Cost Improvement Plans (CIP) in mental health and community trusts

Our internal audit team hosted a round table discussion for executive leads on Cost Improvement Plans (CIPs) in mental health and community trusts in our London office in April 2016. During this event, we considered the drivers and lessons for developing effective CIPs.

Key learnings from this session 

  • Clarify the vision and the strategic direction for service transformation at the outset, setting clear targets and measureable objectives. 
  • Involve clinicians and stakeholders from the local health economy early on in the process.
  • Increase engagement by setting up innovation funds to encourage bottom up contributions - efficiency is a collective responsibility.
  • Identify schemes by using benchmarking data, divisional profitability and SLR information and get clinical involvement in the identification process.
  • Scrutinise schemes for achievability and impact on quality and get senior clinical sign off on quality impact. 
  • Agency staff utilisation should have agreed rules. Look at cost drivers and rationalise costs, removing expensive staff when possible and reinvest savings into the clinical departments.
  • Maximise use of e-rostering to increase utilisation of the back and to identify areas of spare capacity. 
  • A recruitment strategy should be developed, ensuring that staff retention is an integral part of that strategy. Actively work with clinicians to identify posts staffed by agency staff and challenge what is being done to recruit substantive staff to these roles.
  • Medicine management efficiencies should be identified by reviewing procurement and dispensing. Manage the variability of prescribing and develop systems to reduce waste.
  • Peer to peer challenge sessions should be held to drive performance improvement and foster accountability through the middle management chain. 
  • Monitor schemes for their delivery, performance, finance and a quality perspective. All four elements should be integrated rather than being considered in silo. 
  • Review areas of underspend and challenge these as much as overspends to identify efficiencies and hold management to account on a regular basis.
  • Use internal audit to evaluate the overall programme and recommend improvements.
  • Collaborative working should be encouraged by integrating clinical and corporate teams.

Following this event we have agreed to help facilitate an informal network of interested parties working within a mental health setting to allow for ideas to be shared both on process and specific schemes which are being successfully generated. If you are interested in becoming involved please contact Clive Makombera.

For further information, slides from the workshop and additional events please contact Clive Makombera or speak to your usual RSM contact.

To discuss your CIP and how we might help please contact Steve Uttley.


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Future events

A follow up event is being arranged for later in the year.  To register your interest please contact Emma Kennedy.