How one NHS Trust achieved 900% ROI through improved, sustainable performance.

Learn how Nottingham University Hospitals NHS Trust could save on cost and improve turnaround time using LTS Health's unique combination of consulting, technology and learning.

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Sub-optimal performance in Histopathology and Blood Science Service.
Increasing costs and underachieved turnaround times leading to potential penalties and deteriorated quality to patients.

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Solve the challenge from a process perspective.
Combine Consulting, PinpointBPS® and Power of Process.
Identify areas for immediate improvement.
Ensure success and sustainability.

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The Results

£635,000 in realisable savings
900% return on investment (ROI)
Improved efficiency
Reduced risk
Quality service to patients

PinpointBPS® is very impressive. It will provide a strong evidence base to drive our improvements.
— Neil Callow, Finance Director, Empath



Nottingham University Hospital was facing operational challenges that had impacted TAT targets and increased cost, which could have resulted in penalties or, worse, deteriorated access and service to patients.

LTS Health worked with the Trust to address this challenge from a process perspective, providing a holistic view of all activities and associated performance and identifying areas for immediate improvement. Beyond the compelling business case related to financial and TAT targets, there was the need to effectively address service delivery to patients and ensure timely access to tests that are often life-critical.

Addressing sub-optimal performance is critical to any laboratory - but how do you make it sustainable? LTS determined the best course of action to be...


Provide certainty in addressing TAT targets through a rectification of the Trust’s current service quality issues.


Meet the Trust’s Cost Improvement Programmes (CIP) target by identifying realisable savings from the blood science service.


Develop an implementation and sustainability plan - owned and managed by the Trust - to realise improvements and savings.


Develop skills and knowledge to ensure the sustainability of improvements.


Business process innovation

LTS, acting as consulting partner to the Trust, takes a unique approach to business process re-engineering (BPR) which is underpinned by their proprietary technology PinpointBPS®. This tool allows for the accurate systems simulation of a diagnostics environment, in order to test hypotheses for changes to existing processes and quantify the impact that those changes will have on performance (cost, TAT and quality) before implementation. The simulation provides a safe environment in which to run scenarios and set clear objectives, KPIs and actions for delivering the identified improvement. 


The approach

LTS’ BPR service involved several phases that encouraged both participation of Trust staff and transfer of knowledge to the teams responsible for the implementation of those changes. The project components included:

Robust Laboratory Performance Improvement Methodology


Project development and data gathering. LTS worked with managers and service leads to outline the project goal and expected outcomes and gather relevant data.

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Detailed process mapping. Qualified engineers from LTS created an accurate, validated process map of all processes, resources and activities.


Skills development. Trust staff were trained in The Power of Process, an internationally accredited course created by LTS that simplifies laboratory performance. The four-day certificate provided skills in process mapping, BPR techniques, international standards and best practice, fostering close collaboration between the Trust and LTS, to ensure sustainability of the project.


Validated, accurate simulation. To achieve an accurate model of the histopathology department and blood science service, the simulation model was built in partnership with the Trust, thereby achieving the immediate transfer of knowledge and gearing for change on the operational floor.


Improvement workshops. Simulation outputs were reviewed with Trust staff, to identify improvement areas and engender staff buy-in to the change management process.


Scenario testing. Various improvement interventions were developed with the Trust which quantified its impact on the quality and financial status of the service. This allowed the Trust to take the most cost-effective, efficient route to improvement.

Agreed interventions, targets, KPIs and implementation plan. LTS engaged with the Trust to develop a clear plan for implementation, along with measures of effectiveness.


Performance measurement milestones. Target goals and KPIs were identified, highlighting the specifics that needed to be achieved.

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Return on investment


Through the identification of realisable savings of £635,000, the consulting intervention achieved a ninefold/9:1 return on investment (ROI). In addition, the Trust enjoyed savings from improved efficiency in histopathology, reduced penalty risk and increased access to quality service delivery for patients. The consulting intervention achieved these results through three key value areas:


Consulting services provided access to international best practice. Qualified engineers and performance specialists could check and challenge assumptions, while providing coaching and support throughout the intervention. The partnership with LTS also allowed access to innovative techniques and analysis methodologies developed specifically for the diagnostics industry.


Technology provided a foundation for LTS’ consulting efforts. PinpointBPS®, which was used to accurately map and simulate current and future processes in the laboratory, not only tested the viability of the eventual plan of action, but also compared alternative interventions and reduced the risk of failure.


Training ensured that the consulting intervention could bear fruit in the future. Skills development through The Power of Process course, coupled with a detailed execution plan, ensured that implementation could be managed and the improvements sustained by the Trust.


Your laboratory can also reap the benefits of sustainable performance improvement.