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Case Study - East Sussex Healthcare NHS

Acute Healthcare

Turnaround and Transformation Project
(September 2014 to January 2015)


  • Two DGH site acute healthcare provider based in the South of England achieving revenues of £337m (in FY13/14).
  • Significant financial pressures and lack of joined up working practices/systems between the two main sites.
  • £27m deficit forecast in FY2013/14
  • Kingsgate team engaged to deliver 2013/14 position and plan for 2014/15.

Kingsgate’s Strategy – Financial Improvement/Turnaround

Phase 1:

  • Reviewed 2013/14 Trust CIP and financial gap to deliver Plan.
  • Developed run rate improvement plans to support improvement in the 2013/14 forecast outturn.
  • Improved controls, governance and accountability for the delivery of operational and financial plans.

Phase 2:

  • Supported the annual plan process, including CIP development for 2014/15.

Phase 3:

  • Supported the Trust to deliver the 2014/15 Plan and achieve the £18.5m deficit plan.
  • Provided dedicated support to process map the clinical administration functions to underpin process improvement.
  • Support the delivery of the 2015/16 annual plan, including CIP.

Job Planning:

  • Supported the Medical Director in assessing “as is” consultant job plans by specialty.
  • Worked with Medical Director, Clinical Unit Leads and General Managers to develop a ‘demand and capacity’ model for each specialty (and sub-speciality where appropriate).
  • Using the output from the demand and capacity modelling the Kingsgate team were able to make recommendations for the amendment of the “to be” job plans (for the Medical Director and Clinical Leads to lead on negotiations for 2015/16 job planning with individual consultants).

RTT target delivery:

  • Supported development of monitoring and reporting tool for RTT performance.
  • Supported improvements in RTT performance, with trajectories to deliver national targets.
  • Led reporting to TDA.

Estates and Facilities Support:

Phase 1:

  • Reviewed Trust performance against estates and facilities statutory and mandatory targets.
  • Reviewed EFM departmental structure and implement changes as appropriate.
  • Recommended and implemented actions to improve compliance.
  • Identified cost improvements for estates and facilities, informed by outsourcing reviews.
  • Supported the Trust in its discussions with the Department of Health team working on ‘Making Better Use of Government Resources’.

Phase 2: (starting April 2015)

  • Supported the Trust in ongoing development of the Estates Strategy.

Results and achievements

  • CIP of £20.4m achieved.
  • 2014/15 deficit of c.£15m achieved in line with Plan.
  • Robust financial plan/budgets for 2015/16 delivered and bought into by Clinical Services and the Trust Board.
  • Full CIP programme identified with actions and responsibilities for delivery for FY15/16
  • Accountability and review meeting framework established, now being led by Trust management.
  • Pipeline of opportunities worked up and provided to the Trust for taking forward.
  • Development of accountability framework to ensure meets needs of operational and finance needs whilst matching the organisational maturity to manage such a process.