Healthcare systems around the world are facing a common challenge: they’re running out of time.

In the UK, and across many other countries, an ageing population and increasing levels of multimorbidity are driving demand for healthcare at a pace that workforce growth simply cannot match. As services come under mounting pressure, digital health technologies are increasingly presented as part of the solution. From automating routine tasks to digitising workflows and shifting care into community settings, technology sits at the heart of the NHS 10-Year Health Plan and similar international strategies.

The underlying promise is compelling. If technology can save healthcare staff time, that time can be redirected towards delivering more care, improving quality and reducing pressure on an overstretched workforce. But this raises an important question that is often overlooked: what is saved time actually worth?

Following her recent presentation on this topic at HTAi 2026, YHEC Project Director Rachael MacDonald explores why the true value of time-saving health technologies is often miscalculated, and how we can build a more realistic approach.

The assumption behind most economic evaluations

Health economic evaluations have traditionally valued time savings using the concept of opportunity cost. In simple terms, every hour saved is assumed to be worth the value of the next-best activity a member of staff could perform. Typically, staff salaries (including oncosts and overheads) are used as a proxy for the opportunity cost.

While this provides a straightforward framework for analysis, it relies on the assumption that all released time will be redeployed productively.

For example, imagine a technology that costs £25,000 per year and automates administrative tasks, releasing 1,500 hours of nursing time annually. At an estimated nursing cost of £50 per hour, the value of those saved hours is calculated as £75,000. Under this conventional approach, the technology appears to generate a net annual saving of £50,000.

On paper, the investment looks unquestionably worthwhile. The challenge is that the calculation only holds if every one of those 1,500 hours is converted into ‘productive’ clinical activity.

When time savings don’t translate into savings

In reality, healthcare rarely works that neatly. If only a proportion of the released time can be used ‘productively’, the economic picture changes considerably.

In this example, the technology only remains cost saving if approximately one-third or more of the released time can be effectively redeployed. Below that threshold, the intervention shifts from generating savings to creating additional costs.

This example is only an illustration, and it is important to note that the relationship between redeployment of time and cost savings is unlikely to be linear or even monotonic. For example, it is possible that staff operating at 90% capacity could be more productive than those operating at 100% capacity.

This illustrates an important point: the relationship between time savings and cost savings is complex and the value of time savings depends not only on how much time is released, but also on whether that time can realistically be used in a meaningful way.

Not all time savings are equally useful

The scale and distribution of time savings matter just as much as the total number of hours saved.

Many digital technologies report modest time savings spread across large numbers of staff. Saving two minutes per nurse each day may sound impressive when aggregated across an organisation, but two isolated minutes are unlikely to allow a clinician to see another patient, complete a meaningful task or fundamentally change the way they work. However, even just 2 minutes of released time may have a meaningful impact on a person’s wellbeing and so this may still offer value.

By contrast, consolidating those same savings so that fewer clinicians gain an uninterrupted hour each day creates genuinely usable capacity. That hour can be spent seeing additional patients, completing complex documentation, supervising colleagues or undertaking quality improvement work.

In other words, a thousand small fragments of time are not necessarily equivalent to one continuous block of time. Yet conventional economic evaluations often treat them as though they are.

When discussing productivity within the NHS, it is common to see productivity equated to increased activity. It is easier to relate continuous blocks of time to increased throughput; for example, one hour saved per clinician could allow for one extra clinic to be provided. When time savings are fragmented, this argument becomes more challenging. However, just because the value of fragmented time savings on staff wellbeing cannot easily be quantified or monetised does not mean that those savings are necessarily less valuable.

How clinicians say they would use released time

Research from The Health Foundation highlights another important consideration: the value of released time depends on what clinicians are actually able to do with it. When clinicians are given just one additional hour, the most common priorities are direct patient care (27%), reducing overtime (17%), quality improvement (13%), administrative catch-up (10%), professional development (9%), taking a break (7%), training (7%) and research (4%).

Interestingly, the picture changes as more time becomes available. With three hours of released time, clinicians increasingly prioritise activities that are often difficult to fit into busy clinical schedules. Nearly half report they would focus on quality and service improvement (48%), while 46% would dedicate more time to direct patient care. Education and training also become more prominent, alongside continued reductions in overtime and time for administrative work.

These findings suggest that released time is not simply converted into more appointments. Instead, it supports a broader range of activities that strengthen healthcare delivery over the longer term.

Broadening the way we think about value

This raises a broader question for health technology assessment. Current evaluations often focus on whether a technology produces immediate financial savings. However, released clinical time frequently generates benefits that are valuable without appearing as cash savings on a balance sheet. For example, reducing overtime may improve staff retention, allowing clinicians to take appropriate breaks can reduce fatigue and cognitive burden, and creating time for quality improvement projects or training may improve patient outcomes long after the initial investment has been made.

These benefits are real, even if they are difficult to express as direct reductions in expenditure.

A more realistic approach to evaluating time-saving health technologies

As digital technologies become increasingly central to healthcare delivery, our methods for evaluating them also need to evolve.

Rather than relying on a single estimate of cost savings, evaluations should acknowledge that released time often creates capacity rather than saving money. They should:

1. Identify the level of productive redeployment required for a technology to become cost effective.
2. Consider whether the pattern of released time is practically usable and estimate how many additional patients can realistically be treated/seen.
3. Capture broader outcomes such as workflow improvements, staff wellbeing, reduced burnout and opportunities for service improvement, alongside traditional productivity measures.

Ultimately, time is one of healthcare’s most valuable resources, but its value cannot be captured by a simple multiplication of hours by salary costs. Understanding how time is released, how it is used, and who benefits from it is essential if we want to make informed decisions about investing in health technologies.

Moving beyond oversimplified assumptions will lead to more realistic economic evaluations and, ultimately, better decisions for both healthcare professionals and the patients they care for.

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