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FAQs

Our projects always generate numerous questions from our clients’ staff who want to understand what we do and whether our presence will be a threat to them or an opportunity. We have selected a few of the questions our teams are asked most frequently in the early stages of a project.

 

When you're going into an NHS trust, what are you aiming to do?

Our first aim is to identify what opportunity there is: we're the only company with the means to measure real activity and costs. Generally, we spend three weeks analysing right down to the daily level - activity and utilisation and, ultimately, value for money. Primarily, we focus on patient activity - on the kind of level of service given in terms of volume and also, to a certain extent, in terms of quality to the client.

Jimmy Quinn
‘Making change happen in land that time forgot’
Community Practitioner Magazine
December 2007 - Volume 80 - Number 12
Click here to read full article

Are you Management Consultants?

 

Yes, although within that generic term we are Productivity Specialists:
The difference being that we are implementers – not report writers.

Are you Time & Motion people?

 

No, we specialise in improving the effectiveness and efficiency of the processes, management systems and resources the organisation has in place to meet its objectives. In order to understand how the organisation functions presently we do have to observe initially what people do, how they do it and how often; so that is where the confusion about our role occurs.

What are the critical success factors for a project?

Executive engagement. We cannot emphasise enough how critical this is. Sometimes executives believe that having engaged a firm of consultants to effect change absolves them of any active involvement in the project. Nothing could be further from reality, if an organisation is going to achieve continuous improvement. Staff and management need to know that the project has the active support of the Chief Executive – it gives them the authority and confidence to initiate changes to improve productivity, to manage those changes with their staff and to take the time to understand the realities of managing to achieve ‘best value’ in use of resources whilst securing the quality of service for the patients.

Aren’t you just siphoning off money from the NHS like all management consultants?

Absolutely not. We will not even embark on a programme with an organisation unless we can commit to our cost being returned 2.5 times over through improvements in cost effectiveness.

So that means you cut jobs?

If that was the answer, you wouldn't need to use outside help. In most of our projects, cost effectiveness is achieved by cutting out the time wasted and lost through having processes and systems that add no value to what people on the front line are trying to achieve. All of our clients are trying to reduce waiting lists and waiting times (and in many cases financial deficits), or add new services without increasing costs and these can usually be achieved by increasing productivity.

You say ‘usually’. So sometimes you cut jobs?

Sometimes the organisation will not replace natural wastage, which in effect cuts jobs. We are not in charge of that. We always present the client with two alternatives – to achieve more with the same resources, or to achieve the same as before with fewer resources. The executive have to decide, depending on the organisation’s objectives, what route they will take.

So all you do is make people who are already working hard work harder still?

Surprisingly, No. What we help you to do is to work more effectively. Most of the solutions to increasing effectiveness already exist, buried within the organisation and its people. Ask yourself how often you’ve wondered why you work in one way, when another could be so much more effective, but somehow the message doesn’t seem to get through to make the changes happen. We provide the focus to get those changes put in place.

If the answers are already in the organisation, why are we paying you to do it for us, why don’t we just do it ourselves?

It would be great if you could. There is a wealth of information within NHS Modernisation and other initiatives which are meant to enable just such improvements to happen. In reality they haven’t happened because people haven’t had the time to effect a change programme as well as doing the ‘day job’; they have not been able to look at working practices with fresh eyes to see where the true inefficiencies lie and frequently, the management systems are not in place to facilitate change. We provide additional resource, an independent view, and we have the backing of the Executive to make change for the better a reality.

So do you come with a pre-canned system that you will shoe-horn us into?

Certainly not. We have project framework for our teams to work with, which is designed to ensure that the management systems and changes which evolve during the project are bespoke to the organisation. It is a framework, not a prescription. If we did not actively encourage your involvement in creating the new processes, systems and working practices, then you would not ‘own’ or use them. The improvements would not be achieved or sustained and that is of no benefit to us, or the organisation.

So how long does a project last?

Following the initial analysis of approximately 3 weeks which is used to identify some of the major causes of wasted effort, usually between 16 and 20 weeks dependant on the nature of the organisation and the specialities/departments or geography to be covered by the project team.

 

How much experience do you have in the Health Service?

We have been working in the service for nearly 13 years, and have completed well over 100 projects in Acute and Primary Care. We believe we are unique in the range and depth of projects, analyses and comparative studies we have conducted covering all specialities – Theatres, Diagnostics, Outpatients, District Nursing, Health Visiting and supporting departments including Administration, Medical Records, Estates and Catering, to name a sample.

And where will you be working?

We have (or will have) a project office on site. We operate an open door policy because we are proud of what we do, have nothing to hide and open communication is key to achieving the desired results. Much of the time our team will be with you at your places of work rather than driving a desk in the office, so do take the opportunity to speak with us. Share your concerns, ideas and experiences; they will contribute valuably to the success of your project.

How will the employees know what is happening on the project?

