As set out in our recent article on Akeso’s Digital, Data and Technology (DDaT) focus for the year ahead, efficiency and productivity remain among the strongest areas of demand across the public sector. They are also among the most complex to address.
Rising demand, constrained funding and persistent workforce pressures mean the health and care systems must deliver more activity and better outcomes without a corresponding increase in resource. National policy increasingly positions digital, data and technology as important productivity levers, but experience across the system suggests that sustained improvement depends on far more than the deployment of new tools.
Productivity in health and care is shaped by how services are designed, how people work, how decisions are made, and how change is governed. Digital can enable improvement, but only when it is applied selectively, aligned to operational reality and supported by the right commercial and organisational conditions.
Digital Strategy, Prioritisation and Governance
One of the most common productivity challenges we see is not a lack of ideas, but a lack of focused prioritisation. Many organisations are balancing long lists of digital and transformation initiatives against limited funding and delivery capacity, making it difficult to identify and prioritise what will have the greatest impact.
Our work in this area focuses on supporting health and care organisations to establish clear digital priorities grounded in operational need, delivery reality and value for money. This includes developing structured prioritisation frameworks, facilitating organisation-wide prioritisation discussions, and designing governance arrangements that enable consistent, transparent decision-making over time.
In practice, this often involves supporting organisations to put in place end-to-end prioritisation processes, from intake and gate-checking of initiatives, through scoring and sequencing, to roadmap development and governance approval. Instead of producing static strategies, the emphasis is on creating living mechanisms that help organisations sequence change, understand dependencies and focus effort where productivity gains are most likely to be realised.
Commercial and Procurement Advisory
Commercial and procurement decisions play a significant role in shaping whether digital transformation initiatives succeed or stall. Inflexible contracts, fragmented sourcing approaches and weak contract management can limit an organisation’s ability to adapt, scale and realise value from digital investment.
Our work in this area draws on hands-on delivery across provider, system and national settings. We support organisations to use commercial and procurement approaches as enablers of productivity and transformation, rather than as downstream compliance exercises. This includes designing collaborative contracting models, strengthening contract management capability, and developing category strategies that align digital investment with service priorities and system-wide value.
In practice, this has involved supporting system-wide digital contracting across diagnostics, pathology and imaging; designing sustainable regional contract management models; and reviewing significant portfolios of digital spend to identify opportunities for standardisation, value protection and reinvestment. We have also supported major digital procurements, including core diagnostic and imaging platforms, ensuring that sourcing decisions are aligned to long-term service models, with less emphasis on short-term implementation milestones.
This experience spans local, regional and national programmes, including clinically led category management and collaborative procurement models. The emphasis is on commercial structures that support phased delivery, shared outcomes and ongoing optimisation, ensuring that procurement decisions enable productivity and flexibility over time.
Looking ahead, it will be increasingly important to understand how procurement models and digital supplier partnerships need to evolve to support neighbourhood health and left-shift models of care over time. As services move beyond traditional organisational boundaries, commercial arrangements will need to enable collaboration across providers, shared outcomes, and greater flexibility in how digital solutions are configured and scaled.
Workforce Transformation and New Ways of Working
Workforce constraints are among the most significant limits on productivity across health and care. Digital programmes that fail to account for workforce design, skills and adoption often struggle to deliver impact.
Our work focuses on using digital as an enabler of workforce transformation, supporting organisations to reduce administrative burden, improve retention and make better use of clinical and operational capacity. This includes role and workflow redesign, skill mix analysis, capacity modelling and embedding realistic workforce assumptions within business cases and delivery plans.
Recent work has included community nursing and virtual ward initiatives that released significant clinical time through skill-mix and rota redesign, while identifying further pathways for safe, home-based care. We have also supported operating model design to help systems scale capacity without additional inpatient staffing, alongside outpatient pathway redesign informed by demand and capacity modelling and patient co-design. In diagnostics, our work includes workforce scenario modelling across areas such as endoscopy and genomics, helping organisations plan sustainable responses to rising demand.
The emphasis throughout is on change that supports staff and delivers sustained productivity gains, rather than large-scale redesign that is difficult to implement in pressured operational environments.
Automation and Scaling What Works
Automation and robotic process automation (RPA) are increasingly used to support productivity across corporate and clinical services. However, value is often limited when automation is deployed in isolation or remains confined to small-scale pilots.
Our work focuses on treating automation as a service rather than a collection of one-off solutions. This includes establishing scalable operating models, prioritising high-value end-to-end use cases, and integrating automation with wider digital, workforce and documentation change. The emphasis is on shifting low-value admin activity away from clinical and corporate teams and into digital workflows, returning time to care and core operational work.
In practice, this has involved prioritised RPA use cases across corporate and front-line services and supporting a phased transition from legacy dictation towards voice recognition and structured clinical templates. Together, these changes deliver repeatable, low-friction productivity gains in the short term, while laying the foundations for more advanced, ambient and AI-assisted workflows at scale.
Across all automation programmes, governance, benefits tracking and clear ownership are central. Automation is treated as one component of a broader productivity approach, ensuring that improvements are sustained and aligned to service priorities.
A Coordinated Approach to Productivity
Across all of these areas, productivity improvement depends on coordinated change across services, workforce and enabling functions. Digital and data play a critical role, but only when aligned to clear priorities, delivery capacity and effective governance.
As financial and workforce pressures continue, organisations that make progress are likely to be those able to prioritise effectively, govern delivery and embed change in ways that support long-term sustainability.
This requires a pragmatic, evidence-led approach to productivity, one that recognises complexity, supports staff, and focuses on what can realistically be delivered and sustained.
