Bedford Hospital NHS Trust

Bedford Hospital NHS Trust is a 400 bed District General Hospital within the East of England Strategic Health Authority region. Over the last few years they have performed well against most operational targets but were operating in an environment of a recurrent financial deficit of some £12 million. As an organisation, the performance was achieved through what has been described as “exceptional crisis management”. The latest plans tended to reflect the last crisis they faced.

Specific problem areas for the trust included:

  • Capacity was generally fixed despite variations in demand. This was reflected in rigid rostering patterns
  • The hospital faced frequent bed “gridlock” situations, which created an ongoing focus on reactive measures each day
  • Length of Stay indicators were declining
  • Improvement efforts were hampered by a lack of access to timely and accurate operational data, and
  • Culturally clinicians were disengaged, and capacity management was “top down”, rather than controlled by staff at the operational coalface.

Bedford’s Goals

Bedford is focused on improving their effectiveness as an organisation, and is aiming for Foundation Trust status.

Operationally, this means upper quartile performance, minimising organisational risk through uncompromised contractual delivery. They want to achieve this by being more proactive and in control through excellent forward planning, allowing them to align resources to patient demand on an ongoing basis. CapPlan is providing the mechanism for them to achieve this.

In concert with being proactive, Bedford are focused on staff engagement, ultimately moving control from the typical top-down approach to one where clinical and operational staff are empowered to coordinate and manage activity on a daily basis. CapPlan is providing up to date information to provide hospital wide visibility is key to this.

How is CapPlan helping?

CapPlan is the catalyst for change. It’s allowing Bedford to take actions at a local level (i.e. day to day decisions in the hospital) that reinforce the strategic directions they are taking. CapPlan is not a paper exercise, it’s about tangible actions. Bedford is using CapPlan in the following key areas:
  • Daily planning and operations management – The trust has moved from working out how they will get through today to putting proactive actions in place in advance to adjust capacity both up and down.
  • Weekly planning – Each week the Trust is able to plan with confidence what beds they want open and closed, as they have an accurate picture of what activity will look like.
  • Event planning – For periods like Easter and Christmas, Bedford have been able to coordinate effective capacity plans well in advance, and monitor and adjust these as they go through.

Benefits Realised

During the initial implementation phase, Bedford was able to save £110k over the first 4 months, and to date is averaging savings of approximately £600k per annum in Inpatient areas alone. This has been achieved without reducing standards of care, and disproves the perception that “we are always too busy and understaffed to save money.” Additionally, the access to timely operational reports direct to all staff has reduced the MIS resource requirements across the organisation.

In addition to the financial benefits, operational indicators have shown marked improvements in length of stay. As an example, through CapPlan providing the visibility the Trust has reduced long stay patients staying greater than 10 days by 50%.

Other areas of improvement include:

  • Staff planning is evidence based and aligned to workloads, and along with the financial savings from this, life is easier with less bed block events and fairer staffing allocations.
  • CapPlan is providing information that is available to all staff in real time, across all parts of the hospital, creating great visibility.
  • Data integrity has increased markedly without any additional data entry required.
  • Through significantly enhanced visibility, there are no excuses for not knowing the status of the hospital. This has removed silos and created more teamwork.
  • CapPlan has put Clinical staff and the Matrons in the driving seat, with daily coordination and planning undertaken at the coalface without the need for senior management involvement.
  • With limited IT resources available, Bedford have seen the benefits of an implementation process that involves standards based architecture and a simple 1 way integration.
  • Bedford we now are seeing strategic planning benefits from CapPlan. It is a key tool in negotiating and commissioning activities, and also is supporting workforce planning strategies such as annualised hour’s initiatives.

Where to next?

CapPlan is a catalyst for change and has provided a means for ongoing improvement. With Bedford’s Inpatient management processes significantly improved, they are now working with CapPlan on planning and managing Theatre flow, and then they will tackle Outpatient capacity management. What this will provide Bedford with is a whole organisation approach to planning and coordinating staffing and capacity to meet patient needs.

Want to know more?

Bedford NHS Trust would be pleased to talk with you regarding CapPlan and the benefits it can produce. The Trust regularly holds on site “mini workshops” where you can understand further what CapPlan can do for your organisation from management, clinical and IT perspectives. In the first instance, please contact Angela Self at Emendo on +44 (0844) 335 0421 or enquiries@capplan.co.uk to arrange contact with Bedford NHS Trust.