In this slideshow, Wayne Preston, Transformation Director, Buckingham Healthcare NHS Trust and Anthony Kidd, Director, Kidd Smith Associates, outline the key solutions they have found to increasing efficiencies whilst driving quality in hospital administrative services. Wayne Preston and Anthony Kidd presented at How can hospitals do more with less? in October 2012.

1. •Introductions
•Who we are
• The current environment
•The need for change
•The Qipp proposal
•The Barriers to change
•Delivery methods – efficiency, trust objectives, considerations
•Trust objectives, the right solution where to start
•What to do how to do it
•Emerging Themes

2. Administrative Excellence
Programme
Finding the right solutions for
administrative services

3. • Wayne Preston
• Anthony Kidd
Introductions
• NHS Institute for Innovation and Improvement

4. • Almost zero growth in funding
We have to make changes
• The Nicholson challenge of £15-20bn efficiency savings between
2010 – 2015
• QIPP (Quality Innovation Productivity and Prevention)
• First class clinical care third rate administrative support
• Policy drive for greater integration of providers
• NHS reforms GPCG, increasing competition and choice

5. QIPP Report
• The QIPP national work stream report (“Back office efficiency and
The Case for Change
management optimisation”) suggested that as much as 40% to 50% of
the cost of some administrative functions could be saved through use of
shared services, partnerships and out-sourcing solutions.
• The equivalent saving for a typical Trust of £225m turnover could be in
excess of £18m (40% of 20% spend)
• A recent PWC report indicated that typical savings achieved within the
private sector through greater use of shared services are as shown in the
table below:
• It is anticipated that equivalent savings can be made in both front and
middle office functions

6. What’s stopping us?
“Opportunity missed because
of public sector timidity and
being risk averse”
(November 21st 2011 Francis Maude)

7. Challenges to Administrative Change
•Robust information and poor performance
measurement
•Management accountability
•Achieve clinical support
•Management and organisational fragmentation
•Cultural barriers
•A lack of commercial skills / partnering
experience

8. •Internal Improvement
Changing the delivery
•Partnership
•Outsourcing (managed services)
•Stop - Simplify – Standardize - Share

9. The objective of Administration
“the efficient organization of people and other
resources so as to direct activities toward common
goals and objectives”

10. Trust Objectives
For the NHS Trust
Clinical Outcomes
Patient Experience
VFM
Staff Wellbeing

11. What is the “right solution for our Trust”?
What we need to consider
Capability
Capacity
Culture
Risk

12. Review of Administrative Services
Where to Start?
Front Office
Middle Office
Back Office ***

13. • Phase 1
The Programme “What”
• Diagnostic
• Quick Wins
• Strategic Opportunity Assessment
• Readiness review
• Phase 2
• Implementation support

14. • Interviews
The Programme “How”
• Workshops
• Questionnaires and surveys
• Data Analysis
• Environmental Analysis

15. – Resources, Information and CIP
– Learning Networks
Emerging Themes
– Transactional Services
• Payroll
• Purchase ledger
• Sales Ledger
– Partnering
• L&D Mandatory and Statutory
• Recruitment
• Advisory

16. – Resources, Information and CIP
• Context – (18/225 : 28/350 – only spend £30m)
• £30m annual ask 2010/11- 2012/13
BHT Perspective
– Learning Networks
• Protectionism / Take over
– Transactional Services
• Payroll – (£50k a year / but 20% error)
• Purchase/Sales ledger – IT costs
• Like for like (apples and pears)
– Partnering
• L&D - INSTAL
• Local Options – NHS and Other