Lean Pathway Leads to Rapid Change

Providing pathway redesign support to a Regional Health Economy programme, on behalf of an NHS Commissioning Trust which serves a population of c.635k and controls a budget of £900m. It commissions services from a diverse range of providers, including health providers, public sector bodies, independent sector organisations and a range of independent contractors. These include 83 GP practices, 98 pharmacies, 100 dental practices and 75 optometry practices.


The organisation required support to ensure that its service pathways achieved the national 18 week ‘Referral To Treatment’ (RTT) target ahead of schedule.

The requirements of the programme were:

Achieve 18 week RTT initiative across the Gynaecology pathway within 6 months.

Eliminate waste whilst improving customer service and quality.

Enable operational teams to utilise problem solving techniques to continuous improve.


Implement Multi-Disciplinary Team (MDT) clinics to eliminate follow-up appointments and improve efficiency.

Balance workload between consultant teams.

Introduce Standard Operating Procedures (SOPs) to ensure consistency.

Train and develop the team to build Lean skills.

Revise and redesign operational layouts.

Eliminate waste through process mapping and workplace organisation.

Utilise visual management to identify process issues and deploy problem solving techniques to empower teams to resolve day to day problems.


84% Average RTT lead time improvement.

30% improvement in employee satisfaction.

Substantial cost reductions through the elimination of waste and follow-up appointments.

Scope for increased revenue through extra capacity and increased Multi -Disciplinary Team (MDT) Tariff.

Creation of best practice model for roll out across other clinical specialities.

“The team’s knowledge combined with their range of Lean tools and techniques ensured rapid change. Their ability to engage management and clinicians aligned with professional coaching and training provided project sustainability and cultural change.” Service Improvement Manager




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