Performance Improvement in the Public Sector
Manchester University NHS Foundation Trust (MFT) is one of the largest NHS providers in the UK, providing services for over 750,000 people, employing over 28,000 staff and with an annual turnover of £2.5bn. The COVID-19 pandemic had a significant impact on MFT and like other providers all around the country, the response to managing this national emergency included repeated pausing the delivery of planned care, also called elective services, for periods of up to four months over three years. The consequence for MFT was by January 2023, it had the largest waiting list and the longest waits for elective care of any provider in the country.
Commissioned directly for their experience in supporting elective recovery across the country, CF delivered the work in an accelerated timeline, given the need to make rapid progress to reduce the number of people waiting over a year for treatment with a focus on having no-one waiting longer than 78 weeks and reducing the number of people waiting more than 65 weeks.
Over three months, CF mobilised delivery of an elective recovery plan including supporting theatre productivity trajectories and a tactical site optimisation plan. Working in partnership with the COO Directorate Team, the team established a weekly rhythm of output sharing with a strong focus on where analytical insights and practical improvements could be made. Leveraging their unrivalled access to health and care data, CF rapidly analysed over 100 data points, providing new insight for senior leaders. The implications were significant, demonstrating for the first time that the waiting list in some specialities would take in some cases over 10 years to clear without a step change in throughput.
In support of delivering the productivity improvements required to achieve the plan, CF rapidly mobilised a Delivery Unit to set, oversee the delivery of and achieve productivity trajectories for the number of operations per four-hour list, efficiency of how each four-hour list was used (theatre utilisation) and ongoing management of the number of people waiting.
The impact of CF’s partnership with MFT speaks for itself – more patients treated and a more effective use of resources to do so. Despite significant disruption due to industrial action across a number of NHS staff groups, MFT has made significant progress with around 3,450 more people are being treated by the Trust every month in the same cost base than before the work. The total number of people waiting has reduced by 27,000 people with people now waiting on average a month less than they did before, which will result in better health and wellbeing, and outcomes from treatment.
Where MFT was once the provider with the most people waiting, the number of people waiting over 78 weeks has been virtually eliminated such that they now rank 40th nationally. The number of people waiting over 65 weeks has more than halved from 9,000 in May 2023 to 3,700 in January 2024. This represents the largest improvement of any provider in the NHS, over the last six months.
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