Nearly half of NHS acute trusts lack a transformation plan

Research from Transforming Healthcare Consultancy highlights resourcing and funding challenges required to develop meaningful programmes that support the NHS Long-Term Plan

Nearly half of NHS acute trusts lack a formal transformation plan, according to new research.

A study by the Transforming Healthcare Consultancy, (THC), reveals that 44% of trusts are still to develop plans, suggesting that while national initiatives such as the publication of the NHS Long-Term Plan and the launch of the new digital transformation quango, NHSX, are setting the direction of travel; there are still significant challenges for local organisations in delivering sustainable change.

Commenting on the findings, Stephen Seagreen-Bell, managing director at THC, said: “In our experience the reason many NHS providers do not have a transformation plan in place is because they are working towards a wider strategic roadmap to improve services and patient care.

“Although useful for setting a vision for change, these tend to be aspirational and do not address the practicalities of on-the-ground transformation.”

He cited funding and resource planning as two of the main challenges for trusts working to develop and deliver transformation plans.

“The Long-Term Plan is essentially saying we need to do more with less to make the NHS sustainable,” he added.

“In our view, trust-level transformation plans are essential to provide direction, but to be meaningful and deliverable they must include resource plans, funding considerations, and appropriate scheduling. Otherwise they are at risk of becoming ‘wish lists’ that will not affect change.”

Poor infrastructure and endless paper processes are common barriers to delivering better clinical outcomes, and without a fully-resourced plan in place will result in a disjointed approach to digital transformation and improvement

Many strategic roadmaps which include improvement programmes and digital transformation projects are impeded by funding constraints or capacity limitations when dealing with changing or urgent organisational priorities such as winter pressures.

The presence of a transformation plan, Seagreen-Bell argues, allows for more-accurate and realistic planning capabilities, helping NHS providers meet their improvement ambitions:

“Transformation plans help trusts adequately plan for the delivery of high-quality improvement programmes and digital transformation projects in line with their strategies,” he said.

“We’ve seen this approach work time and time again.”

Transformation plans cover a wide range of initiatives and programmes including service development, system implementations, and consolidation of services delivery. They focus on delivering improvements in patient outcomes, increases in service efficiency, and reductions in service delivery costs.

In our view, trust-level transformation plans are essential to provide direction, but to be meaningful and deliverable they must include resource plans, funding considerations, and appropriate scheduling. Otherwise they are at risk of becoming ‘wish lists’ that will not affect change

All initiatives must be outlined in the strategic roadmap of the trust and be developed around the key principles of: Patient safety, better patient outcomes, reducing cost variation of service delivery, standardisation of service quality, increased financial control, and improved financial return on investment and service delivery.

Dean Mawson, a THC associate specialising in clinical safety, said: “Patient safety is the prime driver for change at NHS trusts and while it is important to aim for long-term, sustainable improvement; we must tackle the immediate issues being faced by those working in the frontline, which is what a good transformation plan will do.

“Poor infrastructure and endless paper processes, for example, are common barriers to delivering better clinical outcomes, and without a fully-resourced plan in place will result in a disjointed approach to digital transformation and improvement.”

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