Open medication-change loops
Unresolved cross-setting discrepancies, time-to-reconcile, acknowledgements and confirmed closure.
Measurement dashboard
Three products. Three outcome families. No false aggregation.
Sitora keeps medication reconciliation, avoided supply and released capacity separate so a closed loop is not mistaken for a cash saving and a modelled opportunity is not mistaken for verified recovery.
Product outcomes
What a live pilot dashboard would measure.
Avoidable supply
Signals reviewed, supplies deferred, dispensing outcome, intervention workload and verified cost avoidance.
Reusable capacity
Observed pharmacy/nursing time, chair/bed capacity, unused dose change and validated financial effect.
Rule
Observed exposure
A measured activity, cost or capacity signal. It is not automatically waste.Rule
Plausibly recoverable
The component supported by modelling, operational evidence or a tested intervention.Rule
Verified recovery
Resource actually recovered after an intervention, with a defined counterfactual and safety checks.Wider national research
Supporting signals remain visible, but outside the product outcome totals.
Discharge, bed days, appointments and other domains are retained as research evidence and future expansion opportunities.
Missed elective appointments
Observed8mmissed elective appointments in 2023/24
Opportunity~£1.2bnhistoric NHS England annual cost estimate for outpatient DNAs
Verified377DNAs avoided in a six-month AI pilot
Interpretation and source
This is one of the clearest examples where an observed loss, a quantified financial exposure and a tested intervention already exist.
Source: NHS England, elective care reform and AI DNA pilots ↗Missed GP appointments
Observed16mGP appointments not attended in 2025
OpportunityUnknownrecoverable component still needs local causality and backfill data
VerifiedNot yet nationalnational verified recovery not yet established
Interpretation and source
The scale is measured, but a credible recoverable-value estimate requires practice-level causes, notice periods and whether appointments could actually have been backfilled.
Source: NHS England, Tap the NHS App ↗Delayed discharge
Observed~30,000patients a year staying at least 21 days beyond discharge-ready date
Opportunity500,000bed days NHS England says could potentially be released annually
VerifiedTo verify locallymust be measured as actual bed days released after intervention
Interpretation and source
The national opportunity is significant, but the dashboard keeps modelled releasable bed days separate from verified capacity actually recovered.
Source: NHS England, Urgent and emergency care plan 2025/26 ↗Aseptic and injectable medicines
Observed£3.8bninjectable medicines pathway scale identified in national review
Opportunity>4,000 WTE / >1m bed daysmodelled nursing-capacity and bed-day opportunity
VerifiedTo verify by pathwayactual released nursing time, aseptic capacity and bed days must be measured locally
Interpretation and source
This domain shows why the dashboard cannot collapse everything into pounds: the valuable resource may be nursing time, cleanroom capacity or beds rather than cash alone.
Source: DHSC, Transforming NHS pharmacy aseptic services in England ↗Agency staffing
Observed£1.2bnagency spend in 2025/26
OpportunityImprovingfurther recoverability depends on safe substitution and vacancy causes
Verified~£0.9bn lower YoYobserved reduction versus about £2.1bn in 2024/25, not attributed here to one intervention
Interpretation and source
The register distinguishes observed improvement from causal proof. A lower national spend is real, but it should not be claimed as Sitora-style verified recovery without intervention-level attribution.
Source: NHS England, Month 12 financial position 2025/26 ↗Repeat medicines
Observed67.8mrepeat prescriptions ordered through the NHS App in 12 months to Nov 2025
Opportunity~£300m historic benchmarkhistoric unused-medicines estimate still cited by the NHS
VerifiedUnknown nationallycurrent national verified avoidable waste figure is missing
Interpretation and source
The gap is the story: ordering volume is current and measurable, but the national waste figure remains historic because stock-at-home, consumption and item-level avoidability are not continuously measured.
Source: NHS England medicines waste and NHS App reporting ↗A closed medication loop, an avoided prescription item and an hour of reusable capacity are all valuable. They are not the same outcome and should never be added together as one savings number.