Meridian Productivity Ltd worked with this client in Community Services to improve the management control system in the Integrated Care Teams (ICT). This service has a demand of over 260,000 visits per year which are conducted by staff across 7 different localities with a large geographical spread.
The team spent three weeks at the company’s own cost, identifying issues preventing the services to be the most effective it could be. Across the course of the analysis the main problems were found: an excessive agency and overtime costs, no management control of capacity against demand or over work assignment to staff in place. The managerial behaviour and historical issues within the areas had an impact on the poor running of the service. Staff worked long hours and claims for agency were higher from month to month.
The project put in place a clear management control system:
- forecasting (patient facing targets were set by band and type of healthcare professional, visit norms were set and agreed, demand tools were developed),
- planning (capacity plan was designed and installed to match resources to the demand – patient numbers and needs),
- assigning (tools were developed and implemented which ensured that the target patient facing times were planned in the best possible way and achieved on the day) and
- reporting/follow-up (a loop between all levels of management and staff on the ground with information reaching all tiers ensuring issues are identified and solved as soon as possible). Through a series of workshops with Senior Management, Team Managers and Team Leaders all the elements of the system were developed and agreed.
Through a series of tailored workshops with three levels of management, the behaviour shifted and activity assignment started bringing visible and quantifiable results. The behaviour of the team leaders had impacted on the overall change. One team leader said:
“I assigned visits to one of my nurses the day before using the allocation tool, to fill her day to 80% of visits. She came in late and only started working two hours after the planned shift start. She asked for two hours overtime at the end of the shift as she said she could not manage the workload given. I took her aside and explained why she would not be getting overtime and to be on time the next day as she needs to be able to complete reasonably assigned workload.”
- Savings cashed during the programme of over £253,000 (over £1.58m annually)
- The project paid for itself before the completion
- Optimised use of staff within the existing budget and reducing the agency and overtime spend
- Overall productivity increase by 8%
- Face to Face time increase of 10%
- Clear and straightforward management control system