Achieving financial resilience in the NHS

When technology becomes a productivity multiplier

Financial resilience isn’t a phrase that tends to spark much excitement in the NHS. It can sound abstract, technical, or firmly the domain of finance teams and board papers. But look a little closer and it becomes clear that financial resilience shows up everywhere. It gets tested in clinics running late, in community teams stretched too thin, or in clinicians wasting precious time navigating systems that don’t quite work together.

In practice, NHS financial resilience is not about finding more money or endlessly driving down costs. It’s about whether we can reliably deliver safe, effective care within the resources it has, and still adapt under pressure when needed. As the system enters a period of financial and operational reset, that distinction matters more than ever.

What is NHS financial resilience?

At its core, financial resilience in the NHS is a measure of capability. It’s the ability to manage demand, absorb shocks and keep services running without compromising quality or burning out staff. It is experienced less in spreadsheets and more on the frontline – in whether there is enough time to care, enough visibility to plan, and enough flexibility to respond.

Getting there relies on a number of factors, not least having the right resources, deploying them in the most efficient way, and ensuring that this drives productivity.

While this mix provides a route to financial resilience, we are currently seeing a disconnect between the three elements. The workforce has been steadily growing, yet NHS workforce productivity has increased only marginally. This points towards a fundamental efficiency challenge, where value out is not yet matching the effort, time and hard work that are going in.

It’s not hard to see where this is manifesting either. Highly skilled clinicians often find themselves tied to desks, completing administrative tasks or working around fragmented healthcare systems instead of doing what they do best, such as clinical supervisions, caring for complex patients or training junior staff.

So, in this context, financial resilience in the NHS is not about doing more with less at the expense of staff or patients. It is about being equipped to do the right work, in the right way, with the right resources.

Technology as a productivity multiplier

The Medium-Term Planning Framework calls on the NHS to seize the opportunities offered by technology to bridge this gap. It emphasises the need to decouple workforce growth from service delivery growth by embedding more efficient models of care and moving towards a digital-by-default approach.

To support financial resilience, technology must act as a productivity multiplier, not just an enabler. That means focusing on return on investment, seamless integration with clinical systems, interoperability, access to usable data, and demonstrable improvements in workforce efficiency. Every system should be challenged to show how it saves time, reduces variation or improves decision-making.

So, what are some of the key allies in this quest?

Costing as the Cinderella of the ball

Costing is an under-used and sometimes unloved lever for productivity improvements. Too often, it is treated as a bean-counting exercise rather than one of the most valuable sources of insight to inform decision-making.

Greater NHS financial sustainability relies on understanding the true cost of a patient from every viewpoint and making better decisions from that information. For example, we encountered a consultant that was carrying out endoscopies in a theatre that was conveniently located next to his office instead of 500 yards down the hallway in an endoscopy suite where it should be. The running costs of the theatre were over 10x those of the endoscopy suite, but the consultant was not looking at the task through a costing lens – he had always just taken up the room next door for convenience.

Another example is the cost of paper. Nearly a quarter of a billion pounds is spent by the NHS every year on storing, retrieving and handling paper patient records. £3 per appointment is spent on outpatient paper processing. Putting a number on the costs of these transactions really highlights how paper in the NHS is the epitome of archaic, inefficient practices. Electronic document management can eliminate this dependence on paper and improve hospital workflows and patient experiences in the process.

These are great ways of illustrating that high-cost care does not equate to high-quality care. In many cases, the best outcomes can be delivered at lower cost, but only if processes are designed well and in alignment with costing insights. Now is the time to team up costing data with process design and clinical systems to examine all legacy workflows and rattle out the inefficiencies. This shifts the focus away from the cold costs and towards achieving better outcomes and efficiencies, especially highlighting the best technology use-cases.

Investments that make clinicians lives easier

At board level, financial resilience means having confidence that resources are being used to maximum effect. At ground level, it means clinicians spending more time with patients and less time navigating workarounds.

It’s important to make technology investment choices that support these goals, and as part of wider efforts to achieve the key shifts outlined in the 10-year health plan. Financial resilience comes into play as more services are moved from the hospital to communities, for example. Research suggests that every £100 spent on community care could achieve, on average, £131 in hospital savings. That’s on top of the benefits of patients being able to receive care in their own homes and neighbourhoods.

The ability to plan, schedule and deploy community nursing staff effectively becomes critical. Teams need clear visibility of capacity, caseloads and where the priority patients are so that the more expensive band six nurses are able to spend their time attending the most complex cases and not manually organising schedules for other nurses. Meanwhile, work schedules for cheaper staff can be maximised around lower priority tasks. That’s a simple equation, but often it’s not met because the adoption of scheduling tools has not been implemented yet.

Data, integration and system-wide value

The biggest gains, however, do not come from optimising individual services in isolation. They come from integration.

Neighbourhood care depends on health and social care organisations being able to share information seamlessly, not just with each other, but across community services, local authorities, the police, charities and other partners. Yet data silos and inconsistent governance remain the norm, forcing staff to bridge gaps manually and undermining both productivity and resilience.

Interoperability, open APIs and shared data platforms are essential to joining up services and funding flows across the system. Suppliers increasingly recognise this, but progress also depends on regional collaboration and the ability to scale solutions rather than reinventing them repeatedly.

Building NHS financial resilience gradually

Financial resilience in the NHS is not about austerity. It is about designing services, workflows and systems that consistently turn clinical effort into patient value, even under pressure. Technology, used well, will support this by releasing time to care, improving visibility, reducing variation and supporting better decisions.

Not every investment needs to be transformational on day one, but every investment should contribute to a coherent direction of travel. Incremental steps, clear measures of impact and strong partnerships can help organisations demonstrate value quickly and build momentum. At Civica, we believe financial resilience is built from the ground up. By supporting smarter ways of working across things like clinical pathways, community nursing and document management, technology can help the NHS create the headroom it needs – not just to survive the next financial cycle, but to deliver better care for the long term.