Max Warner
@maxwarner.bsky.social
Economist at the IFS working on health and social care, public spending and public sector productivity https://ifs.org.uk/people/max-warner
Reposted by Max Warner
There's now data out about the resident doctor strikes last month
So how disruptive did they end up being? And what can we say about how the NHS is responding to ongoing strikes?
Short 🧵👇
So how disruptive did they end up being? And what can we say about how the NHS is responding to ongoing strikes?
Short 🧵👇
January 9, 2026 at 11:35 AM
There's now data out about the resident doctor strikes last month
So how disruptive did they end up being? And what can we say about how the NHS is responding to ongoing strikes?
Short 🧵👇
So how disruptive did they end up being? And what can we say about how the NHS is responding to ongoing strikes?
Short 🧵👇
Reposted by Max Warner
This is important as last month's OBR forecast (no monthly breakdown of this yet) expects a big increase in receipts by 2029/30 from higher inflation, boosting the public finances.
That may materialise, but it’s concerning that it hasn’t yet - one watch out for in the new year
That may materialise, but it’s concerning that it hasn’t yet - one watch out for in the new year
December 19, 2025 at 2:39 PM
This is important as last month's OBR forecast (no monthly breakdown of this yet) expects a big increase in receipts by 2029/30 from higher inflation, boosting the public finances.
That may materialise, but it’s concerning that it hasn’t yet - one watch out for in the new year
That may materialise, but it’s concerning that it hasn’t yet - one watch out for in the new year
Reposted by Max Warner
New ONS public finance data today shows central government revenues are still lagging significantly below March expectations.
Given inflation has been higher than forecast, this is surprising - even VAT receipts, which one might expect to rise with inflation, are below forecast
Given inflation has been higher than forecast, this is surprising - even VAT receipts, which one might expect to rise with inflation, are below forecast
December 19, 2025 at 2:39 PM
New ONS public finance data today shows central government revenues are still lagging significantly below March expectations.
Given inflation has been higher than forecast, this is surprising - even VAT receipts, which one might expect to rise with inflation, are below forecast
Given inflation has been higher than forecast, this is surprising - even VAT receipts, which one might expect to rise with inflation, are below forecast
Reposted by Max Warner
A short seven years (!) after I started writing the code, it’s great to see this paper published.
We use high-frequency NHS to data show that short-staffed, less experienced nursing teams deliver worse outcomes – with the largest mortality impacts for patients with sepsis.
We use high-frequency NHS to data show that short-staffed, less experienced nursing teams deliver worse outcomes – with the largest mortality impacts for patients with sepsis.
December 18, 2025 at 9:52 AM
A short seven years (!) after I started writing the code, it’s great to see this paper published.
We use high-frequency NHS to data show that short-staffed, less experienced nursing teams deliver worse outcomes – with the largest mortality impacts for patients with sepsis.
We use high-frequency NHS to data show that short-staffed, less experienced nursing teams deliver worse outcomes – with the largest mortality impacts for patients with sepsis.
Reposted by Max Warner
NEW: How did the introduction of the Ultra-Low Emissions Zone (ULEZ) change London’s geography of work?
In a new @theifs.bsky.social paper, @joelkariel.bsky.social, Fizza Jabbar and I have taken a look – and it turns out people adapt in surprising ways. A thread.
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In a new @theifs.bsky.social paper, @joelkariel.bsky.social, Fizza Jabbar and I have taken a look – and it turns out people adapt in surprising ways. A thread.
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December 17, 2025 at 5:22 PM
NEW: How did the introduction of the Ultra-Low Emissions Zone (ULEZ) change London’s geography of work?
In a new @theifs.bsky.social paper, @joelkariel.bsky.social, Fizza Jabbar and I have taken a look – and it turns out people adapt in surprising ways. A thread.
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In a new @theifs.bsky.social paper, @joelkariel.bsky.social, Fizza Jabbar and I have taken a look – and it turns out people adapt in surprising ways. A thread.
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What's going on? Could productivity in individual trusts really be bouncing around so much? Definitely raises questions about how informative this measure is - we've always found it surprising how high and low some of the changes are
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December 15, 2025 at 5:48 PM
What's going on? Could productivity in individual trusts really be bouncing around so much? Definitely raises questions about how informative this measure is - we've always found it surprising how high and low some of the changes are
[2/2]
[2/2]
NHS England has now produced two sets of productivity growth rates for each NHS acute trust. These are year-on-year growth rates, only 3 months apart (so have a 9 month overlap). But what's striking is that they are essentially uncorrelated!?
