Attaining cost savings and quality care

With the healthcare industry still taking in the full ramifications of last year’s budget announcement from the Government, the need to find cost savings without having a detrimental effect on frontline services is key for all healthcare organisations over the next few years. On the face of it this seems a pretty impossible task. The vast amount of money that needs to be taken out of the system points to wholescale cutbacks, mass redundancies and, to many, the death of the NHS as we know it. However, there are alternatives to this “doomsday” scenario and, by taking a step back and looking at the overall picture of healthcare organisations, potential cost savings can be found. When these are implemented across Trusts, vast amounts of money can be saved with no effect on the frontline services, and without mass job cuts. Using lean management processes, some healthcare organisations in the UK have, in the run up to last year’s announcement, been able to save significant amounts of money. By understanding the processes throughout the whole customer journey, no matter how apparently small and unimportant, examples of potential cost savings can be identified. Working with qualified coaches, organisations can quickly implement lean strategies and often quickly see remarkable cost savings within weeks of beginning the process. Examples of inefficiencies can be found throughout the NHS. For example outpatient clinics, on the whole, run a lot longer than they should. This takes up valuable resources, places extra pressure on staff and can lead to an unpleasant experience for the patient, especially with extended waiting times. A bad patient experience then has a knock on effect for any follow up appointments. Patients are tempted to turn up late because of the long wait during their last visit and sometimes, in non-urgent cases, will simply not turn up at all. These actions then have a further knock-on effect on other patients, creating a vicious circle.

Potential for lean transformation
Implementing a lean programme, which helps to identify unnecessary steps and procedures, can quickly improve the overall customer experience, shortening the time of each appointment, reducing lateness and no-shows, which then enables the number of patients seen to grow substantially and the ability to cut the overall number of clinics that need to take place. However, for such results to take place there has to be complete buy-in from all levels of staff. Throughout the public sector, the need to identify efficiencies is often linked with redundancies and so staff buy-in for programmes such as lean are often tinged, at least initially, with some reluctance. The private sector has a very different approach. Having used lean principles for many years, private sector companies recognise the impact it can have. By creating capacity and reducing cost, they can quickly make a company very competitive in a relatively short amount of time with no enforced redundancies needed. This model has to be a good fit for the public sector in the current economic climate. The public sector has to also look at long-term outcomes, rather than short terms goals. With the amount of savings needing to be made over the coming years, the natural reaction is to find a quick fix. In order to find significant savings a programme of lean transformation needs to be undertaken. Simply using lean as a “fire-fighting tool” for specific problems, as some public sector organisations continue to do, will not provide the type of substantial savings needed – nor will it solve the overall inefficiencies that caused that particular problem in the first place.

Royal Bolton Hospital