Consultant activity and NHS productivity

Karen Bloor et al.'s ¹ recent paper demonstrates that consultant clinical activity, as measured by FCEs, declined from 1999 to 2009 despite improvements in pay in 2003. However, as your correspondent Andrew Will ² correctly pointed out, this measure takes no account of the benefits that might have resulted from the new contract as regards the quality and outcomes of services.

The widely held view that NHS productivity declined during this period has, as the authors acknowledge, been challenged ³ and recently the very organization that created this myth has accepted its error. In December 2012, the Office for National Statistics concluded that rather than falling by 0.4% a year, productivity rose by about 0.7% a year. ⁴ As this new estimate still pays scant regard to improvements in the quality of care, it seems likely that productivity really rose even faster. While there is no room for complacency and even greater improvements in productivity are required over the next decade, official recognition that previous claims of falling productivity were inaccurate is welcome. It is important that the National Audit Office ⁵ and the Public Accounts Committee ⁶ are made aware that they were misled and, in turn, misled politicians and the public.