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[1/2]
December 15, 2025 at 5:48 PM
NHS England has now produced two sets of productivity growth rates for each NHS acute trust. These are year-on-year growth rates, only 3 months apart (so have a 9 month overlap). But what's striking is that they are essentially uncorrelated!?
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Yes I think that's very fair. The government used to make a defence price index, but stopped publication a number of years ago.
December 12, 2025 at 3:26 PM
Yes I think that's very fair. The government used to make a defence price index, but stopped publication a number of years ago.
I think another nuance here is that we often talk about defence spending in terms of % of GDP. That makes sense for some types of questions. But (real) GDP is also much higher, so in real-terms we already spend lots more on defence - and that's probably closer to what matters for capabilities
December 12, 2025 at 3:20 PM
I think another nuance here is that we often talk about defence spending in terms of % of GDP. That makes sense for some types of questions. But (real) GDP is also much higher, so in real-terms we already spend lots more on defence - and that's probably closer to what matters for capabilities
We made that exact chart for our recent IFS Green Budget chapter on defence spending
(ifs.org.uk/publications...)
(ifs.org.uk/publications...)
December 12, 2025 at 3:17 PM
We made that exact chart for our recent IFS Green Budget chapter on defence spending
(ifs.org.uk/publications...)
(ifs.org.uk/publications...)
Hospitals currently have a lot more people admitted with flu than at the same time in recent years. It remains to be seen how the peak will compare to previous years. (Half the IFS healthcare team are also currently laid low with it...)
www.bbc.co.uk/news/live/c6...
www.bbc.co.uk/news/live/c6...
December 11, 2025 at 11:06 AM
Hospitals currently have a lot more people admitted with flu than at the same time in recent years. It remains to be seen how the peak will compare to previous years. (Half the IFS healthcare team are also currently laid low with it...)
www.bbc.co.uk/news/live/c6...
www.bbc.co.uk/news/live/c6...
It also matters for how we think about productivity. The NHS is rightly focused on delivering hospital activity more productively, but it should also ensure that the right activity is being delivered for patients to complete their pathways, rather than simply more activity.
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December 9, 2025 at 8:41 AM
It also matters for how we think about productivity. The NHS is rightly focused on delivering hospital activity more productively, but it should also ensure that the right activity is being delivered for patients to complete their pathways, rather than simply more activity.
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Ultimately, this matters for two reasons. First, for a govt focused on elective waits, it is clearly a concern that increases in hospital productivity and elective activity are not corresponding to equivalent falls in waits. More is needed to understand what is driving this.
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December 9, 2025 at 8:41 AM
Ultimately, this matters for two reasons. First, for a govt focused on elective waits, it is clearly a concern that increases in hospital productivity and elective activity are not corresponding to equivalent falls in waits. More is needed to understand what is driving this.
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On the other hand, hospitals faced strong incentives to increase activity and productivity in this period, which could be driving this pattern. But other policy efforts, like patient-initiated follow-up appointments (PIFU) pushed in the opposite direction.
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December 9, 2025 at 8:41 AM
On the other hand, hospitals faced strong incentives to increase activity and productivity in this period, which could be driving this pattern. But other policy efforts, like patient-initiated follow-up appointments (PIFU) pushed in the opposite direction.
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This growth in the amount of activity happening before a patient leaves the waiting list is not obviously driven by patients being more complex to treat, but that could play a role. It could also be hospitals are delivering better quality treatment.
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December 9, 2025 at 8:41 AM
This growth in the amount of activity happening before a patient leaves the waiting list is not obviously driven by patients being more complex to treat, but that could play a role. It could also be hospitals are delivering better quality treatment.
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It’s not clear why patients are receiving more hospital activity before they leave the waiting list than the year before. This divergence hasn’t been so large in recent years before 2024–25, and we see it happening for almost all medical specialties.
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December 9, 2025 at 8:41 AM
It’s not clear why patients are receiving more hospital activity before they leave the waiting list than the year before. This divergence hasn’t been so large in recent years before 2024–25, and we see it happening for almost all medical specialties.
