LEAN initiative within Health and Social Services (FOI)

​Request

I am requesting information on the cost to administer the LEAN initiative within Health and Social Services including staffing costs

The savings made directly resulting from LEAN initiatives.

Response

The predicted 2017 year end cost to administer the LEAN (Quality Improvement) Programme within Health and Social Services is £447,852. This is made up of £364,862 staff costs and £82,991 non staff costs. The definition applied to “administer” is all trained Lean Practitioner staff employed substantively for the delivery of Lean initiatives.

The recorded savings made directly resulting from LEAN initiatives total in excess of £700,000 recurrently to date.

Lean is not just a cost saving exercise. The brand for LEAN in Health and Social Services is “Quality, Safety, Value” - the order was deliberate and is important.

The primary aim of the LEAN Quality Improvement Programme is to provide higher quality, safer care to patients and service users across Health and Social Services. Many projects deliver numerous significant quality and safety benefits which cannot be quantified as financial savings.

Some examples are below:

The Corbiere Ward Rapid Process Improvement Workshop (RPIW) held in October 2016 delivered a 29% reduction in length of stay for patients. This enabled 65 more patients to receive treatment on the ward during the winter pressure period 1 November 2016 to 28 February 2017.

The Social Work Assessment RPIW held in February 2017 reduced the average waiting time from receipt of referral to 1st contact, from 54 days to four days.

The Beauport Ward Stock RPIW held in May 2017 resulted in Health Care Assistants having 66 more hours per year to care for patients.

Successful Lean Quality Improvement removes waste in processes, enabling our highly trained staff to spend more time providing high quality care to patients and service users.

To relate Lean to making cost savings is a serious error. The quote below is from one of the organisations that inspired the Health and Social Services department to introduce Lean:

David Fillingham, CEO of Royal Bolton Hospital NHS Foundation Trust in the United Kingdom, has said, quite simply, “Good quality costs less.” This was proven to be true as a result of Bolton’s Lean improvements; the hospital reduced trauma mortality by 36% and reduced a patient’s average length of stay by 33%. ThedaCare documented similar results in cardiac surgery; mortality fell from 4% to nearly zero (11 lives saved per year), with a length-of-stay reduction from 6.3 to 4.9 days, and 22% lower cost. It might sound too good to be true, but many hospitals are proving that you can simultaneously improve quality, access, and cost.

Mark Graban, author of the classic text book on the subject “Lean Hospitals” comments on the misplaced belief that Lean is about saving costs, saying “It’s intentional that the word cost is not in the book’s subtitle: “Improving Quality, Patient Safety, and Employee Engagement. “In today’s world, the “need” for Lean in healthcare is very clear in terms of quality and patient safety, waiting times, and staff morale.”