United Kingdom


  • Industry: Government & Public Sector, Healthcare
  • Type: Press release
  • Date: 24/01/2013

New attitude to staff will be key to NHS’ future, says KPMG 

  • Healthcare staff must be viewed as adding value, not cost, for healthcare reforms to succeed


  • Reducing staff numbers is not the best way to save healthcare costs


  • 5 approaches identified which can improve patient care and staff morale



Insufficient attention is being paid to the changing relationship between clinicians and their patients. The result, according to a new report by KPMG, is a health service where the quality of care is dropping below standards expected by patients.


Called ‘Value Walks’, the report is being launched at a conference organised by Reform, the independent think tank, to an audience including leaders from the Royal College of Nursing, General Medical Council and Parliamentary Health Select Committee*. 


Improvements in care will only come from new approach to healthcare staff


It argues that although improving payment systems, purchasing procedures and governance remains important, better health outcomes for patients will only be achieved if hospitals focus on their staff, pay attention to the way clinicians are able to interact with patients and improve the time they can spend on patient care. 


The report also suggests that boosting the morale of clinical staff and allowing them the freedom to try innovative clinical procedures are critical changes that must be made, if real value is to be delivered to patients.  The alternative, according to ‘Value Walks’, is a health service focused bureaucratic changes, when redesigning the way services are delivered is more likely to lead to sustainable differences in the quality and cost of patient care.


Andrew Hine, KPMG’s head of public healthcare, says: “For the past 60 years technical, therapeutic and professional advances have revolutionised many approaches to healthcare, but at the same time the underlying business and care models have remained largely unaltered.  Unlike most other industries, healthcare has proved to be particularly stubborn when faced with radical change and its reluctance means that ultimately the patient is the one who suffers.  In part this is because many new care processes have become imprisoned in the wrong or outdated physical infrastructures, or because some hospitals lack the specialised skills for some of the work they do.  It’s also down to the fact that morale is hit as different care pathways collide in an uncoordinated fashion.”


Stop the rot – policies needed to address growing shortfall in healthcare staff


The report also indicates that, by 2022, OECD countries will be facing a healthcare workforce shortage of between 22 and 29 percent due to a combination of retirement, changing working hours and disaffected staff leaving the profession. 


As a result, patient care will suffer and KPMG believes that the declining number of medical professionals should hospital managers to challenge long-held assumptions that the best way to reduce costs is to reduce staff numbers.  Instead, the report provides evidence in the shape of case studies** from the UK, US, Netherlands and India to demonstrate that care can improve and costs lowered if a new approach is adopted.


Andrew Hine says: “All too often staff are seen as a cost to the system. Yet the old mind-set that believes ‘cost walks on two legs’ needs to be replaced with a new one – namely that ‘value walks on two legs’. After all, no one can dispute that higher staff morale and motivation has a beneficial effect on the patient experience, but if we are to achieve the levels of change necessary it is vital that professional organisations, trade unions and patient groups are included in the ongoing debate on how policy approaches can be implemented.”


Five approaches towards better healthcare provision


The case studies in the report go on to identify 5 key attributes that have can enhance productivity, improve the quality of care and boost the attractiveness of healthcare work.  These are:


  • incorporating a focus on creating value for patients into the culture of healthcare organisations


  • empowering professionals by giving them the freedom to take responsibility for delivery of care, rather than hiding behind ‘management decisions’


  • redesigning tasks and processes so that patient need comes above staff convenience and ensuring that everyone in the care pathway adds value to the patient’s journey


  • actively managing staff performance using outcome measures (eg measuring infection control instead of adherence to hand hygiene policy) to promote a safe culture and continuous improvement


  • challenging traditional approaches to staff management by improving recruitment, induction, reward and appraisal programmes and actively managing poor performance.


Analysis of organisations across the world show that where these 5 approaches are adopted, results improve. For example, in the UK, Circle Health experienced a 22 percent improvement in productivity in 12 months in Nottingham and a ‘return to surgery’ rate 4 times lower than the national average.  In India, the Aravind Eye Care System started with 11 beds and now treats more than 2.6 million outpatients per year.


Andrew Hine concludes: “Hiring more people is not feasible in the current climate, but firing them is not the way to reduce costs and increase performance, either.  Instead, healthcare providers must find ways to utilise the current workforce in a smarter, more efficient way. Changing the habits of the past 60 years is a starting point because doing so will buy enough time for the more fundamental changes, redesign initiatives and innovations that the healthcare industry is just beginning to explore.”




Media enquiries:


Mike Petrook, KPMG Press Office

020 7311 5271 (t), 07917 384 576 (m) or mike.petrook@kpmg.co.uk 


Notes to Editors:


* The Front Line – International Workforce Summit run by Reform on 24 January 2013.

** Case studies focus on Circle Health in the UK, the Virginia Mason Medical Centre in the US, Buurtzorg in The Netherlands and the Aravind Eye Care System in India.


About KPMG


KPMG LLP, a UK limited liability partnership, is a subsidiary of KPMG Europe LLP and operates from 22 offices across the UK with over 12,000 partners and staff.  The UK firm recorded a turnover of £1.8 billion in the year ended September 2012. KPMG is a global network of professional firms providing Audit, Tax, and Advisory services. We operate in 156 countries and have 152,000 professionals working in member firms around the world. The independent member firms of the KPMG network are affiliated with KPMG International Cooperative ("KPMG International"), a Swiss entity.  KPMG International provides no client services.



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