The NHS 10‑year plan challenges Trusts to do what is seemingly impossible: deliver more care, reduce waiting lists, and boost productivity year after year, all while operating with the same constrained budgets and the same overstretched workforce. Expectations keep rising, but the resources to meet them do not. For many organisations, the gap between what is demanded and what feels achievable has never felt wider.
And yet, one fact keeps resurfacing: NHS productivity still hasn’t returned to pre‑COVID levels. The system once operated more efficiently than it does today. That means the capacity is there - or at least, it was. Somewhere within current pathways lies recoverable potential: unwarranted variation, longer‑than‑necessary stays, outdated routines, or bottlenecks that used to be manageable and could be again.
But here is the paradox every operational leader recognises: if everyone is already working flat out, where is this hidden productivity supposed to come from? Teams feel stretched, wards feel full, and service lines feel like they are permanently in “winter mode.” Working harder isn’t an option. Working with less certainly isn’t either.
So perhaps the answer isn’t about pushing harder, but about seeing more clearly.
When Trusts work with integrated planning and accurate costing, care becomes measurable, consistent and comparable. Pathways that feel unique suddenly fit into wider patterns. Variation that was invisible becomes quantifiable. And with benchmarking, organisations can finally see where performance diverges from peers and what closing that gap might unlock.
That is where one of our recent exercises began. Using LOGEX’s integrated costing and benchmarking capabilities, a Trust asked us a straightforward question: “Where could we find more capacity without working harder or spending more?” Benchmarking revealed the answer. Among their most resource‑intensive pathways, elective hip surgery showed a clear, measurable variation in length of stay compared with best‑performing peers - variation large enough to translate into thousands of bed days.
When we modelled what closing that gap would mean, the result was striking: around 15,000 bed days per year, equivalent to 40 beds per night.
The case study below walks through how that opportunity was identified, validated and translated into a practical improvement plan and why this approach can be replicated across many other high‑impact pathways.
About our customer's challenge
The Trust had been searching for realistic ways to increase capacity, but like many organisations, they struggled to pinpoint where meaningful improvement could come from. They were already operating with tight resources and had little room to “work harder.”
What they did have, however, was a strong analytical foundation: integrated costing and planning tools that provided consistent, comparable data. This meant benchmarking could be applied effectively as a practical way to uncover variation that was genuinely actionable.
About our process
Using the Trust’s activity and costing data, we analysed the ten HRG groups with the greatest variation relative to peer performance. These top‑ten areas usually reveal the clearest operational gains.
Within this set, elective hip surgery emerged as a standout candidate:
- High‑volume
- Resource‑intensive
- fully plannable
- and showing a significant difference in length of stay
We then examined where in the pathway this variation occurred and modelled what reducing it would mean for beds, activity and overall pathway performance. Because the Trust already worked with integrated planning, this insight could be directly linked to operational feasibility, including workforce capacity and the knock‑on financial implications.
About the impact
The LOGEX professional benchmark revealed that, across the top ten HRG groups with the greatest difference from peer performance, there was potential to free up as many as 15,000 bed days annually, equivalent to roughly 40 beds per day.
Crucially, the impact goes beyond raw capacity. Bringing workforce and finance into the analysis revealed how this improvement would play out in practice:
- Workforce:
Shorter, more predictable stays reduce day‑to‑day pressure on wards. This creates room for staff to focus on planned activity instead of firefighting flow issues. It also helps Trusts rely less on temporary staffing because beds become available more consistently.
- Finance:
Treating more patients with existing resources improves cost effectiveness per case. Because the estate and core workforce are already funded, any gain in throughput translates into better productivity without additional budget.
- Operational outcomes:
More available beds mean more elective activity, shorter waits and better flow through the organisation — all achieved within the Trust’s existing footprint.
In other words: this isn’t only about efficiency, but about creating genuinely deliverable capacity that strengthens the entire pathway.
After understanding the impact of this fairly simple process, we should consider this: hip surgery is just one example. Similar variation exists in other resource‑intensive pathways such as knee replacements, spinal procedures, abdominal surgery and cardiology interventions.
Imagine if every Trust carried out the same benchmarking exercise across their top ten high‑variation procedures. How much capacity could be made available nationally? How quickly could waiting lists shrink if every Trust found even one pathway with a 5–10‑bed‑per‑day opportunity?
The potential is far larger than one pathway, one Trust or one case study. This is about a method. One that can be repeated, scaled and embedded into the heart of NHS productivity recovery.
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