In three ways: firstly we actively encourage the Senior management to broadcast through your normal communication channels (intranet, email, newsletter) a weekly or fortnightly update on the goals and progress of the project. Secondly: a team of your peers will be actively involved in the project and we expect them to feed back to you – formally and informally – what they are undertaking on your behalf to improve the service. Thirdly, our project team spends most of their time ‘on the floor’, ensuring that suggested changes are fit for purpose and will achieve the goals of the project. We encourage you to approach them any time to discuss ideas and concerns.

What happens once the project is finished?

Because we work with you and there is a transfer of knowledge, the intention is that you continue to refine and improve your processes and working practices with this fresh approach. In the first year after the project we re-visit you to assess how the changes have developed and benefitted the organisation.

How can you make recommendations for the Heath Service if you are not clinically qualified?

Our whole approach is to combine your clinical skills to ensure clinical priorities and disciplines remain sacrosanct, with our skills in identifying ineffective processes and practices which don’t add value to the patient, add cost to the delivery of the service and make your job harder, by improving work planning and communication. It is the combination of both of our skill sets that brings about the best outcomes.

So if you are setting targets for numbers of visits per day then no doubt quality of care will suffer as staff will be rushing to get through the work?

Firstly, we don’t set the targets – you and your colleagues do. You determine what would be best practice and we help you during the project to start removing the organisational barriers to achieving the goals that you and your colleagues have set. We transfer some of our skills during the project to enable you to continuously improve your service delivery. Our projects result in increased quality as work is more planned and organised which frees up more time to spend in patient facing activities.

Are you ‘Lean’ people?

Our methodology includes a wide range of the elements of the ‘Lean’, ‘6 Sigma’ & ‘TQM’ approaches. We do not, however, confine ourselves to one methodology, as over many years in the healthcare market we have found that different clients have needed varying combinations of these elements depending on the specific issues their organisation is facing.

We were impressed by their scientific approach and satisfied with the improvements in efficiency and costs that arose from the survey
Bryan Harty
Chief Executive
Blackrock Clinic

Radiology scanning capacity has increased by 25% to accommodate demand
Lily Byrnes
General Manager
Wexford Hospital

The team were very approachable and open to input from myself as the Clinical Director
Dr Ken Walsh
Perioperative Clinical Director
Cork University Hospital

As a direct result of the project we have seen a 22% increase in overall patient contact volume, which represents the highest reported activity numbers we have seen since our RiO system was installed
Professor Jonathan Warren
Director of Nursing
East London NHS Foundation Trust

In most services we have seen up to 50% improvements in patient facing time which is now consistent and still improving
Michelle Parker
Assistant Director
Provide

This has already resulted in more efficient working in theatre and will allow us in the future to plan our surgical services in a more productive manner
John G. Kennedy
Clinical Director
Perioperative Directorate
University Hospital Limerick

At the time of project close, utilisation of the inpatient occupational therapy group sessions had shown an increase of 15% utilisation, representing a 35% improvement against previous figures (the programme had set out to achieve a 20% improvement)
Professor Jonathan Warren
Director of Nursing
East London NHS Foundation Trust

The Meridian programme put in place controls and measures that highlighted to managers where the problems were so that corrective action could be taken
Steve Warburton
Director of Finance and Business Services
Aintree University Hospital NHS Foundation Trust

Exciting, informative, useful and challenging in equal measure. Most of all it has been worthwhile
Ms. Colette Cowan
Group Director of Nursing/Midwifery
Galway University Hospitals

I think the way in which you and your colleagues became 'embedded' in our staff while maintaining a separate objective voice was very effective
Tony Canavan
COO
Galway & Roscommon University Hospitals Group

We found the whole process a very useful experience which has enabled us to move forward on an important task
Dr Navina Evans
Director of Operations & Consultant Psychiatrist
East London NHS Foundation Trust

We increased the average number of patients per clinic across all specialties - in some specialties by over 30%
Alex Whitfield
Commercial Dir. / Operations Dir. for Medicine
Hampshire Hospitals NHS Foundation Trust

The new ways of working were hardly rocket science but they were precisely what was required
Dr John Kitching
Consultant in Emergency Medicine
Hampshire Hospitals NHS Foundation Trust

They bring an element of expertise that we did not have and helped short cut the process of delivering the changes we needed to increase productivity and improve patient experience
Russell Harrison
COO
Mid Essex Hospital Services NHS Trust

Our current additional capacity sessions have reduced by 30% and productivity within baseline activity has increased significantly - totalling more than 110% of our investment during the life of the project
Steven Vaughan
Director of Operations & Performance
Uni. Hospitals of Morecambe Bay NHS Found. Trust

The work identified efficiency savings which were delivered through supplier contract renegotiations, better stock and menu management
Paul Bond
Head of Estates and Facilities
Basingstoke & North Hampshire NHS Found. Trust

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