Flow Cost Quality

In brief

Poor systems deliver poor results – for patients, NHS staff and taxpayers. Until now a common assumption in the NHS has been that more cost is required to improve patient flow and healthcare quality. However it can be argued that, so far, increases in cost have not resulted in proportionate improvements in access to or quality of care.

Our Flow Cost Quality programme focuses on the relationship between patient flow, costs and outcomes in two NHS hospital trusts. It is examining patient flow through the emergency care pathway and developing ways in which capacity can be better matched with demand, to prevent queues and poor outcomes for patients.

We are working in partnership with South Warwickshire NHS Foundation Trust and Sheffield Teaching Hospitals NHS Foundation Trust. The teams are being supported to:

• understand the emergency care pathway and how it relates to the wider healthcare system

• understand demand being placed on every organisation and department from all sources (emergency, planned, outpatient and follow-up care)

• develop capacity plans to meet the variations in demand and prevent queues – assess the gap between current and required capacity

• test the impact of changes to capacity by reducing the capacity variations, improving productivity, and reallocating resources.

The teams have completed the analysis phase and are now moving on to implementing changes that will improve patient flow across the emergency care pathway.

Dr Kate Silvester is providing dedicated clinical systems improvement expertise and is working closely with teams at both organisations.  Kate has expertise on the design and management of organisational systems to deal with variability in demand and capacity. She originally trained and practised as an ophthalmologist before retraining as a manufacturing systems engineer.

She has extensive experience transferring manufacturing principles to service industries such as banking, airlines and healthcare. She has worked on national NHS programmes to improve the flow of patients through the system, improving the timeliness, cost and quality of healthcare.