Providing quality mental health, learning disability and community health services, the Trust serves a population of one million people through over 5,500 staff and with an annual budget of over £250 million.
Of focus to the project was the Community Paediatrics (Outpatients) and Diana Services within the Families, Young People and Children’s Services directorate. The two areas provide assessment, diagnosis, management and treatment services to children and young people, and care and support for children and families requiring special nursing care in a community setting.
Following successful work with the same Trust within Older Adults, Adult Mental Health, and Musculoskeletal Therapy Services, Meridian Productivity were invited to conduct an Analysis of the Community Paediatric (Outpatients) and Diana Services. This was with the purpose of highlighting areas which if there was greater control, would improve the way the teams were managed.
The analysis was a three week long study, where a total of 53 man days were used to identify areas of improvement across 6 teams with almost 80 WTEs. Issues in the way of working that prevented optimum performance included a lack of performance data, clear targets and expectations, planning standards and a systematic and robust way of allocating work and an effective follow up process. In addition there was a need for greater understanding over the demand and capacity of the Community Paediatrics (Outpatients) Service and controls aimed at clinic maximisation.
The programme sold was an 8 week Improvement Project.
The overall goals of the project were as follows.
- Develop and agree a set of tailored, bespoke daily activity expectations in reference to direct clinical contact
- Install a range of intuitive controls and embed a significant behavioural change towards how work is planned and delivered
- Provide line of sight over service performance by installing individualised reporting information
- Enable an understanding of the demand and capacity of the Outpatients Service in order to drive changes aimed at maximising existing clinic capacity
Meridian worked with the management team within the Community Paediatrics (Outpatients) service and the Diana Services through a series of meetings and workshops. During these various sessions a new management control system was designed to ensure effective running of the two areas.
The key focus was to implement management controls to increase direct clinical contact with patients and maximise existing clinic capacity.
The processes introduced and implemented gave the management of the Community Paediatrics (Outpatients) and Diana Services better control over the proactive governance of activity as well as visibility on a daily and weekly basis of individual and team performance.
The main results of the programme are:
- A 35% increase in the number of contacts with patients
- Identified and cost avoidance savings valued at over £60,000 per annum
- A tailored Management Control System built in partnership with Team Leads and Managers. This is to ensure targets and expectations are translated seamlessly into controls and accompanied with the required behavioural changes to drive patient facing care, treatment and support
- Releasing time to provide managerial support and patient facing care by substantially improving the rota creation process
- A robust Capacity and Demand model that enables management to understand and take action on utilising the right amount of resources and prevent the perpetuation of waiting lists, backlogs and the duration of time patients are waiting for appointments
- The ability to reduce the demand for follow ups through the development of a collaboratively designed, tailored variance management control
- Enabled management to reduce travel time and increase patient face to face contact by analysing the locations of patients to establish hot desk and clinic locations