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For example, the number of outpatient appts grew by 9% in 2024–25 yet the number of patients leaving the waiting list only grew by 4%. This is a big deal: if the number leaving the waiting list had grown at the same rate, the waiting list would be ~1 million lower by now.
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December 9, 2025 at 8:41 AM
For example, the number of outpatient appts grew by 9% in 2024–25 yet the number of patients leaving the waiting list only grew by 4%. This is a big deal: if the number leaving the waiting list had grown at the same rate, the waiting list would be ~1 million lower by now.
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It also isn’t the case that lots of patients are joining the waiting list, counteracting increases in activity. Demand growth remains muted. Instead increases in elective activity have failed to translate into similarly large increases in patients leaving the waiting list.
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December 9, 2025 at 8:41 AM
It also isn’t the case that lots of patients are joining the waiting list, counteracting increases in activity. Demand growth remains muted. Instead increases in elective activity have failed to translate into similarly large increases in patients leaving the waiting list.
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So what explains this difference? We can quickly rule a few factors out. Productivity hasn’t come from squeezing hospital resources, nor has it all gone to increasing emergency activity. Hospitals delivered a lot more elective activity in 2024–25 than in 2023–24.
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December 9, 2025 at 8:41 AM
So what explains this difference? We can quickly rule a few factors out. Productivity hasn’t come from squeezing hospital resources, nor has it all gone to increasing emergency activity. Hospitals delivered a lot more elective activity in 2024–25 than in 2023–24.
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This divergence between productivity growth and waiting list performance is visible at the trust level too. Lots of hospitals have seen productivity growth in 2024–25, for example, without a corresponding improvement in waiting times.
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December 9, 2025 at 8:41 AM
This divergence between productivity growth and waiting list performance is visible at the trust level too. Lots of hospitals have seen productivity growth in 2024–25, for example, without a corresponding improvement in waiting times.
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3/11
NHS England figures suggest that productivity grew by 2.7% in 2024–25. But the waiting list fell from 7.5 million to just 7.4 million between Mar 2024 and Mar 2025, and the % of patients waiting <18wks increased from 57.2% to 59.8%. This is not stellar progress.
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December 9, 2025 at 8:41 AM
NHS England figures suggest that productivity grew by 2.7% in 2024–25. But the waiting list fell from 7.5 million to just 7.4 million between Mar 2024 and Mar 2025, and the % of patients waiting <18wks increased from 57.2% to 59.8%. This is not stellar progress.
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NEW: Hospital productivity growth is beating the government’s targets. So why hasn't the NHS made more progress on cutting elective waiting times?
In a new @theifs.bsky.social comment, we examine what’s driving the divergence between two of the government’s biggest NHS priorities.
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In a new @theifs.bsky.social comment, we examine what’s driving the divergence between two of the government’s biggest NHS priorities.
1/11
NEW: Strong productivity growth and increasing funding has meant English hospitals have been delivering much more elective (pre-planned) care.
So why isn't the waiting list going down more quickly?
🧵 @maxwarner.bsky.social and Olly Harvey-Rich examine what's going on:
So why isn't the waiting list going down more quickly?
🧵 @maxwarner.bsky.social and Olly Harvey-Rich examine what's going on:
December 9, 2025 at 8:41 AM
NEW: Hospital productivity growth is beating the government’s targets. So why hasn't the NHS made more progress on cutting elective waiting times?
In a new @theifs.bsky.social comment, we examine what’s driving the divergence between two of the government’s biggest NHS priorities.
1/11
In a new @theifs.bsky.social comment, we examine what’s driving the divergence between two of the government’s biggest NHS priorities.
1/11
Would you like to lead our @theifs.bsky.social work on healthcare? We are looking to recruit an outstanding economist to become an Associate Director and lead a programme of economic research on health and/or healthcare. Job advert here: app.beapplied.com/apply/jfzr0z...
Associate Director (Health/Healthcare)
Background to the role The Institute for Fiscal Studies (IFS) is Europe’s leading centre for research on the microeconomics of public policy. It is a politically independent registered educational c...
app.beapplied.com
December 8, 2025 at 9:10 AM
Would you like to lead our @theifs.bsky.social work on healthcare? We are looking to recruit an outstanding economist to become an Associate Director and lead a programme of economic research on health and/or healthcare. Job advert here: app.beapplied.com/apply/jfzr0z...