Shropshire Community Health NHS Trust wanted a clearer picture of potential efficiency opportunities to feed into its internal cost improvement plan and contribute to reducing financial pressures within the local health economy.
With experience of producing bespoke financial analysis for a range of healthcare organisations, Arden & GEM’s Finance Solutions team was engaged to investigate general and specific areas of opportunity for efficiency savings. The final report and accompanying action plan produced by the CSU have given the Trust an independent, objective and evidence-based approach to galvanise support for delivering change.
The challenge
Shropshire Community Health NHS Trust provides community-based services for a population of almost 500,000 in Shropshire, Telford, Wrekin and the surrounding areas.
While successfully achieving its organisational financial targets, including statutory financial duties, the Trust was keen to continue delivering services as efficiently as possible and also play its part in alleviating some of the significant financial pressure within the local health economy. To support this objective, the Trust’s leadership team and internal auditors, BDO, wanted a clearer picture of potential efficiency opportunities, from an independent and credible organisation, to feed into the internal cost improvement plan (CIP) for the 2022/23 financial year.
With experience of producing bespoke financial analysis for a range of healthcare organisations, Arden & GEM’s Finance Solutions team was engaged to undertake a review of both general and specific areas of opportunity for further investigation, with an accompanying action plan, by April 2022.
Our approach
A dedicated project group was established to bring together cross-sector healthcare finance knowledge from a national, regional and local perspective with financial resilience expertise and administrative support. The project group worked alongside the Trust’s Deputy Director of Finance to ensure access to any information required and provide ongoing assurance that the project outputs were meeting the clients’ needs.
Desktop review and investigation
The project team initiated the investigation by reviewing:
- The Trust’s annual report and accounting statements for 2020/21
- The annual reports and accounting statements for both NHS Shropshire CCG and NHS Telford and Wrekin CCG for 2020/21.
Shropshire Community Health’s position was then compared with data from Trusts within nationally recognised peer groups based on geography, size, staffing and services. Comparisons used NHS RightCare, NHS Model Hospital and annual report information, with consideration given to minimising potential distortion created by the impact of the COVID-19 pandemic.
Stakeholder interviews
Interviews were then held with the Trust’s:
- Chief Operating Officer
- Chief Nursing Officer
- Director of Finance.
The initial desktop review and investigation informed the lines of enquiry for the interviews with questions tailored to functions and shared with participants in advance to encourage open and constructive discussions.
The interviews confirmed many of the recommendations already identified but added depth, detail and current progress that could better inform action planning and delivery mechanisms.
Final report and action plan
The findings and recommended action plan were structured into four key areas that align with national efficiency terminology:
1. Cost reduction
2. Cost avoidance
3. Income generation
4. Service productivity improvement.
Each area included general findings along with specific opportunities based on comparator data. Further opportunities were also identified within case studies from the NHS Financial Resilience Support Site.
The outcomes
The final report and action plan was completed by the agreed deadline following a three month period of review, investigation and interviews. It has been used within the Trust to secure stakeholder support for implementing the recommended changes, including at board level.
In arriving at the recommendations tried, tested and evidence-based methodologies were used along with a range of data sources to triangulate findings and minimise the distortion from COVID-19.
By working collaboratively with both Shropshire Community Health’s finance team and BDO the plan is aligned with the Trust’s ambition to put appropriate governance structures in place around efficiency plans and complements reports issued by the internal auditors.