We provided support to the Barnet, Enfield & Haringey Mental Health NHS Trust over a two year period, developing and then implementing a major cost improvement programme.
This touched nearly every aspect of the Trust’s operation from front-line clinical services to back-office support services. Adopting a formal project structure with regular reporting to a Programme Board consisting all of the Trust’s Directors and chaired by the Trust’s Chief Executive, we provided support and advice to all aspects of the project. With such a major, complex project with numerous stakeholders, the role of our Transformation Team varied from initiative to initiative. The differing services that were part of the programme necessitated that we deploy a multi-disciplinary team, to include specialists in a number of fields (clinical as well as corporate and finance staff).
The preliminary stages of the project saw the GK Transformation's Team engaged in a detailed assessment of the Trust’s financial performance and evaluation of current working practices, systems, staffing and organisation. This part of the project included a detailed cost comparison exercise, which enabled the Programme Board to view the performance of each service against that of its peers, and in thereby allowed the Trust to identify areas for potential improvement.
Having identified a number of areas where there appeared to be scope for cost improvement, our Team worked with small groups (service managers, senior staff and clinicians) to develop possible alternate service configurations, organisational structures, staffing skill-mix, processes and systems in order to deliver a lower cost, better value for money model. These outline reconfigurations were developed and tested with stakeholders before being presented to the Trust’s Programme Board for approval, which was duly forthcoming.
As we moved forward into the implementation phase of the programme, our Transformation Team remained engaged with stakeholders at all levels of the organisation as well as number of external stakeholders, providing guidance, support and drive to the programme. Along the way time was dedicated to communicating with staff at all levels in order to explain the agreed programme, its objectives and the benefits that would follow, whilst at the same time dealing with the anxieties that such a major change programme brings with it. Throughout, our Transformation Team were keen to make ourselves available to discuss issues with staff at any time, as we never underestimate the importance of this aspect of the programme management responsibility and the importance of stakeholder engagement.
The programme involved the implementation of over 50 different initiatives covering pretty well all of the Trust’s services. We provided support and guidance in a number of areas, as required by the Trust. The type and degree of support would vary according to the complexity of the initiative, the needs of individual managers for support and the importance of the specific initiative to the overall programme. We were therefore involved in a range of activities including;
- Organisational re-design (use of voluntary sector)
- Development of revised staffing structures, skill-mix and reward strategies
- Developing business case for and subsequent project management of an electronic nurse rostering system
- Business process reengineering (lengths of stay and reduction in out of areas placements)
- Procurement of stationery and office equipment, including electronic auction
- Negotiating rebates on utilities bills
- Marketing of PICU beds and Brain Injury Service
- Application of Lean Working methodologies (SUI’s and Risk Management)
- Data Analysis (national insurance charges from Agency staff suppliers)
- Reviewing skill-mix and reward strategies (outpatients)
- Communicating with staff
- Redesign of rosters (Older People’s and Forensic services)
Over the two year period in which Green & Kassab were supporting the Trust through the implementation of this programme, the Trust was able to successfully reduce its expenditure by circa £3million per annum.