Thinking differently – Lean at UCLHIntroduction

The challenge …

We have done well in the past but if we are to achieve our future ambitions, including future capital developments of £1billion over the next decade, and remain as one of the best and safest hospitals in the country we need now to think differently

“If you always do what you always did,

you will always get what you always got.”

Albert Einstein

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The challenge … how do weremove all waste, duplication and error from our processes to ensure we remain one of the very safest hospitals in the NHS?

ensure sustainability so that our clinical teams are able to deliver improvement both today and tomorrow?

lead the way in technology as an enabler for clinical change?

make sure we have the skills and capacity to do this work as well as possible, from the Board itself to the frontline?

truly devolve decision-making to as close to the frontline as possible?

reward staff who take risks to radically improve services?

create healthy surpluses so that we can build world class care facilities and continue to innovate over the next decade?

make this an exciting proposition for staff? 3

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Our challenge - to make major recurrent savings and improve quality…

Over the last 4 years we

have saved over £140m

• 2010/11 £32m

• 2011/12 £43m

• 2012/13 £33m

• 2013/14 £36.5m to save - £35m expected by March 14

Delivering on challenging targets …

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… but it is getting tougher

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Our values and behaviours

We put your safety and wellbeing above everything

Deliver the best outcomes Keep people safe Reassuringly

professionalTake personal responsibility

We offer you the kindness we would want for a loved one

Respect individuals

Friendly and courteous

Attentive and helpful

Protect your dignity

We achieve through teamwork

Listen and hear Explain and involve

Work in partnership

Respect everyone’s time

We strive to keep improving

Courage to give and receive feedback

Efficient and simplified

Develop through learning

Innovate and research

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Efficient and simplified

Two good examples…

Liberating ward sisters to lead:

Increasing time spent in clinical leadership to 75%

by reducing the bureaucratic burden – early days,

fantastically popular with staff

The productive outpatients programme:

Providing clinical teams with the tools and skills to redesign their outpatient service

16% clinics have been through the programme based on Lean methodology

Wouldn’t it be great if non-clinical support services are focussed on

supporting ward sisters in their role in delivering high quality safe

care and patient experienceOur vision:

To improve the quality of care of patients

on all our wards…..

by supporting the delivery of 75% clinical

leadership time for Ward sisters and

Charge Nurses…..

by creating a time-limited VIP conceriege

service for this community….

and using this as a focussed improvement

tool for the benefit of all

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Benefits being realised from clinical teams adopting lean principles

Chair Utilisation, Eastman Dental Hospital, Endodontic

◄Endodontics creating capacity for more activity

Reducing waits weeks

Gastrointestinal 12 to 8

Endoscopy 12 to 5

Endodontics 13 to 7

Women’s health physio 12 to 3

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Efficient and simplified

Scaling this work up

What if everyone was Liberated?

All our corporate support systems were as slick as possible and redesigned around value to the user

What if all our services were designed using Lean methodology? We are scaling up POP to reach all clinics within 2 years Provide support for clinical teams and clinical boards to redesign

inpatient services in the same way Increasing expertise and knowhow Training teams to redesign today and tomorrow

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Efficient and simplified

Focusing on doing this really well to achieve very significant efficiencies and scope to dramatically increase clinical activity within the same footprint over the next few years and generate funds to develop our estate for the future

The Lean method gets us to focus on removing waste and delays out of all systems and process so we;

Simplify what we do, how we do it, are more efficient and release time so more time can be spent on providing the

right care for our patients at the right time.

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Thinking Differently

We are working with our appointed Lean partners (an expert Lean firm called KM&T) to:

Build our five year Lean plan & Work on four priority areas

Urgent careElective careNeurosurgical pathwayLiberating everyone