Supporting the health and care system in improving productivity

We recognise that the health and care system is under exceptional pressure.

Recovering core services and improving productivity is an immediate priority for the NHS. So, to help with this, we've pulled together our relevant guidance and recommendations supporting this work into one place.

We've matched relevant NICE guidance and recommendations to areas of improving productivity and recovering core services. And we’ve aligned these to each of the 2023/24 priorities and operational planning guidance and priority areas of the NHS Long Term Plan.

Using these recommendations means you can be sure the care you deliver is:

  • efficient
  • effective
  • based on the best available evidence
  • directly relevant to current NHS priorities.

While you may have already implemented most of these recommendations, we hope there will be new opportunities to consider. We know that implementation of our guidance varies across the health and care system. So, this resource might provide areas to focus on

We'll continually update this resource with latest relevant guidance supporting the NHS priorities, such as the use of virtual wards.

Each piece of guidance also includes a resource impact assessment, which gives further details on its potential impact. You can find these under the 'tools and resources' tab on the respective guidance page. To help you plan, the NICE resource planner lists all guidance that is due to publish and provides estimates of resource and capacity impact.

This page was last updated on Thursday 29 February 2024.

The guidance on this page is matched specifically to areas of productivity and recovering core services. Please visit our guidance and quality standards for recommendations and advice on wider support.

NHS productivity objectives for 2023/24

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Urgent and emergency care

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NG180: Perioperative care in adults

Productivity opportunities:

Reduced length of stay, release of theatre capacity.

Specific recommendations:


NG185: Acute coronary syndromes

Productivity opportunity:

Reduction in planned admissions, reduction in mortality, myocardial infarction and repeat revascularisation.

Specific recommendation:


NG147: Diverticular disease: diagnosis and management

Productivity opportunity:

Reduced length of stay, release of endoscopy capacity.

Specific recommendations:

  • 1.3 (1.3.5, 1.3.12, 1.3.26​)

NG118: Renal and ureteric stones: assessment and management

Productivity opportunity:

Reduction in surgeries, release of theatre capacity, reduction in bed days.

Specific recommendations:


MTG37: Thopaz+ portable digital system for managing chest drains

Productivity opportunity:

Reduced length of stay.


NG94: Emergency and acute medical care in over 16s: service delivery and organisation 

Specific recommendations:

Productivity opportunity:

Reduced A&E attendance, admissions and delayed discharges.


NG211: Rehabilitation after traumatic injury

Specific recommendations:

Productivity opportunity:

Reduction in length of rehabilitation.


CG103: Delirium: prevention, diagnosis and management in hospital and long-term care

Specific recommendations:

Productivity opportunity:

Releasing specialist capacity and reduced length of stay.


HTE13: Virtual ward platform technologies for acute respiratory infections

Productivity opportunity:

Reduced length of stay, reduced admissions and A&E presentations (further evidence required to confirm).


TA878: Casirivimab plus imdevimab, nirmatrelvir plus ritonavir, sotrovimab and tocilizumab for treating COVID-19

Productivity opportunity:

Reduced hospitalisations, reduced length of stay.


TA902: Dapagliflozin for treating chronic heart failure with preserved or mildly reduced ejection fraction

Productivity opportunity:

Reduced A&E attendances and admissions.


TA929: Empagliflozin for treating chronic heart failure with preserved or mildly reduced ejection fraction

Productivity opportunity:

Reduced A&E attendances and admissions.

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Community health services

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CG139: Healthcare-associated infections: prevention and control in primary and community care

Productivity opportunity:

Reduction in admissions.


NG74: Intermediate care including reablement

Specific recommendations:

Productivity opportunity:

Reduction in admissions, reduced length of stay.


NG211: Rehabilitation after traumatic injury

Specific recommendations:

Productivity opportunity:

Length of rehabilitation.

