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Recently, it was National Productivity Week.1 NHS productivity has dominated public discourse in recent years—argued over by politicians, contested in think tanks and scrutinised in the press. Yet beyond the policy debate, the productivity drive shapes the daily work of thousands of NHS staff: the nurse covering two wards because a colleague's post lies vacant; the physiotherapist extending their shift to clear an inherited backlog; the community team redesigning care to see more patients in the same hours with fewer support staff.