Background:
Faced with rising demand and mounting financial pressures, a Health Board in Wales partnered with Meridian Productivity to address inefficiencies across its Community Services. The brief was clear: identify cash-releasing savings without compromising patient care, while supporting services under increasing operational strain.
The Community Services directorate, comprising over 250 WTEs across 21 teams, sought to align resource with demand, improve visibility of performance, and ensure that valuable staff time was being used to its full potential. With a system-wide deficit approaching £800 million across the region, the stakes for efficiency were high.
Analysis:
Meridian undertook a focused two-week operational analysis, using 30 resource days to map capacity, demand, and daily practice across five core services. Several themes emerged:
Inconsistent expectations around patient-facing time, with many clinicians working to informal norms that allowed less than 50% of their day for direct care.
Limited performance visibility, with managers unable to track or compare actual activity levels against plan.
Passive governance, where variances in delivery were rarely challenged, and opportunities to optimise time went unrealised.
This wasn’t just a resourcing challenge—it was a system issue, rooted in culture, behaviours, and the absence of practical management tools.
Implementation:
Working closely with senior leaders, service managers, and team leads, Meridian introduced a suite of embedded controls and tools designed to deliver both immediate impact and long-term sustainability. These included:
A Fair and Equitable Work Allocation System that ensured caseloads were aligned with capacity and skillset.
Clearly defined expectations for direct clinical care time (DCC%) and average contact durations, making daily planning both measurable and achievable.
Daily, weekly, and monthly review meetings—establishing a consistent rhythm of performance oversight.
Real-time dashboards and management control systems to track individual and team delivery, reduce unproductive time, and allow proactive interventions.
Results:
The programme delivered significant improvements across all five service areas:
£2.9 million in financial opportunity identified, with £500,000 in cash-releasing savings available immediately through vacancy control and improved resourcing models.
2:1 return on investment, exceeding financial targets while supporting improved patient access.
Greater visibility and ownership of delivery metrics, giving local managers the tools to lead from the front.
Embedded behaviours and meeting structures that made performance management routine—not reactive.
By focusing on behaviours, expectations, and real-time performance insights, the Health Board now has the clarity and control needed to make better decisions and deliver care more efficiently.
