Nearly half of NHS acute Trusts 'do not have a transformation plan'

A total of 44% of NHS acute Trusts lack a formal transformation plan, according to research by a network of NHS transformation specialists.

Transforming Healthcare Consultancy, (THC) a team of individual specialists who provide health service improvement, change management and digital transformation services, conducted the research in November 2018.

The research suggests that while national initiatives, such as the NHS Long Term Plan and the launch of the new digital transformation quango NHSX, are setting the direction of travel, there are significant challenges for local organisations in delivering sustainable change.

Commenting on the findings, Stephen Seagreen-Bell, managing director at Transforming Healthcare Consultancy said that the absence of transformation plans at provider level was not surprising: “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.”

Seagreen-Bell 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. 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.”

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 argued, 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 strategy.

"We’ve seen this approach work time and time again. Our experienced financial leads, IT experts, strategists and operational planning specialists have worked closely with NHS colleagues at all levels to help take the pressure off delivering improved clinical outcomes and deliver productivity gains in the short and long term,” concluded Seagreen-Bell.

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
  • Improved financial return on investment and service delivery.

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

Dean Mawson, a THC associate specialising in clinical safety, added that provider level transformation plans can play an important role in patient safety improvements: “Patient safety is the prime driver for change at NHS Trusts and whist 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,” concluded Mawson.


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