Authority #8

NHS Hospital

9 Areas of Improvement

10 months Intervention

1. Theatre Utilisation

Various project elements were addressed during this engagement. 

Throughout the project SSD also assisted with Clinical Engagement, Medicines Management and Outpatient work-streams.
To improve theatre utilisation in the booking and management of theatre lists. 
Created a Theatre Dashboard using extracted data from EPR [Electronic Patient Records] system to work out a percentage of utilisation giving them information unknown for over 2 years. Utilisation measured at 89% against a target of 95% leading to increased operations per list therefore increased income.
Endoscopy productivity:  Full review of the endoscopy service including bookings, IT linkages and patient pathway (including mapping).
Workforce Review: Baseline information gathered against similar NHS trust against number of theatres and staff including banding to discover workforce over banded and heavy of WTE’s [Whole Time Equivalents].
Theatre cost per operation: 
 Review high cost operations including gathering data regarding costs of: stock, consultant, nursing, cleaning, length of stay, etc. to calculate cost per operation on average against income for the operation. Examples for Orthopaedic operations showed a £2k loss per operation believed to be due to cost of stock and loaning of equipment. -

2. Community / Length of stay
Objective: To close one ward by end of financial year
Created Length of Stay [LOS] Dashboard to show patient numbers of admittance and LOS averages to show how the trust (and divisions within the trust) was performing against previous years and track progress of LOS. 
Process mapped various pathways of how to prevent admission in to hospital using GP case management plans to guide correct level of care required and if that could be completed in the community    

3. Agency / Bank Costs
Deep dive on costs of agency staff:  Created cost information regarding: agency and bank staff (usually nurses or interims) to show which directorates have the highest spend, graphed by quarter against previous years.

4. HR
Create E-Rostering Business Case to improve staff rosters: Collected data of current ward areas, staffing numbers, etc. establishing potential savings of implementing E-Rostering system with investment payback period. Projected saving of £1.6M per annum     

5. Finance
Financial reporting of entire programme:  Created reporting document to automatically update on a monthly basis demonstrating progress of the programme to transformation steering executive board

6. Medical Efficiencies
Reduce Consultant PA’s [Planned Activities]:  Created Consultant PA Dashboard to break down consultant job plans by their Planned Activities to inform which areas were over cost.

7. Estates
Reduce number of buildings used/rented:  Merged various data into one system to geographically map the buildings that the trust has staff based in and/or use establishing costs per site by area used. Several buildings to be closed and sold, improved usage for hot-desking within retained buildings, better linking with social care and health practioners.

8. AHP's
Workforce Review: Build portfolios of all Allied Healthcare Professional [AHP’s] to be able to gather all data into one system; to then baseline against a similar NHS trust finding which areas has over banding or heavy of WTE’s.
Set up and running of consultation meetings with various Heads of Service to determine new workforce levels

9. Maternity
Review Ante Natal income:  Review of patient number by collating data from various systems in the trust and the community to discover under recovery of fee due on the maternity tariff. Shortfall of £216k in the first 6 months.