Case Studies

Re-engineering a charity’s processes and saving £650k

Trinity Hospice provides compassionate, quality end-of-life care to adults and children across the Blackpool, Fylde and Wyre areas of Lancashire. It must raise £7m each year to provide its extensive services in a purpose-built hospice, in the home, and the community.

When David Houston was appointed Chief Executive in September 2010, Trinity was in considerable financial difficulty and not only likely to miss its target of a £200k annual surplus, it was going to show an operating deficit of £1.3m. With a precarious future compounded by the economic climate and falling donations, the Trustees were convinced that they were urgently in need of additional financial expertise and a turnaround plan.

It became apparent that financial reporting systems were simply not ‘fit for purpose’ for a £7m charity. Following an in-depth financial review, and with the help of FD Solutions over a period of 12 months, financial information systems were transformed. There simply hadn’t been sufficient meaningful management information (MI) for an organisation of this size under stress. Production of MI needed to be put into place without delay.

Trinity was now in a position to make better decisions, so from this challenging situation a huge opportunity arose to focus on how the charity could improve both its efficiency and its effectiveness and become ‘Fit for the Future’.

David Houston said, “We had two choices – we could do what many hospitals and councils were doing at the time, ie cutting back on our people across the board, or we could embark on a ‘Fit for the Future’ change programme tied to our new strategic vision where we would fundamentally challenge the way we do things and focus on efficiency.

Trinity engaged HR Director Solutions, sister business to FD Solutions, for the additional expertise needed. Significant change required that each department was redesigned, starting with non-clinical departments, and Trinity went back to basics with everything that it did. Improvements in efficiency saved £600k per annum – half of the cutbacks needed.

“We simply wouldn’t have achieved this without Ruth Lewis of HR Director Solutions, redesigning from the ground up, helping 950 volunteers, staff and the community to understand why we needed to change and to involve them in designing a demanding and yet ultimately positive outcome. We had to make sure that everyone was ‘getting on the bus’ as well as checking that it was going in the right direction!” David said.

He added, “The predominant culture back in 2010-11 was a wonderful, caring and consensual environment, but one not used to a performance management culture. We needed everyone to buy in and understand that part of performance management is also about everyone fulfilling their potential – including Directors – and helping to lead and engage in the change programme. Ruth’s knowledge and experience of health, corporate and not-for-profit sectors helped us to bridge that gap.

“For example, our rostering had become convoluted. Given a long-standing caring and consensual framework, managers tended to agree to staff’s preferred hours. When we adopted an electronic rostering system, it almost keeled over, because the software could not accommodate the working patterns in place. So step-by-step improvements in efficiencies were made at all levels. Of many examples, we changed the evening meal for staff to a light self-service meal, with their agreement.

“As part of department redesigns, we did have to make a number of redundancies that were not voluntary. It would have been impossible without the managers being on-board – they were the ones who knew what was possible without compromising the quality of patient care or our core values. They were critical to the departmental redesigns.

“I think it speaks volumes that through all of this, we retained the support of our 950 volunteers and the community. We worked hard on all aspects of stakeholder management and Ruth was very effective at helping us manage our external communications. We were open and honest. We had only positive media coverage about what was happening and why.

“Six months on, our patient satisfaction levels are that 88% of patients are ‘very satisfied’ and our quality of care is still ‘Gold Standard’. We are now a very tight ship, with 80% of our staff involved in front-line care, 11% in fundraising and 9% in administrative roles.

“Following a revision of income generation strategy, we increased the number of charity shops from eight to 14, corporate fundraising has generated a further £100k and the efforts to focus on individual giving and enhanced legacies have now borne fruit generating a further £300k. From an operating deficit of £1.3m in March 2011, we saw a small surplus in March 2013 and we forecast a £300k-£400k surplus for the year to March 2014.

“Quite a turnaround and one which we couldn’t have achieved so quickly without Ruth’s help in supporting our committed staff and volunteers. Ruth is now helping us strategically to bed in our new cultural perspective. At Trinity we are ‘Fit for the Future’ and better placed to achieve our vision with partners that by 2020, everyone on the Fylde coast will have access to good end-of-life care and a good death”.