Acute Healthcare Foundation Trust – West Midlands

A large general hospital based in the West Midlands with a revenue of £317m and a deficit of £2.5m therefore requiring a cost improvement programme. The Trust was under severe financial pressure and required savings from specialties across the Trust with medical productivity and job planning being a big priority. Dearden HR was commissioned to lead on this work in partnership with Kingsgate (a specialist financial and operational management organisation) who were undertaking a wider turnaround piece of work.

Key Issues identified

  • A job planning policy/guidance which was not fit for purposee
  • Out of date job planning data with no regular reviews
  • Lack of clarity/understanding of actual medical activity/productivity within services
  • PA allocation for Consultants and programmed activities requiring a streamline to meet the needs of the service–on-call, routine work, DCCs, SPAs and CPD
  • Pay bill increasing year on year without increase in activity levels
  • Temporary staffing spend increasing significantly year on year with no central controls
  • Usage of APAs with little obvious justification and lack of regular review

Dearden HR delivery

  • Assessment of job planning data, process and policies
  • Desktop analysis of consultant job plans and SAS doctors
  • Triangulation of job plan data with payroll and medical rosters/planned activity
  • Review of extant policies and procedures
  • Reported risk adjusted savings opportunity of £2m in relation to job planning, SPAs, on-call allowances, temporary staffing and theatre productivity
  • Reported weak controls and processes for job planning and temporary staffing expenditure
  • Developed a plan to reduce medical pay spend, ensure a transparent and fair job planning process and an increase in productivity