Background:
A leading Scottish NHS Health Board, responsible for the mental health and learning disability services of approximately 109,000 people, faced persistent challenges across its 12 community services and five inpatient wards. Despite multiple internal initiatives aimed at improving workforce efficiency, the organisation continued to struggle with underutilised clinicians, unclear performance expectations, and an increasing reliance on expensive bank staffing.
The Trust’s leadership sought support from Meridian Productivity to identify and implement sustainable solutions that would improve clinical productivity, reduce financial pressures, and enhance care quality across adult, older adult, CAMHS, rehabilitation, and learning disability services.
Analysis:
Meridian’s three-week operational analysis spanned 28 sites and included detailed studies with over 120 staff across inpatient and community services. In parallel, 12 months of historical data was analysed to uncover trends in service delivery, activity levels, and workforce utilisation.
Key findings included:
Low productivity across clinical teams, with only 1.8 recorded community contacts per WTE per day
A disconnect between observed clinical time and what was being captured in systems
Widespread variation in caseload management and contact duration (averaging 81 minutes per patient)
Lack of standardised planning tools, performance expectations, or systems to match workforce capacity to patient demand
Significant delays in discharge due to inconsistent care plans and unmet treatment needs
These inefficiencies were costing the Board millions in avoidable workforce expenditure and delaying timely access to mental health care.
Implementation:
Meridian led a 17-week structured improvement programme, working hand-in-hand with clinical leaders, operational managers, and frontline staff. The programme introduced:
A Workload Capacity Model to align clinical resource with caseload demand
Weekly care planning tools and structured patient scheduling
A Bank Staff Monitoring System, reducing reliance on temporary staff
Performance dashboards including an Operational Management Report, giving leaders real-time insight into activity and productivity
Weekly allocation and coaching meetings, fostering accountability and empowering managers to take corrective action
Training and one-to-one coaching ensured the management team could confidently sustain improvements beyond the programme’s duration.
Results:
The impact was immediate and sustained:
14% increase in clinical productivity across all service lines
£2.17 million in total financial benefits, including:
£1.07 million from avoiding unnecessary recruitment
£147,000 in annual bank staff cost savings
£134,000 from reduced cost per contact
33% reduction in bank staffing costs during the programme
Staff now consistently exceed historical patient contact averages
The Trust now has full visibility of workforce capacity, enabling better planning, reduced waste, and improved patient access
With a robust management control system embedded, this Health Board has positioned itself to meet increasing demand for mental health services without increasing headcount—delivering better outcomes at a lower cost.
