Background:
NHS Borders, a Scottish Health Board providing community and inpatient Mental Health and Learning Disability services, faced persistent challenges in improving productivity and financial performance. Despite several internal efforts, the organisation lacked visibility into resource utilisation and struggled to align capacity with patient need. With growing demand and increased pressure on budgets, the Board partnered with Meridian to address these issues and drive sustainable improvement.
Analysis:
Meridian carried out a three-week, in-depth operational analysis across 28 NHS Borders sites. The review engaged directly with frontline teams and identified significant underutilisation of clinical staff, the absence of structured workload allocation systems, and inconsistencies in care planning that caused treatment delays. A lack of performance monitoring also limited managers ability to make data-driven decisions, compounding service inefficiencies.
Implementation:
Meridian introduced a structured Management Control System tailored to NHS Borders’ needs. This included tools for workload capacity modelling, enhanced operational reporting, and care planning templates. Structured allocation meetings were established to better match workforce to demand, and management coaching supported cultural and behavioural change. These interventions were co-designed with staff to ensure clinical safety and long-term adoption.
Results:
The initiative resulted in a 14% improvement in clinical productivity and delivered annualised financial benefits totalling £2.17 million. Bank staff costs were reduced by £147,000 annually through improved rostering and capacity planning. With new systems embedded, NHS Borders gained lasting visibility over performance and capacity, ensuring the organisation could continue to deliver high-quality care while making best use of its workforce.
