation in the volume of inpatient activity reported. This would have an impact on the reported opportunity saving shown in the Better Care, Better Value indicators. The changeover also caused large variation in reported outpatient activity.

Full figures on the indicators for quarter 2 2007-08 can be found at www.productivity.nhs.uk