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Primary care

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Elective care

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NG118: Renal and ureteric stones: assessment and management

Specific recommendations:

Productivity opportunity:

Reduction in surgeries, release of theatre capacity, reduction in bed days.


MTG76: AposHealth for knee osteoarthritis

Productivity opportunity:

Delay/reduce need for knee surgery.


MTG37: Thopaz+ portable digital system for managing chest drains

Productivity opportunity:

Reduced length of stay.


MTG32: Estimating fractional flow reserve from coronary CT angiography

Productivity opportunity:

Reduction in number of scans/tests.


NG45: Routine preoperative tests for elective surgery

Productivity opportunity:

Reduction in number of scans/tests.


MTG73: Optilume for recurrent bulbar urethral strictures

Productivity opportunity:

Reduction in repeat interventions.


MTG49: Rezum for treating lower urinary tract symptoms secondary to benign prostatic hyperplasia

Productivity opportunity:

Reduced length of stay, increased theatre utilisation.


MTG53: The PLASMA system for transurethral resection and haemostasis of the prostate

Productivity opportunity:

Reduced length of stay, increased theatre utilisation.


MTG58: UroLift for treating lower urinary tract symptoms of benign prostatic hyperplasia

Productivity opportunity:

Reduced length of stay, increased theatre utilisation.


MTG29: GreenLight XPS for treating benign prostatic hyperplasia

Productivity opportunity:

Reduced length of stay, increased theatre utilisation.


TA906: Rimegepant for preventing migraine

Productivity opportunities:

IV/SC to oral administration, change in setting and person delivering care.


TA905: Upadacitinib for previously treated moderately to severely active Crohn’s disease

Productivity opportunities:

IV to oral administration, change in setting and person delivering care.


TA898: Dabrafenib plus trametinib for treating BRAF V600 mutation-positive advanced non-small-cell lung cancer

Productivity opportunities:

IV to oral administration, change in setting and person delivering care.


TA888: Risankizumab for previously treated moderately to severely active Crohn's disease

Productivity opportunities:

IV to subcutaneous administration, change in setting and person delivering care.


TA882: Voclosporin with mycophenolate mofetil for treating lupus nephritis

Productivity opportunities:

IV to oral administration, change in setting.


TA832: Relugolix–estradiol–norethisterone acetate for treating moderate to severe symptoms of uterine fibroids

Productivity opportunities:

Reduction in planned attendances/appointments, change in person delivering care.


TA824: Dexamethasone intravitreal implant for treating diabetic macular oedema

Productivity opportunity:

Reduction in clinical appointments.


TA799: Faricimab for treating diabetic macular oedema

Productivity opportunity:

Reduction in clinical appointments.


TA800: Faricimab for treating wet age-related macular degeneration

Productivity opportunity:

Reduction in outpatient injections.


TA672: Brolucizumab for treating wet age-related macular degeneration

Productivity opportunity:

Reduction in outpatient injections.


TA617: Lusutrombopag for treating thrombocytopenia in people with chronic liver disease needing a planned invasive procedure

Productivity opportunity:

Reduction in length of stay.


TA626: Avatrombopag for treating thrombocytopenia in people with chronic liver disease needing a planned invasive procedure

Productivity opportunity:

Reduction in length of stay.


TA868: Vutrisiran for treating hereditary transthyretin-related amyloidosis

Productivity opportunity:

IV to subcutaneous administration, change in setting and person delivering care.


NG94: Emergency and acute medical care in over 16s: service delivery and organisation 

Specific recommendations:

Productivity opportunity:

Reduced A&E attendance, admissions and delayed discharges.


NG50: Cirrhosis in over 16s: assessment and management

Productivity opportunity:

Reduced variceal ligation and endoscopic monitoring surveillance.


NG126: Ectopic pregnancy and miscarriage: diagnosis and initial management

Specific recommendation:

Productivity opportunity:

Reduced surgical procedures.


