Improving Value for Money

by Steven Course, Chief Finance Officer, Nynn-Hui Chang & Marco Aurelio, QI Team Improvement Advisors

Often the rationale for undertaking QI has focused on doing the right thing, with the main focus not on the financial gain resulting from the improvement work. However increasing pressure on NHS budgets and rising patient demand is putting a strain on the system to deliver more with fewer resources. With this in mind a priority for some of our QI work within the trust going forward is what we’ve called improving value for money.  One of the ways we’d like to tackle this at ELFT is through the use of QI methodology to deliberately redesign systems to eliminate waste and improve efficiency.

One team currently using QI to tackle an aspect of waste is the Salary Overpayments project team, comprised of colleagues from finance and human resources (HR). Last year the trust had 229 overpayments totalling £369,000. This represents a significant amount of unnecessary waste in the system not only financially, but administratively from staff needing to recover the overpayments.

The team aims to reduce salary overpayments by 30% by April 2018 and are using QI methodology to do so. Early on the team used data from trust finance systems to begin to understand where and why overpayments were happening within the trust. Interestingly what they found was that the majority or late payments were caused by late submission of staff change or leavers forms.

Why is this? What were users of this system in this case saying? To develop their knowledge around, the team sent out a survey to some 500 staff to understand what some of the barriers to submitting change forms were and what might be done to help. Some key themes that emerged included lack of clarity around the process for submitting forms, confusion over the date for form submission to payroll and difficulty in using the online forms among others.

The team were able to use the great insight from the survey to begin to develop a whole host of potential change ideas to the system including the re-introduction of positive returns, changes to the intranet, new guides and help documents and changes to the London field weighting on change forms.

While the team are in the early stages of testing some of these, they are keen to more fully understand the user experience around submitting change forms. To do this they’re looking for a few volunteers who regularly submit staff-change and leavers forms to join a focus group to explore this.

So if you’re interested in being part of this drop us an email to elft.qi@nhs.net

To find out more out about developing a value for money based system please take a look at some of the following resources:

• Increasing efficiency and enhancing value in health care – Nolan et al.
• Value creation systems – Swenson et al