Background
A major NHS Trust, serving the East of England, manages over 260,000 community healthcare visits each year through its Integrated Care Teams (ICTs). These teams provide essential services to patients across a wide geographical footprint, often supporting complex health and social care needs.
However, rising reliance on agency staff, inconsistent caseload allocation, and reactive workforce planning were placing pressure on the system. The Trust needed to strengthen operational control, optimise existing resources, and reduce avoidable costs—while safeguarding patient care.
To support this transformation, the Trust partnered with Meridian Productivity to review and improve how capacity was planned and deployed across its community services.
Analysis
Meridian’s expert consultants conducted a three-week diagnostic review, working alongside clinical leaders and operational staff. The analysis revealed:
High agency usage and unsustainable overtime costs, increasing month by month
No standard method for forecasting demand or allocating caseloads across staff
Inconsistent workforce planning and a lack of visibility over capacity at team level
Low morale due to uncontrolled workloads and a reactive operating culture
The absence of a unified performance system meant that frontline managers were left to make daily decisions in isolation, often without the tools or data to plan effectively.
Implementation
Meridian introduced a structured, four-part management control system to support data-led decision-making and better match capacity to demand:
Forecasting: Patient-facing time targets were developed by role, alongside tools to model demand across localities
Capacity Planning: Each team’s resources were mapped to expected demand, ensuring more balanced distribution
Workload Assignment: Practical tools allowed team leaders to allocate visits more effectively, improving predictability and reducing last-minute adjustments
Performance Monitoring: A reporting loop enabled fast issue resolution and empowered all management levels to take ownership of team performance
Hands-on coaching and tailored workshops ensured these tools were embedded in daily routines, creating a measurable shift in leadership behaviour and staff engagement.
Results
The impact was both immediate and long-lasting:
£253,000 in cash savings during the programme, with annualised savings of £1.58 million
8% increase in overall productivity across Integrated Care Teams
10% improvement in patient-facing time, directly benefiting continuity and quality of care
Significant reduction in overtime and agency spend, improving budget control
Enhanced team morale, with managers reporting greater confidence in planning and performance conversations
By enabling better resource utilisation and embedding a consistent performance culture, the NHS Foundation Trust is now delivering more coordinated, efficient, and patient-centred community care—without additional staffing investment.
