An organisation-wide efficiency and cultural transformation for University Hospitals Coventry & Warwickshire NHS Trust

UHCW recognised the need to transform its culture and introduce new ways of working while delivering the highest quality of patient care through engaged and capable people.

UHCW were not only looking to make these improvements, but also to sustain the change and to introduce a culture of continuous improvement within the Trust. Due to our unique expertise and experience of building operational excellence within our own business and those of our NHS partners over many years, Unipart were enlisted to support the transformation.

The objectives of the programme were to:

Contribute to improvements in patient experience, through enhanced quality, safety and access

• Effectively engage the organisation for the shaping, communicating and adoption of programme delivery 
• Develop service transformation capability within senior and clinical teams, as well as within the Trust’s own internal Transformation Team 
• Optimise the efficiency, productivity and utilisation of resource and increase revenue, profitability and provide enduring financial stability 

A high level initial scoping activity was first conducted in order to deeply understand, and benchmark among peers, the underlying challenges and improvement opportunities within UHCW. This would involve an array of staff engagement approaches aimed at effectively targeting and engaging employees across clinical and non-clinical functions. These activities would also serve to identify, scope and validate a number of opportunities that existed for service improvements initiatives and prioritisation. The improvement opportunities identified covered themes such as patient flow, patient experience, cost reduction and revenue. This would span wards, pharmacy, catheter laboratories, procurement processes and clinical specialties. More specific projects were also initiated as a result of the benchmarking activities, such as an end-to-end review of clinical coding processes.

Throughout the duration of the programme engagement of clinical staff in improvement initiatives would be key. Working in collaboration with executive management, the delivery team facilitated a range of engagement sessions with clinicians that actively involved them in scoping, designing and delivering the programme to its successful conclusion.

To deliver the anticipated benefits - and ensure they are sustained - the Trust Leadership and Transformation Teams were engaged in developing a standard methodology, to be deployed in order to build internal capability and engage staff at all levels, for improving performance and patient experience. A visit to a local Unipart facility provided an opportunity to see real life examples and bring to life the systematic application of the tools and standards embodied within the proposed methodology.

The overall transformation programme delivered a return on investment of 5:1 during the 18 month duration, with a target ROI of 12:1 over a 3 year period. These benefits include:

• £2m additional revenues (£750k non-elective and £1.3m elective) as a result of improving coding processes
• Recurrent procurement savings of £1.3m per annum were delivered
• Renegotiations with 107 suppliers, 76 of which would result in cost savings of approximately £1m annually
• £210k of annual cost savings from Pharmacy waste reduction by accounting for inpatient supplies in discharge prescriptions (TTOs)
• 25% increase in ‘cath lab’ procedures; reducing patient waiting times and increasing revenues
• Significant inpatient length of stay reductions resulting in improved patient flow, additional income generation and improvement patient experience and safety
• Knowledge transfer over to ward staff, Pharmacy and the Trust’s Transformation Team, to improve employee ownership, embed existing improvements and support future continuous improvement