Annual Lecture ‘Thinking Through Strategy’ for students undertaking the MSc in Health Management course

This is a voluntary position . I am Vice-Chair of the organisation, Chair of the Governance Committee, Chair of the Remunerations Committee and a member of the Finance Committee.

Responsible for the operational delivery of the Theatres, Anaesthetics and Critical Care portfolio on two hospital sites - The Chelsea and Westminster Hospital and the West Middlesex Hospital. The portfolio included two 13 bed Intensive Care Units, two Critical Care Outreach Teams, 27 Operating Theatres and 4 Procedure Rooms, Site Based Anaesthetic Departments (50 Consultants on the Chelsea Site, 25 Consultants on the West Middlesex site and 80 Junior Doctors working across 10 rotas), Pre-Operative Assessment on both sites and Elective Theatre Scheduling on both sites. This portfolio had 720 staff, a budget of £59 million. Achievements in Post included: • 5% Improvement in Theatre Productivity across the year in post. • Improved Reporting of Theatre Productivity metrics in the Qliksense Application. • Digitisation of the 6-4-2 Theatre Scheduling Meetings, reducing meeting time from 6 hours per week to 2.5 hours per week, and saving £103K of staff time.• Reversal of £1.7million overspend at the end of the 22/23 financial year to balanced budget in October 2023. • Delivery of £1.3million of Cost Improvements in the 23-24 Financial Year. • Developed and Improved Visibility of Theatre Productivity Metrics in the Qliksense Application. • Operational Management Lead for NHSE London Region Best Practice Scheduling Guidance – this was a paid position for 4 hours per week. At the conclusion of the project I had chaired stakeholder groups from across the region to identify best practice and incorporate this into guidance documentation.

Chelsea and Westminster Hospital NHS Foundation Trust was the incubator site for the National Improving Elective Care Coordination of Patients (IECCP) Programme, developing capability and proof of concept for the Federated Data Platform that was nationally commissioned by NHS England in November 2023. This post had a specific focus on the development and deployment of the Theatres Scheduling Module ‘Inpatient’ Module that manages Pre-Operative Assessment (POA) and elective surgery. I also led on the development of the local Digital Health Questionnaire (DHQ) that was used to improve the efficiency of the Adult Pre-Operative Pathway. The DHQ had a response rate of 86%. The successful delivery of both of these projects required collaboration with multiple Industry Partners and with internal operational teams. The position also required me to participate in the wider roll-out of the functionality across the North-West London ICS and host familiarisation sessions for other Trusts across the country adopting the tool. Following the implementation of Federated Data Platform Theatre Utilisation increased by 8% and on-the-day cancellations related to pre-operative assessment reasons dropped by 57% to 1.2%. Other benefits realised by the implementation of the Federated Data Platform and the Digital Health Questionnaire were:• Patients were booked for POA 30 days ahead of TCI Date (previously 17 days)• An Automated Theatre Scheduling function suggesting 254 patients per month to fill elective theatre lists not fully booked at 2 weeks.• 36% of patients (180 patients per month) identified as not requiring a Pre-Operative Assessment• This in turn lead to POA being conducted 15 days ahead of TCI, as opposed to 10 days • After roll-out 407 patients responded stating they no longer wanted surgery• 222 patients without NHS numbers identified

Responsible for leading 5 Transformational Change Programmes aligned with the organisation's 5 year strategic plan:- Inpatient Flow Improvement Programme- Theatres Improvement Programme- Outpatient Improvement Programme,- Administration Improvement Programme- Clinical Pathways Redesign Programme. Successful delivery of these programmes of work involves working closely with the Electronic Patient Records Team and Digital Research & Innovation Teams to identify and implement digital solutions that lead to improved efficiency and improved patient safety, quality and outcomes. Achievement in Post included:• Development and Delivery of complex clinical transformational programmes (inpatient flow, outpatient improvement and clinical pathway redesign) during the Covid-19 pandemic. • Rapid establishment and delivery of the Covid Safe Working and Medical Workforce Programmes in response to the 1st Wave of the Covid-19 Pandemic.• Implementation of other projects to improve workplace efficiency such as Electronic GP Communications; Implementation of Voice Recognition Software; Implementation of Robotic Processing Automation; Desk and Room Booking System.• Development and Implementation of Change, Project, and Programme Management Training for Senior Managers to ensure project successful delivery of the projects and programmes, leading to achievement of the Trust’s strategy.• Leading the 2021/22 Better Value (Financial Improvement) Programme

