Learn the lingo series: "QIPP: Quality, Innovation, Productivity and Prevention"

Written by Jyothis George on 06 October 2012. Modified on 06 October 2012. Hits: 8903

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Quality, Innovation, Productivity and Prevention, or QIPP programme was created to enable the NHS to achieve 'efficiency savings' which could be reinvested in the NHS..


In the 2008-09 NHS annual report, Sir David Nicholson, Chief Executive of the NHS, acknowledged that the unprecedented levels of investment seen in the NHS since 2000, was likely to be frozen in 2010-11. He stated that, in this situation, there would be a need

to unlock £15-20 bn of efficiency savings. This has since been labelled the ‘Nicholson Challenge’. QIPP programme was created to enable the NHS to achieve this challenge. Health systems in the rest of the UK have also developed efficiency saving programmes due to their allocated budgets being cut. Like England, NHS Scotland is aiming to improve productivity and quality whilst making efficiency savings. However, NHS Wales and the health service in Northern Ireland are focusing on medicines with the former aiming to achieve savings through improved medicines management and the latter using a series of QIPP indicators, increasing the use of generic prescribing and developing a national formulary to find savings.


In the past 40 years, the NHS budget has enjoyed an average annual increase of 3.9%, above inflation. However, over the

last 10 years this has been nearer 7% with the budget doubling to reach over £102bn by 2010/11. That is the equivalent of £1 of every £13 of the UK’s economy being spent on the NHS. But, as a result of the rising deficit, the Coalition government is reigning in spending on public services, including the NHS. These budgets will no longer receive the generous growth rate that they have been used to.


Sir David Nicholson has outlined three categories in which the efficiency savings should be made;

  •  40% from management costs, administration and central budgets savings – admin reductions by a third, by 2014, have been estimated at £1.9bn.
  •  20% from service redesign and change – e.g. moving services from secondary to primary care
  •  40% from savings through the tariff in the acute sector, such as efficiencies in hospitals.

A set of 12 national QIPP work streams covering areas from medicines use to emergency care were also set up to support NHS staff and organisations in achieving the required savings. The work streams, which sit within the Department of Health, are led by NHS managers and clinicians who are tasked with developing initiatives to drive efficiency and quality, as well as assisting local NHS organisations to implement these initiatives. Their remits, which are constantly evolving, are decided independently by each work stream lead. However, the overall strategic direction is underpinned by the NHS Operating Framework.

The relevant workstreams to diabetes include; ‘Long-term conditions’, aimed at improving the quality of services so patients can manage their conditions more frequently; ‘Right Care’, which looks to increase the value of NHS resources and reduce variations in outcomes; and ‘Medicines Use’, which provides guidance and support on the efficient use of medicines.

It is predicted that the NHS will need to achieve a 4% increase in productivity year on year until 2015 if the Nicholson Challenge is to be achieved; this would be a remarkable increase considering NHS productivity fell by 0.3% every year between 1995 and 2008.

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Editor's note: This article has been generated from information provided by Sanofi Diabetes. Please also note that the article is not regularly monitored and may become less accurate over time as things evolve. Please see this section for the latest news on NHS, reforms etc.

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