NHS Darlington

What the Client Said

Oakland built an in-depth understanding of our needs and their pragmatism and flexibility have been central to our success
Assistant Director, Modernisation and Reform, NHS Darlington

Background

The National Health Service (NHS) Darlington is one of 12 Primary Care Trusts (PCTs) managed by the Strategic Health Authority for the North East of England. Working in partnership with NHS County Durham, NHS Darlington is responsible for commissioning (i.e. planning and buying) and providing (i.e. delivering) health services for a diverse community of around 600,000 people across the region. They employ approximately 3,000 staff and have an annual budget of £1.1 billion to spend on services.

Assignment

In March 2009, NHS Darlington engaged Oakland to work in partnership to improve patient outcomes, safety and service efficiency by developing and implementing a large-scale quality improvement programme across the organisation. The programme and its supporting infrastructure would also play a key role in helping NHS Darlington with their journey towards a culture of continuous improvement.

Approach

Oakland developed a simple and pragmatic approach to the improvement programme in NHS Darlington that was highly customised to meet their service needs. It involved:

Executive Engagement

• Creating executive buy-in through interviews, workshops and leadership forums to establish clarity on the role they played in the programme’s success.
• Developing a clear ‘vision’ and direction for quality.
• Quality improvement training to ensure the leadership team were well versed in the concepts and methodologies associated with the improvement programme.
• Coaching the executive team to ‘walk the talk’ and demonstrate absolute commitment for the programme in words and deeds.

Quality Improvement Training

• Training ‘Improvement Leaders’ in each of the service areas with an in-depth knowledge about the DRIVER methodology – a proven approach to continuous improvement. This created people who could coach others across the organisation and enabled each service to start to reap the benefits of improvement initiatives.
• Quality improvement training for over 5% of the staff population in the quality tools and techniques of the DRIVER methodology. This cohort could then use the approach to lead improvement projects and teams across all areas of the business.
• Training for the executives and the senior management team to provide them with sufficient understanding of the methodology and tools to support improvement teams.

Quality Infrastructure

• Establishing a set of key performance indicators and appropriate reporting mechanisms.
• Designing, distributing and analysing a culture survey to develop a baseline understanding of the organisation’s culture and approach to quality.
• Developing and implementing a communications strategy.
• Holding high-profile communication events and forums aimed at facilitating the sharing of best practices.
• Developing a Governance process to ensure that the programme continues to gain momentum.

• Developing the criteria and process for selecting priority areas to reengineer in the PCT.
• Designing standardized materials to ensure a consistent approach to process improvement across the organisation.
• Identifying and delivering breakthrough wins in service that were able to drive improvements in patient pathways, creating exemplars for the approach.

Achievements

• The Executive team in NHS Darlington identified a common view of the ‘vision’ for Quality Improvement and this has provided the basis for developing a PCT wide approach to quality improvement. They have also determined pre-requisites for the achievement of that vision and identified the key opportunities for aligning quality improvement initiatives to the PCT’s strategic agenda.
• All of the executives and senior management team have been trained in the DRIVER improvement methodology so that they are equipped to support improvement teams in the business and most have already been actively involved in supporting quality improvement projects.
• Over 130 people trained in the PCT’s highly customised quality improvement approach and now leading improvement projects.
• Over 75 DRIVER continuous improvement projects running across all directorates delivering significant benefits to patients, staff and the organisation.
• Four major breakthrough projects have been delivered with significant improvements to waiting times, non-attendance rates, wound care management costs, resource utilization and access for patients. They are widely perceived to have not only delivered real insight to the business but they have also provided a meaningful example of the way that the DRIVER methodology can provide benefits to a primary care environment in the NHS.
• The programme team have been conscious of the need to build a solid foundation for the PCT by creating a critical mass of employees that are engaged, inspired and enabled to transform the business through process improvement. A number of initiatives have been put in place to help the PCT to start to establish this foundation but it will continue to be a main area of focus for the programme as it develops into maturity.

To contact one of our quality improvement or NHS experts for immediate help or further information please contact us or telephone: +44 (0)113 234 1944