The report says improved productivity could deliver £33bn in annual savings and prevent 20,000 deaths a year by 2040, reducing projected health spending from 9.5% to 8.7% of GDP.

Anita Charlesworth, co-chair of the NHS Productivity Commission and senior economic adviser at The Health Foundation, said: ‘The problem is not a lack of committed and talented people or an absence of ideas; it is that the NHS is not set up to deliver sustained productivity growth. Our research points to a fundamental redesign of the operating conditions – not another disruptive reorganisation, but a reset to make improving productivity a defining focus for the NHS over the next decade and beyond.'

Despite improvements in recent years, NHS productivity remains below pre-pandemic levels; while consultant numbers rose by 44% in the last decade, the number of patients on the waiting list treated following hospital admission fell by 5%.

The authors found matching the best performing health systems could result in 18,500 - 20,600 fewer deaths each year from treatable causes and 2.5 to 4.5 additional years in good health for every person in the country.

The report's recommendations include:

• a five-year planning and investment framework
• workforce plan for non-clinical teams, including managerial, analytical, digital and commercial roles
• a national test-and-learn approach to identify, evaluate and scale models of care and emerging technologies
• strengthening NHS regions.

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Chief executive of The NHS Alliance, Sir Ciarán Devane, said: ‘Lack of capital investment has been a long-running drag on NHS productivity. More must be done to turn the tide on years of neglect, as part of a broader switch to a more long-term planning approach.

‘We also agree that a more streamlined, supportive regulatory system which encourages local autonomy and innovation will be vital for future progress.

‘We welcome the report's emphasis on the importance of NHS leaders and managers who are key to delivering a safe, smooth-running service providing high quality care for patients, and good value for the taxpayer.'

Tim Lane, president of the Royal College of Surgeons of England, said: ‘Without investment in operating theatres, diagnostics and other essential infrastructure, there is a real risk the NHS will continue to underutilise one of its most valuable assets: its surgical workforce. If these capacity issues are not addressed, the significant reductions in waiting times that patients need and deserve will remain out of reach.'

Chris Carroll, chief executive for Bupa Global, India & UK said: ‘Our 2026 Bupa Wellbeing Index found that more than a quarter of people are delaying seeking treatment in the current cost-of-living crisis. The Health Foundation report underlines gains by acting sooner, including diagnosing cancer earlier and identifying and managing conditions such as high blood pressure and diabetes before they become more serious. Moving from treatment to prevention is an approach we strongly support for the workforce. Encouraging people to access timely support and engage with their health earlier is critical to wider productivity.'

A DHSC spokesperson said: ‘We are already making important progress to realise the productivity gains that are achievable within the NHS, and making sure that patients see the benefit through record numbers of appointments, tests and scans.

‘These gains are being driven by many of the things The Health Foundation recommends: smarter use of technology, less reliance on agency staff, and leaner back-office operations. For patients, this means faster treatment, shorter waits, and an NHS that is more accessible in the evenings and at weekends.

‘There is much more to do, but we will keep driving progress through our 10-Year Health Plan to deliver better care for patients and better value for taxpayers.'

The DHSC said acute sector productivity grew by 2.6% in 2025-26, building on 2.7% growth the year before, and comfortably outstripping the long-term historic average of just 0.6% a year.

It added NHS England productivity projects are scheduled to deliver £17bn in savings for taxpayers over the next three years.

The DHSC said it was working with NHS England to design a new measurement of NHS productivity rooted in patient outcomes, adding spending on agencies had already almost halved from £2.1bn in 2024/25 to £1.2bn in 2025/26.