NG148: Acute kidney injury: prevention, detection and management

Specific recommendation:

Productivity opportunity:

Reduced outpatient procedures.


DG56: Quantitative faecal immunochemical testing to guide colorectal cancer pathway referral in primary care

Productivity opportunity:

Reduced colonoscopies.


MTG64: KardiaMobile for detecting atrial fibrillation

Productivity opportunity:

Reduced repeat diagnostics and cardiologist appointments.


MTG64: KardiaMobile for detecting atrial fibrillation

Productivity opportunity:

Reduced repeat diagnostics and cardiologist appointments.


HTE11: Artificial intelligence technologies to aid contouring for radiotherapy treatment planning: early value assessment

Productivity opportunity:

Reduced time to review and edit structures (further evidence required to confirm).


HTE13: Virtual ward platform technologies for acute respiratory infections

Productivity opportunity:

Reduced length of stay, reduced admissions and A&E presentations (further evidence required to confirm).


HTE14: Digital technologies for delivering specialist weight-management services to manage weight-management medicine: early value assessment

Productivity opportunity:

Improved access and reduced patient waiting (further evidence required to confirm).


TA911: Selpercatinib for untreated RET fusion-positive advanced non-small-cell lung cancer

Productivity opportunity:

IV to oral administration, change in setting, person delivering care (further evidence required to confirm).


TA914: Pembrolizumab for previously treated endometrial, biliary, colorectal, gastric or small intestine cancer with high microsatellite instability or mismatch repair deficiency

Productivity opportunity:

Reduction in planned attendances/appointments.


TA931: Zanubrutinib for treating chronic lymphocytic leukaemia

Productivity opportunity:

IV to oral administration, change in setting, person delivering care.


TA942: Empagliflozin for treating chronic kidney disease

Productivity opportunity:

Delayed disease progression and associated treatment costs.

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Cancer

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MTG37: Thopaz+ portable digital system for managing chest drains

Productivity opportunity:

Reduced length of stay.


TA898: Dabrafenib plus trametinib for treating BRAF V600 mutation-positive advanced non-small-cell lung cancer

Productivity opportunities:

IV to oral administration, change in setting and person delivering care.


TA887: Olaparib for previously treated BRCA mutation-positive hormone-relapsed metastatic prostate cancer

Productivity opportunities:

IV to oral administration, change in setting and person delivering care.


TA876: Nivolumab with chemotherapy for neoadjuvant treatment of resectable non-small-cell lung cancer

Productivity opportunity:

Reduced need for subsequent treatment.


TA865: Nivolumab with fluoropyrimidine- and platinum-based chemotherapy for untreated unresectable advanced, recurrent, or metastatic oesophageal squamous cell carcinoma

Productivity opportunity:

Reduced number of chemotherapy cycles.


TA712: Enzalutamide for treating hormone-sensitive metastatic prostate cancer

Productivity opportunity:

change in setting and person delivering care, IV chemotherapy to oral.


TA689: Acalabrutinib for treating chronic lymphocytic leukaemia

Productivity opportunity:

change in setting and person delivering care, IV chemotherapy to oral.


NG230: Thyroid cancer: assessment and management

Specific recommendations:

Productivity opportunity:

reduction in surgeries.


NG231: Barrett's oesophagus and stage 1 oesophageal adenocarcinoma: monitoring and management

Specific recommendations:

Productivity opportunity:

reduction in imaging, reduction in surgery.

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Diagnostics

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DG49: PLGF-based testing to help diagnose suspected preterm pre-eclampsia

Productivity opportunity:

Reduction in bed days, reduction in unnecessary admissions.


NG155: Tinnitus: assessment and management

Productivity opportunity:

Reduction in scans/tests.

Specific recommendation:


DG37: Point-of-care creatinine devices to assess kidney function before CT imaging with intravenous contrast

Productivity opportunity:

Reduction in cancelled and rebooked CT scans, increased utilisation of CT scans.


