The Health Foundation NHS Productivity Commission report Breaking the cycle: How to build a more productive NHS was published on 22 September 2026.

The report sets out how the NHS in England can improve productivity by making better use of its existing workforce, technology, infrastructure and resources. It concludes that long-standing barriers including short-term planning, fragmented accountability, insufficient investment in infrastructure and limited capacity to deliver change have constrained NHS productivity and patient care. 

The College submitted evidence to the Productivity Commission in December 2025 which highlighted 4 priority areas for improving productivity across pathology services and the wider NHS: 

• a national digital pathology strategy supported by central funding 
• improved interoperability of Laboratory Information Management Systems (LIMS) 
• diagnostic stewardship to reduce unnecessary testing and deliver higher-value care 
• dedicated workforce planning for pathology to address staffing shortages and service bottlenecks 

Several themes in the report align with those identified in the College evidence including:

Sustained investment in infrastructure and capital that supports frontline care: poor IT systems, ageing estates, limited diagnostic capacity and inadequate support services restrict the productivity of clinical staff.  

Strengthening diagnostic stewardship: opportunities exist to improve value within clinical pathways by reducing low-value activity, including unnecessary diagnostic testing. 

Digital transformation and interoperability: potential for technology, data and artificial intelligence to transform NHS productivity is recognised. However weak digital infrastructure, inconsistent data standards and poor interoperability continue to limit progress across the health service. 

Workforce planning: productivity growth requires a different mix of resources by investing in capital, as well as analytical, operational, management and digital capability. Investment to support existing front-line staff and addressing barriers to workforce wellbeing is also recognised.  

These are crucial for delivery of pathology services, modern laboratories and digital systems to support faster diagnosis, improved patient pathways and to enable more efficient use of workforce capacity.  

The College will continue to work with partners across the health system to strengthen pathology services and support a more productive NHS. Critical to this is evidence-based workforce planning for pathology that aligns staffing with demand, recognising that different specialties – and regions – will require different solutions and staffing based on current workforce capacity and infrastructure.  

Notes: 

The report's findings make a number of system-level recommendations largely aimed at the Department of Health and Social Care (DHSC) in England including:  

• Establishing a stable, 5-year planning and investment framework to align revenue funding, capital, workforce planning, digital investment and payment policy to replace reliance on short term funding pots and support long-term productivity growth  
• Establishing a national test-and-learn approach to identify, evaluate and scale models of care and emerging technologies, including capabilities to evaluate, adopt and spread AI at pace 
• Strengthening the role of NHS regions and giving greater freedom and responsibilities for improving NHS services and productivity locally 
• Strengthening data standards and mandating interoperability