COMMENT: Reaction to report revealing that hospitals are becoming less productive

WITH the news that hospitals are becoming less productive, there have been calls to link pay to performance. However, it is not the reported productivity challenge or the bonus-related pay that is the key issue. More fundamental is the fact that we don't know the true productivity figure, or in many cases how to improve it.

Given that up to 70% of a trust's expenditure relates to its people, a trust's workforce strategy is at the centre of its organisational strategy. How staff time is managed has a major impact on productivity, as well as a direct impact on the quality of care delivered. In our experience up to 4% of staff hours can be lost through inefficient management of the workforce alone.

Productivity losses of this level should come as no surprise, since managing and controlling a trust's workforce is highly complex; ensuring that each unit has the right staff with the right skills 24/7 is a difficult and time-consuming task. The work is also undertaken by clinicians reducing their front line service availability.

Given this inefficiency and complexity it is difficult to understand that one of the largest employers in the world still has an inherent reliance on paper-based workforce systems. Managers and staff are often ill equipped to plan, manage and measure the efficiency and effectiveness of staffing. Yet they are expected to deliver the required improvements whilst maintaining standards of care.

Right now our priority has to be to provide trusts and their managers with the right tools to not only ensure that organisations can drive productivity improvements, but also to ensure quality care provision.