An important part of Our Healthier South East London is NHS trusts working together to improve care and strengthen the financial sustainability of the local NHS.
There is a significant affordability challenge across the NHS nationally. Every part of the NHS is facing this issue and is working on ways to make sure that organisations work as productively as possible. This will help ensure sustainability of our services in the future.
We are exploring every opportunity to get better value for money and the best results for our patients, making the most of resources that are under increasing pressure.
In south east London we can make more substantial savings by focusing on productivity at scale – across all of the providers at the same time – than by each organisation doing this alone.
There are six NHS trusts co-operating on this work, developing more collaborative ways of working which could reduce costs and help manage demand:
- Dartford and Gravesham NHS Trust
- Guy’s and St Thomas’ NHS Foundation Trust
- King’s College NHS Foundation Trust
- Oxleas NHS Foundation Trust
- Lewisham and Greenwich NHS Trust
- South London and Maudsley NHS Foundation Trust
Our main objective is to, where possible, consolidate overheads – these are the costs that trusts incur during their day-to-day activity. Our early estimates suggest that up to £260m could be saved by:
Standardising and consolidating non-clinical support services, wherever possible
At present, non-clinical support services (such as HR, finance) are duplicated across trusts, tasks are repeated and there is significant variation in quality. The consolidation of non-clinical support functions will lead to savings through economies of scale, standardisation and simplification of processes, improved technologies and effective talent management. We aim to have established a new model for HR, IT, procurement and finance in the next three years.
Optimising the workforce by aligning staff bank services and managing agency contracts
We can achieve savings by: reducing demand for temporary staff; reducing agency rates; increasing supply of affordable temporary staff; and working with the London Ambulance Service so that, where appropriate, patients can be treated on scene and discharged (for instance, training and educating paramedics into newly defined roles, such as advanced practitioners). By 2021 we want to have built a large staff base by offering competitive rates and other non-financial benefits.
Taking advantage of trusts’ collective buying power
There is price variation, inefficiency and a large volume of waste in our procurement systems. Furthermore, there is a lack of data and proper analytics to support product decisions, with clinicians aligning patient outcome/cost with products. We think that (aligned with the Carter Review) supply chain management can be centralised while some responsibility is retained locally. We want to adopt a category by category approach to drive down price variation and common processes to reduce unnecessary waste and inefficiency.
Consolidating clinical support services to generate economies of scale and deliver consistent, high quality services
We have a number of common challenges across the clinical support services. There is variation in service and medicines costs; peaks and troughs of demand; and system and process inefficiencies which delay turnaround and reporting times, impacting patient outcomes. We plan to address these and achieve savings by reducing the drugs bill and improving pharmacy infrastructure services; workforce re-profiling and process improvements that make use of available technologies to create a leaner, multi-skilled workforce with improved retention rates; sharing equipment and contracts; and optimising purchase and use of consumables and reagents by using our collective power to negotiate.
Making best use of trusts’ estates
There is currently too little activity at some sites, and too much activity at others. Lack of accurate data means strategic planning and decision making is difficult. In 2021, we want organisations to have total transparency of information informing a south east London wide estates strategy. We will work to ensure estates are fit for purpose, flexible and will fulfil future service requirements. The idea of collaboration within estates is not new, but collaborative productivity will allow it to happen on a new scale. This would build on important work done by organisations such as Essentia, Community Health Partnerships, NHS Property Services, and the OHSEL estates group. Read more about our estates work