The report found delayed discharge was a major contributor to a 11% fall in productivity since the pandemic.
'About half' the drop in productivity is attributed to 'outside the NHS's control — industrial action, social care, rising [sickness] of patients', with strikes alone accounting for a third of the drop in output.
The review found around a further third of the drop in productivity was due to statistics not capturing improvements such as sending patients home on the same day.
While the workforce has increased the report notes this is being driven by a rise in inexperience staff noting post pandemic turnover in experienced leadership and management.
The internal review outlines a number of steps being taken to improve productivity, including a focus on health rather than illness by investing in preventative care, keeping people independent for longer and caring for them as close to home as possible, investing in IT systems and the modernisation of NHS facilities to reduce disruption.
Taken together these actions are designed to meet the commitments made in the Spring Budget to increase NHS productivity growth to an average of 1.9% from 2025-26 to 2029-30, rising to 2% over the final two years.
Dr Layla McCay, director of policy at the NHS Confederation, noted hospital productivity was 5.8% higher than in 2022/23 and agency use was down by 13%, adding: 'Clearly the NHS has further progress to make and health leaders are fully committed to that. However, this will forever be a challenge if the government does not wake up to the scale of the population's health problems and the capital investment that is desperately needed to truly modernise and transform what the health service can offer its patients.'
Dr McCay called on the next Government to 'put the NHS on a more sustainable footing, including by increasing capital spending to at least £14.1bn annually and to commit to fund and deliver the NHS Long Term Workforce Plan, alongside an equivalent plan for social care'.