Responsible for the operational delivery of Neurosurgery, Neurology, Epilepsy, Neuro-Muscular Disorders, Neurodisability, Neurophysiology, Endocrinology and Metabolic Medicine. The Directorate had a headcount of 320 staff and an expenditure budget of £42 million. Achievements in post included:• Improvement of RTT Compliance in Neuro-Medicine Specialties from 78.% to 93% over 6 month period.• Successful delivery of innovative business cases for Intra-Operative MRI. • Successful delivery of Trust-Wide Project that eliminated all agency spend on Band 2-5 Bank Admin & Clerical Staff and resulted in 94% fill rate for temporary posts. • Implementation of Daily Reporting to improve compliance with Patient Acuity Scoring, leading to £300K income recovery.• Improved scheduling for Day-Case/Short Stay Unit resulting in improved efficiency and cost reduction.• Trust-Wide Ward Catering Spend Review yielding cost improvement and sustainability benefits.• Delivery of a Business Case to expand Neurosciences In-Patient capacity to address service growth, reduce outsourcing and improve private patient provision. • Developing and Leading the Brain Directorate Staff Survey Action plan that led to improvements of between 11% and 29% on the ten targeted metrics.• Leading redesign of Clinical Pathways in Video-Telemetry, Movement Disorder and Ketogenic Diet Services to increase capacity and decrease waiting times. • Developing research capability in Brain Directorate doubling income from £2million to £4million in 3 years.• Successful implementation of new treatments arising from the aforementioned research – this included representing the Trust at tariff discussions with Commissioners.• Consistent delivery of cost improvement equating to 2% to 4% of expenditure budget.• Participation in NHSE HSS Tender Evaluation.• Restructure of Directorate Administrative Teams to include apprenticeship to promote career development and staff retention.

Responsible for a portfolio of Medical and Clinical Support Services that included Radiology, Interventional Radiology, Gastroenterology, Neurology, Epilepsy, Neurophysiology, Neuro-Muscular Disorders, Neurodisability, CAMHS, Psychology, Physiotherapy, Occupational Therapy, Dietetics, Speech & Language Therapy, Social Work and Play Therapy. Across these services there was a combined approximately 500 staff with an expenditure budget of £53million. This role had organisational responsibility for DM01 Diagnostic Waiting Times. Achievements in post include: • Improving compliance with Trust-Wide DM01 Diagnostic Waiting Times from 90% to the National Target of 99%.• Appointed with the remit to redesign and improve a Service in Special Measures and a Team in Difficulty. Significant improvements were made and recognised by an External College Review, by implementing new governance structures, organising patient listening events, redesigning pathways and processes, relocating inpatient facilities, and commissioning individual and team coaching to support staff.• Centralising MRI admissions to improve efficiency and reduce cancellations.• Implementation of MRI Sedation Service reducing need for general anaesthetic in some patients and improving capacity by 25%• Consistent delivery of cost improvement equating to 2% to 4% of expenditure budget.• Supporting the Interim Medical Director with Managing Higher Professional Standards Cases.

This General Manager position had operational responsibilities for the delivery of Oncology and Palliative Care Services across four hospital sites plus tertiary services such as Haemato-Oncology, Bone Marrow Transplantation and Radiotherapy on the St.Bartholomew’s site. Services in the Cancer Portfolio were Medical Oncology, Clinical Oncology, Chemotherapy Services, Radiotherapy, Haemato-Oncology, Bone Marrow Transplant, Breast Surgery, Specialist Endocrinology and Palliative Care. For a 12 month period I had organisational responsibility for the delivery of Cancer Waiting Time Targets and the Cancer Peer review Programme. This directorate had an expenditure budget of £53 million and a headcount of approximately 300 staff. Achievements in Post:• Delivery of 9 out of 9 Cancer Waiting time targets through a 12month improvement programme, from an initial position of achieving 2 of the 9 targets. • Review and redesign of Chemotherapy Services on one hospital site to address safety concerns, improve efficiency, increase activity thus giving more patients the opportunity to have care delivered closer to home. • Consistent achievement of circa £4million annual cost improvements. • Leading Projects to improve scheduling and efficiency of chemotherapy administration. • Service and Inpatient Ward re-organisations to improve efficiency and decrease bed base whilst maintaining activity.• Income recovery of circa £4million per annum for palliative care activity. • Income recovery of £100K per month for chemotherapy activity. • Developing successful Business Cases for Acute Oncology & Palliative Care Services to ensure that the services met National Standards. • Successful transfer of a service to another provider (including TUPE of staff).