Client

Lewisham and Greenwich NHS Trust

Duration

9 Months

Scope 

The programme focused on accelerating performance improvement across core UEC pathways while embedding sustainable change. An improvement programme was established across ED, Acute Model, SDEC, Flow and Discharge.

The team worked alongside clinical and operational leads to refresh and deliver existing high-impact initiatives, such as introducing structured huddles, optimising triage flows, re-designing flow management meetings, and strengthening the use of board rounds. A key objective was reducing breaches, improving patient throughput, and lowering length of stay, with an emphasis on system integration and clinical ownership.

We provided hands-on delivery and programme governance design, introducing standardised project management documentation, KPIs, and a tailored governance framework to support both tactical ‘quick wins’ and longer-term improvement opportunities. Our collaborative approach ensured capacity building within Trust teams, alignment with QI functions, and readiness for BAU transition. The programme also included demand and capacity modelling, development of a new model for acute medicine, SOP development, workforce planning, and cross-site coordination to improve consistency, responsiveness, and patient experience.

Impact

•Improved T1 ED performance 16%

•Improved T3 ED performance 8%

•Implemented SHOP model across medical wards, increasing discharges by 30% in four weeks

•Designed processes to manage stranded and super stranded patients to increase complex discharges more than 50%

•Developed a new acute medical model, recurrently funded by closing 31 escalation beds and removing the need for boarding