A new report from Apogee has found that everyday workplace frictions across NHS organizations are quietly eroding frontline capacity, costing the system more than 35 million staff hours each year.
The report, derived from disclosure responses from across England’s NHS trusts, found that these lost hours translate into more than £1 billion of unrealized productivity, enough to fund roughly 20,000 full-time NHS roles or more than 40 million patient appointments.
“We often talk about the productivity of the NHS in terms of large-scale transformation programs, but our research shows that a significant amount of time is still wasted in small, everyday moments of friction that occur thousands of times a day.”
Apogee CEO James Clark said: said.
The loss is not due to a lack of digital tools, but is rooted in how legacy systems sit alongside paper-based habits and fragmented workflows. The “Time Back. Care Forward” report frames this problem as one of friction, the minor interruptions employees experience thousands of times a day, and argues that solving these problems can free up time that otherwise would otherwise be locked up in care.
Problems arising from daily friction
The key point of the study was that NHS staff spend an average of eight minutes a day commuting to work, transferring information and communicating with patients.
That’s roughly 35 hours per person over the course of a year, which is equivalent to almost a week of work. When scaled up to the entire workforce, this increases to more than the 35 million hours cited in the report.
The first point of friction, “Employee Starts Work,” captures the time lost at the start of a shift until the employee logs in and accesses their device.
On average, employees wait more than 80 seconds to reach an available desktop, with some delays extending to six minutes or more. Throughout all of this, one patient is identified. Multiply this by thousands of login events each day, and even though each individual delay may feel insignificant, the cumulative impact on capacity becomes clear.
The second area, ‘information mobility’, reveals that digitalization has not always meant simplification. Despite the advent of electronic systems, many trusts still print more than 1.1 billion pages annually, effectively copying paper workflows into PDF format and creating redundant steps, duplication and added administrative load. This hybrid approach fragments information movement and forces employees to switch between digital and physical media, often within the same job.
The third point of friction, ‘patient contact’, focuses on communication gaps. The report estimates that about 5 million appointments are missed each year, without detailing how many are related to poor communication, missed reminders or unclear instructions.
At the same time, Apogee’s analysis shows that many trusts lack telemetry capabilities to measure how long key processes take, making it difficult to pinpoint where delays are occurring and which interventions have the greatest impact.
How this affects NHS staff
The findings were stark when compared to NHS England’s Frontline Digitization Programme, which aims to transform services from paper-based analog processes to a fully digital, interoperable foundation. The program is a multi-billion pound effort to deploy or upgrade electronic patient records (EPRs) and ensure trusts reach a basic level of digital capability.
However, the Apogee report suggests that digitizing records alone does not automatically create smoother workflows or better employee experiences.
In fact, digital-first investments can improve at least one element of the employee experience: document retrieval. Employees can quickly access electronic records. But if logging in, moving attachments, tracking signatures, or coordinating with colleagues across multiple channels is still slow and clunky, the overall efficiency gains are limited.
“What’s surprising is that this isn’t due to a lack of technology. In most cases, the systems are already in place, but they don’t work together effectively,” Clark said.
“Organizations have digitized their processes, but they haven’t always simplified them. Paper has become PDF, but fundamental inefficiencies remain.”
What this study highlights is that technology-led innovation must be combined with process-led redesign. Otherwise, improvements will be localized and not systematic.
Moreover, the “productivity gap” created by small frictions undermines the case for the 2% productivity target in the 10-year health plan. Policymakers are increasingly looking to digital tools and AI-based automation to reclaim time and offset staffing shortages, but these benefits may be partially offset if avoidable delays continue to bottleneck underlying workflows.
For trusts that are already under pressure, this means that even a successful EPR rollout may not translate into measurable improvements on the shop floor unless login friction, document processing and communication paths are redesigned around clinical workflows.
From an employee experience perspective, the report hints at broader implications for burnout and morale. When clinicians spend meaningful portions of their shifts wrestling with broken or fragmented systems, they are unable to focus on direct care. This can reduce job satisfaction and reinforce the perception that digitalization is just another layer of bureaucracy rather than a true enabler.
From friction to frontline capabilities
Apogee’s research shows that the problem isn’t always about the technology, but how employees experience it.
The report argues that reclaiming treatment time depends less on procuring new systems and more on optimizing the way existing devices, information and communication channels are connected, allowing staff to move seamlessly from one task to the next.
One of the key messages of the report is that reducing friction even slightly can lead to significant returns. It is estimated that reducing routine delays by just 25% would save around £250 million in staff time each year, effectively creating a partial “virtual workforce” without the need to recruit or train additional staff.
For systems under increasing pressure, thousands of small process improvements can lead to measurable improvements in frontline capabilities.