The NHS must increase productivity by 6% every year if it is to make projected efficiency savings of £21 billion by 2014. At the same time, it is expected to maintain or improve the quality of care. We know staff costs make up 60% of the NHS budget, so it is likely that both the number and composition of the 1.7 million-strong workforces will need to change in order to meet these targets. We argue that while substituting registered nurses with healthcare assistants (HCAs) is desirable in terms of financial benefits, there is not enough research evidence to identify the impact of changes or maximisation in skill mix upon efficiency (represented by the number of NHS cases treated) and the quality of care experienced by service users.

The NHS must increase productivity by 6% per annum if it is to make projected efficiency savings of £21 billion by 2014. At the same time, it is expected to maintain or improve the quality of care. Given that staff costs are 60% of the current NHS budget, it is likely that both the number and composition of the 1.7 million strong workforces will need to be changed to meet these targets. Healthcare management will be greatly affected by these changes. We argue that skill maximisation (e.g. increasing the responsibilities of healthcare practitioners) is the key to increasing productivity and care quality. We argue that to increase output (represented by volumes of cases treated) and quality of care is not just necessary, but essential. We therefore argue that the key to addressing the future of healthcare is the maximisation of the use of human resource.