Appointed Turnaround Director and Interim CEO working alongside a Kingsgate led PMO team
The Trust served a population of 258,000 and had undergone very little change over a number of years. The Trust had however suffered from a high turnover of CEOs
The Trust operated from its original 1960’s building site and had built a new wing in 2006, the layout of which has caused operational issues in the Emergency Department
The Trust had one of the highest outpatient clinic cancellation rates in the NHS (32%) and a high average length of stay
In 2010/11, the Trust delivered only 63% of its planned cost improvement programme and missed its A&E four-hour wait, 18-week to treatment and 6-week diagnostic targets – all key performance measures
In 2011, the Trust published its financial accounts highlighting the need to find £17m of efficiencies in the following year, almost all of which had to be delivered in less than one year. These in-year savings were in addition to the further year on year savings highlighted in the cost improvement plan of £12m in 12/13 and £10m in 13/14 and the lack of any future development plans for the Trust
Key issues and requirements
One of the crucial factors in the Trust’s turnaround was the need to drive through the change in an extremely short period of time.
Many of the financial targets could only be achieved with a change in the way the Trust operated.
The first action was to establish a broader Transformation Plan supported by a structured communications strategy.
The Cost Improvement Plan (CIP) was key to the Transformation Plan. It detailed the key actions the Trust needed to deliver to complete the initial turnaround in the first twelve months.
Delivery & Moving towards Sustainability
Phase I – Stabilisation
Reviewing the skillset of the Chairman, entire Trust Board and senior management team
Improving the delivery of clinical care, meeting key targets and realising related efficiencies
Planning for £17m efficiencies, with £13m delivered within 12 months
Phasing bed reductions, reduced length of stay and 500 outpatient clinics across the Trust
Reducing elective activity
Improving the efficiency of the Operating Theatres Department, which suffered 9% cancelled lists
Maximising savings in non-clinical staff spend, including medical secretary restructure
Putting in place controls for long-term reductions in bank and agency staff spend at the Trust
Phase 2 – Moving towards sustainability
Renegotiating aspects of the commissioners’ contracts not reflecting expected or actual activity
Repatriating business and realisation of unattributed activity and renegotiating supplier contracts
Developing a five-year clinical strategic, building on the Transformation Plan to ensure a robust future for the Trust, including achieving Foundation Trust status by 2014
Improving staff morale and engagement across the Trust
Results and achievements
Achieved the largest cost improvement programme in the East of England NHS and one of the largest in the country
Achieved a financial surplus
Established a new Executive Team in place with the skills to take the organisation forward
The Trust implemented a permanent clinically led quality impact assessment process to ensure quality of care was maintained
Serious Untoward Incidents across the Trust fell
The Trust reduced 500 outpatient clinics run by the Trust annually
Increased discharges from increased from 116 per week to an average of 129; the average length of stay reduced in pilot wards
Over the year, the Trust permanently reduced 66 inpatient beds
A new Ambulatory Care Service was launched, helping over 12,000 patients avoid being admitted
Over £500,000 was realised having renegotiated contracts with commissioners through the year
Over £600,000 was realised from repatriated business and unattributed activity
We are a turnaround, transformation and transition business working in challenged or failing organisations. We understand how to improve results in difficult environments. We both design and deliver solutions in all stages of turnaround and challenged situations.