ACUTE HEALTHCARE FOUNDATION TRUST - West Midlands
Case Study: Medical Productivity
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
● Temporary staffing spend increasing significantly year on year with no central controls
● Usage of SPAs with little obvious justification and lack of regular review
● Lack of clarity/understanding of actual medical activity and productivity within services.
● Out of date job planning data with no regular reviews.
● A job planning policy/guidance which was not fit for purpose.
● Pay bill increasing year on year without increase in activity levels
● 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.
● Assessment of job planning data, process and policies
● Review of extant policies and procedures
● Reported weak controls and processes for job planning and temporary staffing expenditure
● Triangulation of job plan data with payroll and medical
● Reported risk adjusted savings opportunity of £2m in relation to job planning, SPAs, on-call allowances, temporary staffing and theatre productivity
● Developed a plan to reduce medical pay spend, ensure a transparent and fair job planning process and an increase in productivity
● Desktop analysis of consultant job plans and SAS doctors