IMPOWER Consulting with Lincolnshire County Council

Performance Improvement in the Public Sector

IMPOWER has helped one of the country’s largest acute hospital trusts to kickstart a culture shift in the way patients are assessed by implementing an effective model for discharge and flow.

Working with clients in Lincolnshire that were under intense scrutiny at a national and regional level, the consultancy team navigated a highly complex system to keep all stakeholders on board.

Crucially, consultants demonstrated their ability to work in a challenging and ever-changing environment with frontline staff to co-produce new ways of working.

“There’s the temptation to get involved in trying to fix every problem but you have to stay focused and can’t get distracted,” says IMPOWER senior manager Sam Ingamells. “We use our judgement of when we need to react and where we need to put our fingers in our ears and not jump into where the action is! There are things we can’t influence and things we can – like identifying the patients who are in a position to go home safely.”

Where previously too many patients were staying in acute hospital beds unnecessarily, systems are now in place to bring a more consistent and timely approach to assessing whether they can be safely discharged.

It has significantly increased rates of discharge, relieved some of the pressure on wards and generated substantial cost savings while identifying further opportunities for efficiency.

But the project’s primary aim was never about saving money. It was to bring about a culture shift that galvanises practitioners around a common purpose so acute beds are not viewed as a ‘safe place’. Over time, it should see more patients discharged to receive care and support in the most appropriate setting rather than face lengthy stays in hospital beds.
IMPOWER’s collaborative and relational approach has proved highly effective, leading to sustainable changes that are now being led and built on by staff working on wards.

“One reason I pushed for IMPOWER to lead this work is because the partnership between health and the local authority is key to success and they’re seen as a trusted partner within both,” explains Nikki Pownall, system flow director at United Lincolnshire Hospital Trust.

“It’s a complex system and they are very good at navigating it. They know and understand all the players and have relationships with them and that’s so important.
They also have the same values in terms of a patient-centred focus. Patients are at risk of spending too long in acute hospital beds and IMPOWER are helping us change that culture.
Whereas previously changes haven’t stuck, the intensive support IMPOWER provided in the frontline has resulted in improvements being embedded. When I walked around the wards in January I found so much of the positive work was continuing even though their consultants had moved away from those areas. The fingerprints of IMPOWER are all over these successful improvements.”

The consultancy has since been awarded a further commission to carry out a similar project on surgical wards that will further embed the model and enhance patient outcomes.

View the IMPOWER Consulting profile in the MCA Members Directory.