NG45: Routine preoperative tests for elective surgery

Productivity opportunity:

Reduction in scans/tests.


HTE6: Genedrive MT-RNR1 ID Kit for detecting a genetic variant to guide antibiotic use and prevent hearing loss in babies: early value assessment

Productivity opportunities:

Reduced cochlear implants, reduced surgery (further evidence required to confirm).


DG56: Quantitative faecal immunochemical testing to guide colorectal cancer pathway referral in primary care

Productivity opportunity:

Reduced colonoscopies.


MTG64: KardiaMobile for detecting atrial fibrillation

Productivity opportunity:

Reduced repeat diagnostics and cardiologist appointments.


HTE11: Artificial intelligence technologies to aid contouring for radiotherapy treatment planning: early value assessment

Productivity opportunity:

Reduced time to review and edit structures (further evidence required to confirm).

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Maternity

View/hide related guidance and recommendations

DG49: PLGF-based testing to help diagnose suspected preterm pre-eclampsia

Productivity opportunity:

Reduction in bed days, reduction in unnecessary admissions.


CG190: Intrapartum care for healthy women and babies

Productivity opportunity:

Reduced variation in care.


NG194: Postnatal care
Productivity opportunity: reduced variation in care.

NG201: Antenatal care

Productivity opportunity:

Reduced variation in care.


NG121: Intrapartum care for women with existing medical conditions or complications

Productivity opportunity:

Reduced variation in care.


NG126: Ectopic pregnancy and miscarriage: diagnosis and initial management

Specific recommendation:

Productivity opportunity:

Reduced surgical procedures.

NHS Long Term Plan

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Digital

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HTE3: Guided self-help digital cognitive behavioural therapy for children and young people with mild to moderate symptoms of anxiety or low mood: early value assessment

Productivity opportunity:

Reduced waiting lists/quicker access to support, reduced admissions (further evidence required to confirm).


HTE8: Digitally enabled therapies for adults with depression: early value assessment

Productivity opportunity:

Reduced practitioner time per patient, improved access and reduced patient waiting (further evidence required to confirm).


HTE9: Digitally enabled therapies for adults with anxiety disorders: early value assessment

Productivity opportunity:

Reduced practitioner time per patient, improved access and reduced patient waiting (further evidence required to confirm).

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Mental health

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HTE3: Guided self-help digital cognitive behavioural therapy for children and young people with mild to moderate symptoms of anxiety or low mood: early value assessment

Productivity opportunity:

Reduced waiting lists/quicker access to support, reduced admissions (further evidence required to confirm).


HTE8: Digitally enabled therapies for adults with depression: early value assessment

Productivity opportunity:

Reduced practitioner time per patient, improved access and reduced patient waiting (further evidence required to confirm).


HTE9: Digitally enabled therapies for adults with anxiety disorders: early value assessment

Productivity opportunity:

Reduced practitioner time per patient, improved access and reduced patient waiting (further evidence required to confirm).

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People with a learning disability and autistic people

View related guidance and recommendations
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Prevention and health inequalities

View/hide related guidance and recommendations

DG49: PLGF-based testing to help diagnose suspected preterm pre-eclampsia

Productivity opportunity:

Reduction in bed days, reduction in unnecessary admissions.


CG190: Intrapartum care for healthy women and babies

Productivity opportunity:

Reduced variation in care.


NG194: Postnatal care

Productivity opportunity:

Reduced variation in care.


QS167: Promoting health and preventing premature mortality in black, Asian and other minority ethnic groups

Productivity opportunity:

Reduction in health inequalities.


NG121: Intrapartum care for women with existing medical conditions or complications

Productivity opportunity:

Reduced variation in care.


NG201: Antenatal care

Productivity opportunity:

Reduced variation in care.

Visit our NICE and health inequalities page for our guidance and advice on ways of minimising health inequalities.

Contact us

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