Latest analysis of activity and staffing data in England shows output-per-input growth in the acute sector has markedly decelerated, signalling that the widely reported “green shoots” of recovery may be less robust than portrayed.

According to Health Foundation and the Strategy Unit, although the acute sector recorded approximately 2.7 % productivity growth in 2024/25, the pace of improvement “slowed sharply” in the final quarter of the year and into early 2025/26. The drop was especially pronounced in emergency inpatient care, where staffing growth out-paced activity uplift, reducing overall gains in efficiency.

“Further analysis reveals weakening growth across all components of care, with the fastest fall in emergency inpatient care.” — Health Foundation commission lead.

For provider systems and clinical workforce planners this trend raises a number of operational flags:

• With productivity gains stalling, sustaining throughput will depend less on ad-hoc staffing uplift and more on effective deployment and process efficiency.
• Emergency and unscheduled care pressures—where productivity improvement is weakest—remain a strategic risk heading into the autumn/winter period.
• Planned care and elective recovery programmes will need both increased capacity and sharper operational performance to meet targets, given that simple volume growth is not offsetting slower productivity gains.
• Systems may need to place greater emphasis on non-staff-volume levers (such as flow redesign, theatre efficiency, diagnostic turnaround, and digital supports) to sustain improvement.

View of Altin Biba CEO at ProMedical

“From our operational vantage, the data indicates that scaling capacity alone will not deliver the required performance uplift. Workforce deployment must also integrate efficiency levers such as standardised rotas, weekend/evening breakthrough lists, and targeted diagnostics back-ups. In short: staffing plus process optimisation is now the imperative.”

As the NHS moves into its winter planning phase, the slowdown in productivity growth represents a caution signal: without dual focus on capacity and operational efficiency, system pressures may intensify rather than recede.

References

• HSJ: “NHS productivity slows despite ministers hailing ‘green shoots of recovery’.” HSJ
• Health Foundation / Strategy Unit analysis: “Can the NHS meet its 2 % productivity challenge?” The Health Foundation