In their financial plans for 2025-26, NHS trusts expected to spend £6.6 billion more than they had available. This spending deficit prompted a response from new NHS England chief executive Sir Jim Mackey who called for a “fundamental reset of the financial regime” to get a grip of the situation,[1] echoing the health secretary who previously declared that the “culture of routine overspending without consequence” was over.[2] As a result of these efforts, within weeks the projected deficit was cut from £6.6 billion to £2.5 billion,[3] a 62 per cent reduction.
This fall demonstrates two key points. First, that savings are possible when sufficient political will exists to demand them. And second, that despite this progress significant work remains to put the NHS on a genuinely sustainable financial footing. Achieving this is essential as the NHS faces growing demand for services and an ageing population, placing pressure on it at a time when the public finances are stretched. To ensure funds are directed towards healthcare delivery, it is crucial to explore targeted cost-saving strategies that enhance efficiency without compromising care quality.
Building on work previously done by the TaxPayers’ Alliance in 2022 which examined NHS estate data to identify efficiencies,[4] this note looks at four areas of potential savings for the NHS in England. These are electricity costs, missed appointments, postage costs and laundry costs.
Breaking down costs by NHS trust allows for comparative analysis between trusts, allowing lessons to be learnt from top performers to deliver more efficient practices. By addressing these areas, the NHS will be able to better use its resources, achieve significant financial savings and open new avenues for further cost savings in the future.
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[1] NHS England, Update on 2025/26 planning round, 6 March 2025, www.england.nhs.uk/long-read/update-on-2025-26-planning-round/, (accessed 3 April 2025).
[2] Department of Health & Social Care, Road to recovery: the government’s 2025 mandate to NHS England, 30 January 2025, www.gov.uk/government/publications/road-to-recovery-the-governments-2025-mandate-to-nhs-england/road-to-recovery-the-governments-2025-mandate-to-nhs-england, (accessed 3 April 2025).
[3] NHS England, Working together in 2025/26 to lay the foundations for reform, 1 April 2025, www.england.nhs.uk/long-read/working-together-in-2025-26-to-lay-the-foundations-for-reform/, (accessed 3 April 2025).
[4] Cook, S., An analysis of hospital estate spending in the English NHS, TaxPayers’ Alliance, 5 May 2022.