What are we doing?
West Middlesex University Hospital NHS Trust has been undergoing a staff led cost improvement programme (CIP) since September 2010 to ensure we provide the best possible clinical care enabling patients to have high quality, seamless healthcare, whilst also securing financial stability for the hospital.
Background
For the past few years, the Trust has been working hard to reduce its historic deficit of £22m and we are on track to break even this financial year. However, in common with the whole of the NHS we face a challenging financial environment which means all public services need to reduce costs signficantly. We have a CIP to deliver £19.7 million savings over the next two years.
The proposed changes outlined in the White Paper entitled ‘Equality and Excellence: Liberating the NHS” will see many more patients treated closer to home. This requires acute hospitals to examine how and where their interventions will make the most difference. This offers us opportunities for innovation and further productivity and efficiency improvements
The main purpose of our ambitious cost improvement programme, which will run for the next two years, is to ensure the services we provide to the community are more co-ordinated and efficient. Importantly this is not about cutting back on healthcare that people need. This is about reducing duplication, cutting out waste and improving pathways of care for patients.
As part of this we are encouraging all our staff to innovate and make positive changes to improve patient care. It is important to identify where we have already made a positive difference and to celebrate these successes. Staff are ideally placed to know where barriers to improvement exist and to highlight how these could be overcome.
Our overall goal is to deliver new standards for efficiency and productivity, and provide excellent quality local health care.
How are we delivering the Cost improvement programme?
Crucially, this cost improvement programme is staff led. The plans aim to improve processes, decrease inefficiencies, reduce bureaucracy, cut out waste and improve pathways of care for patients.
Key to our plan is the need to prioritise clinical frontline services over non clinical support to ensure the delivery of high quality services.
The Cost Improvement Programme is leading to new ways of working and a more efficiently run and productive hospital with the best workforce capability and skill mix. There is now a greater emphasis on follow-up care in the community so patients can recover and return to their normal lives quicker. Reductions in length of stay will allow us to reduce bed numbers with a corresponding reduction in staff posts. As changes continue we anticipate reducing our reliance on bank and agency staff significantly and will critically review the need for posts which result as a consequence of natural wastage. Our plan is to reduce the number of beds by about 30 in this summer.
The Trust currently employs in the region of 1,921 whole time equivalent (WTE) staff. This is a combination of 1,750 permanent staff, 150 bank and 20 WTE agency staff. The aim of the CIP plan is to reduce this by 261 WTE posts over the next two years mainly through natural wastage and reducing reliance on temporary staff. The overall reduction in medical staff is less than 1% in comparison to 38% in management and administrative staff. Changes to nursing and midwifery shift patterns will help us reduce expensive bank and agency costs.
From discussions with staff and patients we know that our processes within outpatients need to be improved. This will be achieved by changing working practices and maximising the use of technology to deliver a high standard of service to patients.
