23 Sep 2026

A new report from the Health Foundation’s NHS Productivity Commission calls for a greater focus on outcomes and more effective use of data, to enable the NHS in England to “deliver high-quality patient care and remain on a sustainable footing.” As the organisation responsible for commissioning and managing the UK’s largest suite of national clinical audits and clinical outcome reviews, HQIP agrees. Our programmes, which are delivered on behalf of NHS England, the Welsh Government and others, are already providing much of the evidence needed to support this ambition. The report argues that productivity improvement must be “hardwired” into how the NHS in England operates. HQIP believes that systematic use of national clinical audit, registry and outcomes data should form part of that operating model.

To meet rising demand within its budget, [the NHS] cannot keep doing more of the same” Health Foundation NHS Productivity Commission report, 2026 

Breaking the cycle: how to build a more productive NHS stresses that “at its heart, productivity means achieving better health outcomes from the resources available”, stating that productivity shouldn’t be “viewed as a purely financial issue or through the narrow lens of technical efficiency”. Instead, the report is clear that “productivity is about creating a health system that consistently makes well-judged trade-offs to direct resources where they will have greatest impact on patient outcomes.”  

To achieve this, it argues that “systems, providers and boards should have more scope to use data to guide improvement”. This would put reliable healthcare data at the heart of productivity. The Commission highlights the NHS’s rich data as one of its major strengths, but identifies underinvestment in data, technology and improvement capability as a barrier to better performance. As such, it recommends stronger outcomes measurement, consistent recording of high-quality data and transparent reporting, as well as interoperable systems and greater analytical capacity at provider, system and regional levels.  

NHS provider organisations…should face stronger expectations to use data” Health Foundation NHS Productivity Commission report, 2026 

Clinical audits have an important contribution to make in the delivery of these recommendations. By measuring care against evidence-based standards, and comparing performance across organisations and populations, they show where resources are maximising outcomes and where variation, delays or gaps in care need to be addressed. National clinical audit and registry data (managed through HQIP’s programmes) should form a core part of the NHS’s approach to improving productivity, care and patient outcomes. They cover major pathways including cancer, mental health and maternity, and are developed with both clinicians and patients. HQIP’s CEO, Chris Gush explains: “They are an existing national asset for productivity, not an optional extra.” Although the report does not refer specifically to national clinical audit, its emphasis on outcomes measurement, benchmarking, high quality data and shared evaluation strongly reinforces this case, stating that the NHS’s “national data assets should make it one of the world’s leading environments for real-world evaluation.” 

Crucially, HQIP’s national programmes reduce the need for every organisation to build a new evidence base from scratch. Standardised data, national benchmarking, and established improvement resources help to avoid duplicated local analysis and repeated small-scale pilots. This supports the Commission’s call for shared learning, pooled expertise and reusable national infrastructure, rather than requiring individual organisations to solve common problems alone. 

In an era of tightening resources, data becomes a force multiplier, turning raw numbers into actionable insights” HQIP’s CEO, Chris Gush 

Of course, data will not improve productivity on its own. It must be translated into insights, combined with clinical leadership, and used to guide practical changes in care. Clinical audit provides the evidence needed to focus improvement where it will deliver the greatest benefit. It can reveal unwarranted variation, identify high-value practice, support safer and more efficient pathways, and show whether service redesign has achieved its intended results. Used well, it connects productivity with quality, ensuring that efficiencies are judged not by lower costs or higher activity, but by better outcomes and experiences for patients. 

The challenge now is to make systematic use of this data, that is already being collected by the NHS. Embedding national clinical audit and registry data within planning, commissioning and improvement will help healthcare providers to make more informed choices, use scarce resources more effectively, and spread successful practice faster. The Health Foundation’s report sets out the conditions for a more productive health service. HQIP’s programmes offer part of the practical infrastructure needed to deliver this; helping the NHS to turn data into insights, insights into action, and action into better care. Or, as HQIP’s CEO, Chris Gush, puts it: “In an era of tightening resources, data becomes a force multiplier, turning raw numbers into actionable insights.” This is not a call for more local data collection or reporting. It is a call to make better use of information already collected nationally, reduce duplication, and connect data more directly to decisions.

Read in full: Health Foundation NHS Productivity Commission report, Breaking the cycle, September 2026 

More about HQIP 

HQIP manages the UK’s largest suite of national clinical audits and clinical outcome reviews and hosts the National Joint Registry, the largest orthopaedic registry in the world, on behalf of NHS England, the Welsh Government and others.  

Resources from HQIP

• Reports with actionable recommendations and easy-to-use infographics
• Benchmarking tool, National Clinical Audit Benchmarking (NCAB) 
• BMJ Leader blog from HQIP: Audit, Registry and Outcomes Data: At the Heart of Strategic Commissioning 
• Article: Healthcare data – The key to improvement and efficiency by HQIP’s Chair, Dame Celia Ingham Clark 
• Article: Using data to maximise resources by HQIP’s CEO, Chris Gush
• Further improvement resources