Cost Improvement Plans

02 August 2016

In April 2016 following requests from a number of our clients we held a roundtable session in London bringing together a number of our mental health and community clients across London and the South East. The aim of the session was to share ideas and to see whether through any shared learning it could help to reinvigorate local CIP and help to highlight any further areas to seek savings which might not have previously been considered or at least explored in detail.

The second part of the session looked at the process and where there may be potential to help improve the processes for planning, managing, monitoring and holding to account. There were some great ideas shared and we are already planning a follow up session in the autumn to see whether there have been further developments since the initial meeting.

It will be of no surprise to note that almost without exception the biggest challenge came from the need to control agency and temporary staffing expenditure. At the nub of the issue is how effective the rostering can be to maximise the use of permanent staff and bank and to minimise the use of agency staff. This needs to be allied through to wider workforce initiatives around effective recruitment and an area that is often overlooked, that of Retention. Organisations can save considerable amounts of time and money by looking after their staff and persuading them to stay working at the organisation. Recent audit studies we have undertaken have shown that few organisations are systematically asking the question of leavers as to why they are leaving and therefore it goes without saying that organisations can be slow to learn the real reasons that cause people to look for jobs elsewhere. If this information could be harnessed and lessons learnt in the same way that organisations are increasingly able to do when their patients are dissatisfied, this may help to increase retention rates with a financial and qualitative knock on effect right through the organisation.

See below some of the other key points of interest and tips for success to emanate from this first 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 reinvesting savings into the clinical departments.
  • Maximise use of e-rostering to increase utilisation of the bank 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.
  • Medicines 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.
  • Review areas of underspend and challenge these as much as overspends to identify efficiencies and hold management to account on a regular basis.
  • 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 get in touch with one of the contacts on the back page of this document or speak with your usual RSM contact.