NHS Trust
Four distinct assignments at NHS Trusts, involved conducting in depth reviews and developing recommendations for improvement actions, in the areas of:

  • Mental Health Care Management
  • Community Waste collection, Laundry and Courier Services
  • Estates Maintenance and Statutory & Regulatory Compliance
  • Environmental Management

Mental Health Care Management
The Care Programme Approach (“CPA”) was first introduced by the NHS in 1991 and has seen progressive evolution. The brief involved carrying out a review of the effectiveness of the implementation of the electronic CPA system, which forms the platform on which the Care Program Approach Policy, introduced by the Trust in 2004, had been implemented. This included:

  • The Care Programme implementation organisation
  • Project management programme
  • System implementation problems
  • Performance measurement and exception reporting
  • Resource management (e.g. training / case loads)

Community Waste collection, Laundry and Courier Services
 The department reviewed provided the following services for the local Trust and the area Primary Care Trusts:

  • Courier services between major community sites for the transfer of mail, CSSD instruments, pathology samples and chiropody instruments, laundry and clinical waste
  • Weekly delivery of clean and collection of soiled laundry to domestic properties within the locality
  • Meals deliveries and equipment and office removals

The brief was to review the scope and efficiency of these services within the Trust, understanding the management control systems; staff roles, responsibilities and rotas; working efficiencies; and operational issues in the area. Also to look at the cost of the service and the impact of the NHS Agenda for Change on costs and efficiency improvements to ascertain if the targeted flexibility had been achieved.

Estates Maintenance and Statutory & Regulatory Compliance
NHS Trust Estates department have the responsibility for maintaining the premises, such that they comply with statutory and regulatory standards for healthcare premises. The brief was to:

  • Carry out a review of the effectiveness of the Estates Management Systems with particular regard to Property Management and Maintenance.
  • Assess the degree to which the Trust achieved Statutory Compliance.

Areas included in the survey were:

  • Understanding the full scope of services provided by Estates
  • Reviewing the Estate Strategic Plan
  • Examining Performance Measurement, Reporting and Management Systems
  • A Risk management process audit
  • Critiquing Operational Management practices
  • Statutory Compliance Gap Analysis

All the appropriate Health Technical Memoranda published by NHS Estates, together with relevant publications form the Health & Safety Executive were studied and a matrix compiled with which to check for statutory and procedural compliance in estates management and maintenance.

Environmental Management
NHS bodies have a responsibility to identify all potential impacts of their organisation’s activities by a process of environmental audits and appraisals. This enables them to:

  • Set up a plan of action on the environment;
  • Address all environmental impacts produced as a result of delivering a healthcare service;
  • Establish a plan of action to identify where to target resources that will improve the environment.

All NHS bodies must comply with or exceed Government commitments to addressing and reducing their environmental impacts in the key target areas of: energy, waste, water, transport and procurement.

The review was undertaken to provide assurance that an effective process of Environmental Management was implemented and was operating satisfactorily. The review also tested the process against the management criteria of both the Core Standards and the Environmental Management Standard, (which provides a more detailed classification of key environmental areas).

In all four areas of work, recommendations for improvements were made and action plans and project timetables agreed.

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