Background:
Nottinghamshire Healthcare NHS Foundation Trust delivers a broad range of mental health, intellectual disability, and community health services to over 190,000 people annually. With more than 8,800 staff, including community nurses, therapists, and mental health professionals, the Trust plays a vital role in supporting patients across diverse care settings.
Faced with growing service demand and increased pressure on urgent community and rapid response services, the Trust partnered with Meridian Productivity to enhance operational control, improve workforce deployment, and reduce patient waiting times—without compromising quality of care.
Analysis:
Meridian began with a comprehensive review of the Trust’s Integrated Neighbourhood Teams and Rapid Response services. This included direct observation, structured workshops, and data analysis across clinical and operational levels.
Key challenges were identified:
A lack of visibility into staff performance, making it difficult to measure or manage productivity
Absence of daily targets and planning norms specific to clinical roles and bands
Unstructured workload allocation processes, leading to inefficiencies and burnout
No consistent follow-up mechanism to tackle lost time or variances in service delivery
The analysis also revealed missed opportunities to optimise capacity, particularly in managing referrals and aligning resources with patient need.
Implementation:
Over 14 weeks, Meridian supported the Trust in building a robust Management Control System (MCS) tailored to its community services. This involved:
Defining role-specific daily clinical contact targets using evidence-based planning standards
Developing a fair workload allocation framework matched to staff band and skill mix
Installing real-time performance dashboards and weekly review reports
Coaching managers at every level to actively manage capacity, address performance issues, and drive service improvements
Establishing variance tracking processes to reduce lost clinical time and improve governance
These changes were co-designed with team leads and service heads to ensure sustainable adoption and behavioural change across teams.
Results:
The improvement programme delivered both operational and financial impact:
60% reduction in average waiting time for therapy services
19% increase in face-to-face patient contacts, improving access and throughput
51% drop in the longest waiters, reducing risk and improving patient experience
£787,000 identified savings, with a clear delivery plan in place
30% reduction in bank, agency, and overtime usage, representing a further £94K in annualised cost avoidance
A capacity and demand model providing accurate forecasting of required workforce levels
New daily and weekly reporting tools enabling proactive, data-driven decision-making
Conclusion
This case study highlights how Nottinghamshire Healthcare NHS Foundation Trust achieved measurable improvements in patient access and staff efficiency through a structured, data-led improvement programme. By aligning workforce capacity with patient need, the Trust reduced waiting times, increased contact rates, and unlocked over £880,000 in annual savings—all while strengthening the foundations for long-term, sustainable change.
