Performance Improvement in the Public Sector
In its first year, Improving Together has helped Mid Yorkshire Teaching NHS Trust create the foundations for long term sustainable performance improvement – namely through a disciplined Board to Ward management system – aligning priorities, empowering frontline teams to deliver measurable improvements for patients and staff.
What could 10,000 empowered NHS staff achieve?
Starting in January 2025, the Mid Yorkshire Teaching NHS Trust partnered with KPMG to implement a disciplined Board-to-Ward management system to drive improved patient outcomes and smarter ways of working.
Working shoulder-to-shoulder with leaders and frontline teams, the focus of the KPMG team was clear: help align priorities, optimise leadership behaviours and build the internal systems and capability to make improvement systematic rather than episodic.
The programme, Improving Together, translated this management system into daily practice.
At Executive level, leaders now set a small number of breakthrough priorities and review them through visible performance routines. At ward level, teams run daily huddles, track performance visually and test improvements in real time. Crucially, the two are connected. Ward-level measures directly link to Trust objectives. Leaders can see variation and bottlenecks as they emerge, and frontline teams understand how their daily actions contribute to organisational performance.
The formative results in the first year have been notable, including:
• Patients spend 10% less time than equivalent months in previous year in 3 elderly care wards, returning home sooner and freeing beds for others who need them.
• MRI waiting times cut by 50% in one focus ward, reducing average waits from six days to three and bringing diagnostic clarity days earlier.
• Pre-10am discharges improved by 46% in surgical wards, improving flow in the hospitals.
• CT waiting times reduced by 80%, with on-time scans increasing from 42.5% to 100%, eliminating avoidable diagnostic delays.
This approach was not a single intervention or external fix. Whilst this is early in the Trust’s journey, there has been a cumulative effect of performance improvement where teams are empowered to solve problems every day, connected to a clear strategy from Board to ward. Moreover, as the programme continues to scale, spread and embed itself and further learnings are uncovered, the benefits can be expected to significantly accumulate.
This partnership between KPMG and the Trust is helping create an organisation where:
• Priorities are clear and limited
• Performance is reviewed daily, not retrospectively
• Frontline teams own problem solving
• Improvement is sustained because it is embedded in routine
This is the first year of a multi-year improvement journey where challenges will naturally arise as the climate in the NHS evolves and new ways of working start to scale, spread and embed across Mid Yorks’ 10,000 staff. But with the organisation’s newfound capability and commitment in the approach towards making improvement systemic, they will be able to continue deliver improvements for years to come.
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