Financial Improvement Review of Ealing Service Delivery UnitBackground West London Mental Health Trust (Trust) is a provider of a full range of mental health services for children, adults and older people living in the boroughs of Ealing, Hammersmith & Fulham and Hounslow. The Trust also provides specialist and forensic mental health services, including high secure services at Broadmoor Hospital in Berkshire.
ApproachThe Green & Kassab consultant team tested and evaluated the assumptions and viability of the existing in-house cost improvement plans with the Clinicians, Managers and Directors of Ealing SDU and where required, with the Trust executive lead. From this, the consultant team were able to identify whether the existing plans were likely to be successful, Whether or not they would achieve the levels of savings that were planned within the specified timeframe, and whether the in-house stakeholders had the necessary resources and ability to deliver the plans.OutcomesInterserve Facilities ManagementBackground Interserve Facilities Management (IFM) – one of the UK’s leading facilities management
companies – asked Green & Kassab to review the Health Records Service that they
were providing to Dudley Hospitals NHS Trust, as part of a comprehensive Private
Finance Initiative (PFI) contract, covering a range of 17 general facilities management
services.
ApproachThe Green & Kassab consultancy team first examined the terms of the existing contract to establish whether they were reasonable.Any areas where services could be refined or eradicated altogether were identified. This involved observing the processes used in getting the physical medical records from the Health Records Service library to medical staff, when required, and then back onto the library shelves. The library had 1.3 million records, which were stored in a secure offsite warehouse and records were not being returned to the shelves promptly. OutcomesGreen & Kassab listed service inefficiencies and provided detailed recommendations. An example was the considerable amount of time spent by IFM staff searching for records which had not been replaced on the shelf before being required again.Green & Kassab’s recommendations included: Kings Lynn & Wisbech Hospitals NHS Trust Cost ImprovementBackground Green & Kassab was asked to assist the King's Lynn & Wisbech Hospitals NHS Trust to identify and then assist with the implementation of cost saving measures in excess of £1m per annum.
ApproachAfter carrying out a preliminary scoping exercise, Green & Kassab and King's Lynn & Wisbech Hospitals NHS Trust agreed to focus on:OutcomesThe successful implementation of these various cost improvement measures helped the Trust to achieve a balanced budget position over the next 3–4 years.Green & Kassab continued to provide ad hoc support to specific parts of the Trust, which were having difficulty in achieving their financial recovery plan over the following years. Green & Kassab has also provided the Trust with further ideas for reducing costs over the last 3–4 years since the completion of the main programme. These further ideas have followed from our work with other trusts and have provided some additional benefits to the Trust. The Wellington Hospital – Operating Theatres ReviewBackground The Wellington Hospital is owned and operated by HCA International and is the largest
independent hospital in the UK. It has 266 registered beds, 15 intensive care unit beds, 19
high dependency unit beds and 11 operating theatres.
ApproachThe objectives of the review of the operating theatre services were to:OutcomesGreen & Kassab presented its recommendations to the Theatre Manager, Deputy Theatre Manager and Chief Nursing Officer and this was followed by presentations to the Executive and other theatre staff.The recommendations were well received and Green & Kassab is continuing to assist management with the restructuring process so that the benefits can be realised as quickly as possible. Strategic Review of Eastern Shared ServicesBackground Green & Kassab was commissioned, by the Chief Executives of the six NHS Primary Care Trusts that were stakeholders in Eastern Shared Services (ESS), to undertake a strategic review of the ESS operations. This review required identification of the areas where cost savings could be made in the future service delivery, to support the financial recovery plans of the six PCTs.
ApproachGreen & Kassab undertook a review of the principal operations of ESS such as Buildings and Estates Management, Catering, Cleaning, Finance (including Payroll & Accounts), Information & Communication Technology and Procurement.OutcomesA number of potential areas for savings were identified such as:Value Test of Barnsley NHS Trust Catering ServicesBackground ISS Mediclean – one of the UK’s largest Facilities Services Providers to the NHS – invested a substantial amount in refurbishment of the catering facilities at Barnsley NHS Trust under a long-term catering contract set up as a Private Finance Initiative (PFI). As with all PFI contracts, formal testing of the catering services was required every 4–5 years by an independent firm, to demonstrate that service costs represented reasonable value within the marketplace.
ApproachGreen & Kassab consultants produced a methodology that demonstrated how their technical databases and knowledge of the marketplace would be used to value test the catering services. This satisfied the requirements of both ISS Mediclean and Barnsley NHS Trust.OutcomesGreen & Kassab’s benchmarking report was favourably received by both ISS Mediclean and their client, Barnsley NHS Trust. Furthermore, the ISS Mediclean contract with Barnsley NHS Trust was found to represent reasonable value and secured for a further five years. |
