NHS Darlington Primary Care Trust

NHS Darlington Primary Care Trust wanted to improve patient outcomes, safety and service efficiency.

Oakland worked with the senior team and across the primary care trust, winning support for the project and identifying where processes could be simplified. A key part was to involve staff in this, so they owned the changes – rather than ‘doing it to them’. The whole project was highly tailored to the Trust and its focus.

More than 130 people were trained in the PCT’s highly customised quality improvement approach which subsequently led to more than 75 improvement projects.

Significant improvements were achieved in waiting times, reducing non-attendance rates, wound care management costs, resource utilisation and, very importantly, increased access for patients and more time for clinicians to provide care.

Oakland won an open tender to work with NHS Darlington, to create a culture of continuous quality improvement across the PCT. Our approach was to encourage and support their culture, rather than attempt to impose one on them- this was our winning differentiator.

Paul Slater, the Oakland Partner who led this project, said: “There was a sense of ‘we’ve seen it all before’ at the beginning of the work, so it was really important to show how we would deliver value and not dictate to them or produce a consultancy report and walk away.

“We won people over by showing how, if we could save time through efficiencies, this would not result in job losses, but more time to spend with patients on a daily basis.”

An unusual aspect of Oakland’s approach on this project was to have one of the team appointed almost full time on site. Paul explains: “This meant we had someone on hand to drop into team meetings and ensure everyone had a good idea of what they should be doing.

“This built good relationships with the joint project team and meant we were involved in their everyday operations – ultimately everything was a better fit with their culture and we could get new processes up and running quickly.”

One of the key challenges was finding enough time for everyone to be trained to develop new skills.

Oakland created an approach based around ‘Releasing time to Care’ and focused on the benefits to clinicians, for their personal careers and job satisfaction because everyone would have more time with patients.

The Oakland team also went through PCT processes to see what could be taken out or reduced – as an example, one area had 18 referral stages which eventually reduced to just one.

The project significantly reduced patient waiting times, with one area improving its target waiting times from 65% to 90%.