Social Value
NHS Confederation partnered with CF beginning in 2022 to produce the “Value in Health” report series, which explores the relationship between NHS spending, health outcomes, and economic activity, demonstrating the significant economic value of NHS investment. The first nationally modelled attempt at such a distinction, the series determined which care settings offer greatest return for finite investment in addition to developing an approach to evaluating interventions that are implemented across the UK health system to support to look towards the long term, ultimately supporting ICSs, the NHS and local and combined authorities to systematically embed a learning system approach focused on both improvement and value for money.
The NHS Confederation, the membership body for all NHS organisations, partnered with CF to produce the “Value in Health” series. This initiative aimed to create an understanding of the contribution that the NHS made to economic growth. The series set out new insights from the relationship between NHS spending, health outcomes, and economic activity. Creating insights around the question, “What is the return on investment of health spending?”
The cost of the NHS is often discussed given it consumes 40% of the national budget. However, little attention is paid to the economic benefits that result from spending on healthcare. In 2023 the government made economic growth the central plank of its agenda and NHS Confederation commissioned CF to undertake independent analysis to determine the link between investing in healthcare and the impact it has on a range of factors, including labour productivity, economic activity and healthcare outcomes.
The team brought together previously unconnected data, including health data on activity, outcomes, and spend, as well as economic and demographic data. Curating the data to the lowest granularity and establishing a longitudinal data set. The project was shaped with continuous member input and used a sprint-like process to generate evidence, socialise it, and seek media attention.
CF’s preliminary report quantified the positive relationship between increasing NHS spending, health outcomes and economic activity and opened the conversation for the development of the following three.
The next report examined local variations in NHS spend and identified which care settings can deliver the most economic output when funding increases. This analysis involved splitting historical clinical commissioning group (CCG) spending increase figures by highest and lowest across community, primary, acute and mental health settings, and examining how changes in spend by sector for CCGs are related to growth in GVA. CF then explored system productivity as it relates to spend. To understand how community spend influenced acute activity, we compared the differences in acute activity levels for two groups of CCGs, one spending more on community care and one spending less, enabling us to understand how differences in community spend related to differences in acute spend. This analysis found that spending in primary and community care yielded even better returns, with £14 per £1 spent for those places spending less relative to needs.
These findings were tested and socialised across NHS confederation members, and led CF to push further upstream, looking at the issue of prevention, through a systematic literature review. CF analysing 13,502 articles to identify 96 suitable papers with 146 unique ROIs to examining the return on investment at the intervention level, concluding there was an £11 billion opportunity from improving investment decision-making.
The work demonstrated the significant economic value of investment in the NHS, quantified the positive relationship between increasing NHS spending, health outcomes, and economic activity, and determined which care settings offer the greatest return for finite investment. The series has fundamentally changed the conversation around NHS spend, charting a journey towards preventative healthcare and having a significant impact on national policy.
View the CF profile in the MCA Members Directory.