Cultural Change Delivers Sustainable Improvement  


One of London’s busiest acute hospitals, serving more than 350k people, treating daily 500 patients in A&E, 450 inpatients, and 800 through outpatients.


The Trust was facing significant financial pressure and a deterioration in its key operational metrics, in addition to various cultural challenges.

Linea were engaged on behalf of the Trust and NHSE/I to design, implement and manage a Recovery Programme to resolve various operational, quality and workforce issues, whilst delivering a financial surplus and programme of cultural change.

We were also required to provide operational, crisis & recovery management support to the Executive team as part of the Trust’s response to the Covid Pandemic.


  • Devised a recovery programme tasked with achieving in-year financial delivery against the control total.
  • Devised an annual efficiency programme to deliver £17m.
  • Created and led change programme focus on cultural change, care quality improvement, operational productivity, financial control and workforce empowerment.
  • Developed overarching approach, work streams, key risks, KPIs and delivery support mechanisms, supported by the creation of a PMO, programme team, programme metrics and governance structure.
  • Review of governance meetings to improve information, prioritisation & candour, supported by Improvements board, recovery meetings and redesign of financial reporting frameworks, ensuring fiscal control & robust operational management.
  • Established and led an executive command centre to support the Trust Covid response
  • Established a PPE inventory system and sourced stock unable to be supplied nationally – ensuring appropriate supply of PPE and no stock shortages.


In-year financial improvement of £6m in < 3 months.

Implementation of multi-year programme to deliver annual savings of c.£17m

Created a Theatre & Outpatient activity reporting & performance management framework, improving theatre activity by 30% and outpatient activity by 15%.

Delivery of £4.5m of workforce efficiency savings over 3 months.

Created one of the first COVID Screening operations at Tottenham Hotspurs Football Club to support staff, consequently extending the service to staff & patients of organisations across North Central London Region.

Transferred the Women’s Health Operation to THFC to maintain capacity and reduce patient risk, a UK first. Whilst also establishing a temporary MRI scanning operation at Barnett Football Club.

Linea’s knowledge, expertise and support has left the Trust in a much better position on many fronts. The team engaged at all levels of the organisation providing unparalleled advice and support, imparting their know-how and experience to resolve a number of strategic and operational challenges. Our re-energised Improvement Board and enhanced reporting will stand us in good stead for the future.  

Chief Executive Officer




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