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Returning back to work after a lovely Christmas Break and entering a Brand New Year (just like now I suppose) I remember clearly, the routine January Stationery Stock Take. Making sure that any urgent orders go in before the annual block on non-essential orders memo was received by the Supplies department.  Usually about the same time as the local council appeared on most main roads filling in holes and repairing pavements that have been a hindrance for the past eight months, but now money needed to be spent before it was taken away in next year’s budget.


That was my first experience of “cost savings” as a junior administration clerk in the NHS.  I had never seen or heard about money, or lack of it until then.  In the early nineties it wasn’t a big issue although today it is a very different story!


More and more things came into force and it wasn’t long before a scandal occurred within the local hospital where I was starting to develop my career.  A manager of one of the Service Departments had been found to have a number of computers at home that belonged to the hospital and other items that had been purchased for personal use.  I was amazed!  Not just because of how they managed to do it but the fact that they were a laundry department with computers, as I was still involved in retrieving records of births and deaths from microfiche received on a weekly basis.


I wasn’t privy to how they found out but obviously somebody had a suspicion and they decided to ask some questions.

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As I progressed throughout my career full of loyalty for my organisation and number of different things started to cloud my judgement of taking things at face value.  I suppose the profession that I had fallen into, didn’t help either.  Clinical audit was just beginning to make an appearance in clinical organisations.  A way of identifying if something that should be happening, wasn’t.  


I loved this role.  


Getting into the nitty gritty of clinical notes, processes and procedures and checking assessing practice against policies and guidelines.  I’d found my niche!


In November 1999, I applied for a post in a large teaching hospital as a Team Leader but unfortunately, I didn’t get that role and was offered a more junior role which after careful consideration I chose to accept.


Within the first week, I knew that this organisation, or rather, department, worked very differently than those I’d worked in before.  I had left my previous role with over 15 projects in process.  Not all of them were at the same point, all at various stages but I was always kept busy.  In this new role I was given one project to see how I coped!  As I looked around at the lady doing her knitting whilst she waited for Dr Jones to return from leave and watching a couple of members of staff plan when they were going to next take their sick days I started to get a “feeling”!  I had worked in the NHS for a long time and I did so because I cared about it and the services we provided.  Although I wasn’t on the front line I still felt that my contribution was valued.

It wasn’t long before I was given the opportunity to apply again for the role that I originally applied for.  Unfortunately, the previously successful candidate had broken his leg in a few places meaning that he was unable to start in his post for a significant amount of time!


One of the questions I was asked in interview was “what would be one of the first things I would look at in my new role?”.  My answer? “Telephone records!”


Within a month, I was asked to escort a member of staff out of the building after being found guilty of fraudulently using the telephone for personal use equating to hundreds of pounds.

From then my career continued to progress, still heavily being involved in the Audit Agenda where I was often asked to undertake detailed confidential reviews into clinical practices, disciplinary investigations and performance monitoring procedures.


As my role within the organisation reached the executive level, cost savings became the upmost importance.  The organisation employed dedicated team of “Lean Practitioners” to support executive leads with making efficiency savings within their areas.  The key to this whole agenda was to “think out of the box”.  Forget about how it has always been done and look at possibilities as to how it could be done.


This is when the big changes came about and it was so exciting!


Individual desk printers and photocopiers were replaced with low maintenance Multifunctional Devices to be used across departments.


Departments were asked consider not printing out reports or meeting papers and were issued with tablets or IPADs.

With responsibility for one of the biggest stationery costs to the organisation; paper, we began to outsource our printing of outpatient, treatment and admission letters.  This not only cost us less than the average postage stamp but also provided a guarantee of delivery times meaning that we no longer had piles of envelopes waiting to go out in the mailing office.  Not forgetting the poor office junior responsible for folding the letters and stuffing envelopes.


Some areas started to look at outsourcing their dictation and with the right policies in place this can save thousands especially when you think of all of those medical reports, litigation transcripts not to mention the general day to day clinical correspondence.

We were then asked to look at duplication of roles across the organisation.  Not only was it confusing for patients calling in to query appointments, but the management of organisation policies and procedures were also affected.  


I’m not saying that any of these projects were easy and certainly one of the biggest projects that left me with sleepless nights was the management of clinical notes.  We went from having 15 locations spread across 3 locations miles part, storing clinical casenotes, to one central off-site library.  This then contributed to the next project to make those clinical handwritten notes into an electronic record ready to move into a brand new hospital which would pride itself on being paperless.  Of course, this included administration and Executive papers which would have to be carefully planned with a full and reliable filing structure to allow them to be found on the appropriate computer.


The list of efficiencies is endless and all it takes is someone to come along and take a look from the outside.  Someone to question why it is done that way and ask if consideration has ever been made to that new solution that may be available.  Somebody with time to investigate what is out there, what others are using and what else is on the horizon.

Whether it is a small business, a private medium to large enterprise or a public organisation there are always efficiencies to be made.  It’s just finding the time to look.


And that’s why I do what I do!


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