Erika Bannerman, managing director, NHS Shared Business Services (NHS SBS), suggests that finance, procurement and payroll are not a footnote to the NHS's productivity challenge, but one of the most important places to start solving it.
A clinician beginning a shift will often log into four or five separate systems before seeing a single patient. Details are entered, re-entered, checked and chased across platforms that were never designed to work together. By the time the ward round starts, valuable time has already been lost, not to patient care, but to administration that should be invisible.
New YouGov research commissioned by NHS SBS found that 94 per cent of NHS staff spend time every week on administrative tasks, with more than a quarter spending over ten hours on them.
Finance, procurement, payroll and workforce administration are often labelled as "back-office" functions, implying they sit apart from patient care. They do not. When these services are fragmented, inconsistent or poorly connected, the consequences become visible on the front line through delayed processes, duplicated effort and clinical staff spending valuable time on administration rather than caring for patients.
The NHS Ten-Year Health Plan sets out an ambitious vision for care closer to home, better use of data and sustained productivity improvement. Delivering that ambition requires operational foundations that work consistently across organisational boundaries. Without them, reform risks becoming a patchwork of local workarounds.
The cost of fragmentation
Everyone pays the price when the systems underpinning the NHS fail to work efficiently.
NHS corporate costs have risen by £1.85 billion since 2018/19, a 40 per cent increase, yet productivity remains below pre-pandemic levels. At the same time, operational inefficiencies are taking a toll on staff, with 51 per cent reporting that they contribute to stress or burnout and 30 per cent regularly working beyond their contracted hours.
Despite employing significantly more staff than in 2019, the NHS has delivered only modest increases in elective admissions and outpatient appointments. While productivity is influenced by many factors, fragmented systems and duplicated administration reduce the return on investment and absorb capacity that could be directed towards patient care.
The issue is not simply cost, but capacity. Every hour spent navigating multiple systems, correcting data or repeating routine tasks is an hour lost to patient care, service improvement and innovation.
What already works
Encouragingly, examples of success already exist across the NHS.
At Central and North West London NHS Foundation Trust, automating a single consent process freed the equivalent of 56 clinical hours a day. In Sussex, a new "anytime" payroll model improved both staff satisfaction and payroll accuracy. These are not marginal improvements, but tangible capacity returned to a workforce operating under significant pressure.
Not surprisingly, 67 per cent of NHS staff say that more joined-up operational systems would make the biggest positive difference to their working lives.
Automation and AI are not a panacea. The most successful transformations redesign processes first, then apply technology to remove friction and improve outcomes.
In our recent report, Futureproofing the NHS, Mark Jennings, Chief Solutions and Services Officer at Strasys, observed that NHS organisations are typically "20 per cent special and 80 per cent standard". Much of the work supporting healthcare organisations is repeatable.
Standardisation does not diminish local autonomy. It releases capacity, allowing organisations to focus on the areas that genuinely require local innovation and clinical leadership.
For NHS leaders, the priorities are clear: standardise high-volume, repeatable processes; redesign workflows before applying technology; and use workforce, finance and procurement data to anticipate pressures rather than simply report them.
The opportunity is significant. NHS SBS estimates that wider adoption of shared services and digital platforms could deliver a further £3 billion of efficiencies by 2030. Workforce analytics can also identify staff at increased risk of leaving with accuracy rates approaching 95 per cent, enabling earlier intervention before workforce pressures affect patient care.
The data already exists. The challenge is to make it consistent, timely and actionable, treating it as a strategic asset rather than a retrospective reporting tool.
So what is stopping us?
The reality is that the cost of change is often immediate and local, while the benefits are realised over longer time horizons. Without governance and incentives that recognise this imbalance, even well-intentioned collaboration can stall.
Success depends on shared purpose, clear accountability and genuine partnership, with solutions developed alongside local leaders and frontline teams.
The Ten-Year Health Plan calls for a level of coordination across organisational boundaries that the NHS has never before attempted at scale. Delivering that ambition requires an operational foundation that is equally ambitious: connected, data-enabled and designed around the needs of staff and patients.
The opportunity now is to scale what works by connecting systems, simplifying processes and adopting proven solutions more consistently.
The NHS of the future cannot be built on fragmented systems, duplicated processes and unnecessary administrative burden. It requires a modern operational foundation that allows talented people to focus where they add the greatest value.
When the back office works well, few people notice, and that is exactly the point. Clinicians spend more time with patients, decisions are made faster, resources are used more effectively, and the system performs as it should.
The future NHS will not be defined by the technology it adopts, but by the capacity it creates for people to deliver exceptional care.
When asked what they would do with time saved, 22 per cent of staff said they would spend it directly with patients and service users. There can be no clearer reminder that improving operational productivity is not a back-office issue. It is one of the most practical and immediate opportunities we have to improve care, strengthen the workforce and build a more resilient NHS for the future.
