Background
Royal Papworth Hospital NHS Foundation Trust is internationally recognised for its leadership in cardiothoracic care and pioneering transplant procedures. In 2019, the Trust relocated to a state-of-the-art facility on the Cambridge Biomedical Campus. While the new hospital enhanced clinical capabilities, it also introduced new challenges—specifically, reduced anaesthesia flexibility and lengthened patient preparation times due to the absence of anaesthetic rooms. These workflow changes impacted theatre and catheter lab utilisation, contributing to longer patient journeys and growing waiting lists.
Following a successful outpatient improvement programme with Meridian Productivity, the Trust’s executive team commissioned a further theatres and cath labs productivity project in early 2022, aiming to boost throughput and address operational inefficiencies.
Analysis
Meridian conducted a detailed operational review across both theatres and cardiac catheterisation labs, uncovering:
Suboptimal scheduling and inconsistent use of 6-4-2 planning
Delays caused by undefined operating hours and insufficient changeover controls
Poor visibility of key performance data and causes of underutilisation
Inefficiencies in pre-op, intra-op, and post-op processes due to outdated planning norms
Despite Royal Papworth’s clinical excellence, legacy habits and resistance to change created a cultural barrier that needed to be addressed to improve operational performance and financial outcomes.
Implementation
Meridian’s 12-week implementation programme focused on optimising theatre and cath lab scheduling, redefining planning norms, and embedding stronger performance management.
Key initiatives included:
Installation of daily and weekly utilisation dashboards, supported by daily huddles and variance tracking
Development of theatre and cath lab logs to capture delays and drive real-time action
Recalibration of procedure durations, anaesthesia times, and changeover standards based on data and observation
One-to-one coaching and CPD-accredited workshops with clinical and operational staff to foster ownership and engagement
Realignment of staff rosters in line with AfPP guidelines to ensure the right skill mix matched operational hours
By strengthening the 6-4-2 scheduling process and enhancing visibility of plan vs actual, Meridian supported a shift from reactive firefighting to proactive performance management.
Results
The project delivered measurable, sustainable improvements:
9.7% increase in theatre productivity: procedures per session rose from 1.89 to 2.07
6.8% increase in cath lab productivity: procedures per operating day rose from 32.5 to 34.7
Financial improvements exceeded expectations, delivering gains beyond the targeted £198,900, with projected additional revenue in the millions
Significant cultural change, with clinicians and managers now fully engaged in performance oversight and improvement
