1. Thinking differently –
Lean at UCLH
Introduction

2. 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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3. The challenge … how do we
remove all waste, duplication and error from our processes to ensure
we remain one of the very safest hospitals in the NHS?
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ensure sustainability so that our clinical teams are able to deliver
improvement both today and tomorrow?
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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?
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truly devolve decision-making to as close to the frontline as possible?
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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?
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make this an exciting proposition for staff?
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4. Delivering on challenging targets …
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
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5. … but it is getting tougher
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6. Our values and behaviours
We put your safety and wellbeing above everything
Deliver the best
outcomes
Keep people safe
Reassuringly
professional
Take 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
Work in
partnership
Respect
everyone’s time
Develop through
learning
Innovate and
research
We achieve through teamwork
Listen and hear
Explain and
involve
We strive to keep improving
Courage to give and
receive feedback
Efficient and
simplified
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7. 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
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8. Wouldn’t it be great if non-clinical support services are focussed on
supporting ward sisters in their role in delivering high quality safe
carevision: patient experience
Our and
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….

9. 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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10. 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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11. 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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12. 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 care
Elective care
Neurosurgical pathway
Liberating everyone
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