From insight to impact: Delivering on NHS productivity pack potential

July 29, 2025

Image: © sturti | iStock

National benchmarking has identified opportunities for NHS Trusts, but the real work begins after the spreadsheet closes. Gareth Jenkins from Changeology Group explains that insights alone won’t drive recovery and outlines the steps NHS organisations must take to turn opportunities into action

In early 2025, NHS England issued every Trust a “Productivity and Efficiency Opportunities Pack” – benchmark-infused documents outlining improvement potential based on national cost and activity comparisons. From workforce spending to outpatient throughput and overnight stays, the packs promise tens of millions in efficiency potential. But there’s a problem: Data doesn’t deliver.

With NHS England making 2025/26 a year of financial reset, every Trust must reduce its cost base by at least 1% and improve productivity by 4% just to maintain stability. Boards must now show how they will “exhaust all opportunities to improve productivity and reduce waste”, while still protecting the quality and safety of core services.

At Changeology, we help NHS organisations bridge the gap between theoretical opportunity and operational reality.

The productivity pack paradox

The packs vary in structure from trust to trust but are technically robust. They offer a nationally consistent baseline for performance, identify cash-releasing and productivity-enhancing opportunities, and encourage organisations to plan around clear metrics. Unfortunately, they lack both insight and context.

The packs have no mechanism to prioritise high-yield schemes, no framework to govern delivery, and no practical guidance on managing cross-divisional improvement at pace.

This has resulted in initiative overload in many Trusts – hundreds of loosely defined schemes, each competing for time and attention, stretching leadership bandwidth and frontline engagement.

From data to delivery: Changeology’s structured approach

In Trusts nationwide, we’ve consistently delivered results by combining strong diagnostics with embedded, real-time delivery support.

We apply a four-stage methodology:

Mobilise: Establish governance, reporting tools, and working cadence from week one.
Diagnose: Validate assumptions using frontline insight and operational data.
Deliver: Implement a focused portfolio of high-value, owned initiatives.
Embed: Transfer knowledge, build internal capability, and lock in assurance.

As noted in a previous article, “We start with Current State Analysis (CSA) – not spreadsheets, but on-the-ground engagement that surfaces hidden inefficiencies in workforce, planning, and delivery.” ^(1,2)

Translating insight into operational levers

At Airedale General Hospital, Changeology was brought in mid-year to reset a struggling Waste Reduction Programme. Of 306 initiatives, only 54 were delivering any in-year value. We reviewed all Gateway documentation, removed £2.5 million in placeholders, and rebuilt the programme’s tracker around real-time status, named ownership, and risk stratification.

Most significantly, we identified that just 44 initiatives – 14% of the total – accounted for 92% of potential value. By focusing governance and delivery support on these high-impact schemes, the Trust delivered:

£15.2 million total savings.
£7.5 million recurrent.
A renewed sense of control, grip, and belief across clinical and operational teams

“It’s not about how many initiatives you launch, or the total value of speculated ideas. It’s how well you deliver the right ones – and make them stick.” – Gareth Jenkins, Partner, Changeology Group.

Case in point: Chesterfield Royal Hospital

At Chesterfield, the issue wasn’t ambition – it was structure and deliverability.

We led the development of a £16 million transformation portfolio across 114 initiatives. Gateway documentation, named leads supported each, and a live Transformation Tracker used weekly by divisions, executives, and the Board.

We installed a full governance architecture within two weeks, including:

Divisional week-on-week reporting.
Executive oversight via a single transformation dashboard.
Gateway reviews and assurance processes adopted Trust-wide.

This created a delivery culture based on visibility, discipline, and support – precisely the kind of environment NHS England now expects under its revised operating model and performance compact.

The Trust’s Finance & Performance Committee noted that it was in a “vastly improved position” to deliver recurrent improvement compared to previous years.

Ideation to transformation

When we talk of documentation, this is not just an admin exercise, nor an elongation or extrapolation of high-end figures within Productivity Packs; it is the ‘what’, ‘when’ and ‘how’. Invariably, benchmarking does not account for local specifics, but Changeology does. We know that the productivity packs are very loose guides, full of assumptions and compiled by parties who rarely understand the specifics of departments within Trusts. We work alongside the staff and management in Trust areas to:

Understand their respective areas.
Quantify and identify true financial opportunity.
Devise a detailed plan for how that opportunity can be delivered (and when).
Identify what resources and commitment is required to deliver the plan.

To deliver productive, financial or performance improvement requires a full understanding of what levers need to be pulled within an area. To do that, one must be immersed in that area and understand the art of the possible. That is the inherent flaw of benchmarking and data; the lack of insight and understanding. To make improvements happen, people and processes must be understood, engaged with and prepared to make the changes required to realise said improvements.

Documentation, benchmarking, reports, and data support transformation but do not deliver transformation. People deliver transformation.

Bridging the delivery gap at scale

This isn’t just about Trust-level transformation. Changeology has also led regional-scale programmes – including a 12-month Endoscopy recovery initiative across four North West Trusts and a Cancer Alliance.

Using a standardised Management Operating System (MOS), real-time dashboards, and site-level delivery support, we achieved:

+21% regional activity uplift.
£4.9 million in cost avoidance.
78% reduction in patient breaches at UHMBT.
+103% increase in appointments at LTHTr.

“A standardised MOS was deployed across all Trusts…The result? A 21% activity increase, £4.9 million cost avoidance, and a 78% reduction in breaches.”

This kind of scalable operating model is exactly what’s needed as the NHS transitions toward more devolved accountability with greater system flexibility – but higher expectations for delivery.

✅ What Changeology has proven works

Validate assumptions with frontline insight (CSA).
Prioritise high-value, deliverable initiatives.
Embed structured routines and governance (MOS).
Track progress weekly – not just at month-end.
Transfer capability, not dependency.

These principles have underpinned successful transformation portfolios valued at over £45 million across just three sites – delivering real, validated improvement in-year.

Conclusion: From benchmarking to behaviour change

The productivity packs give NHS leaders a clear message: “Here’s where you need to improve.” But that’s not the same as delivery.

With 2025/26 described as a “reset moment” in NHS England’s planning guidance, Trusts are now expected to provide not just ambition – but proof of delivery. Real-time governance. Recurrent value. Transparent, auditable plans.

“Boards don’t need more reports. They need traction.”
– From Financial Recovery & Transformation in the NHS

As NHS England moves to earned autonomy, with ICBs and providers held jointly accountable for improvement, Changeology is the partner that brings structure, pace, and discipline – turning insights into results.

From benchmarking to behaviour change, we make NHS transformation stick.