Knowledge Transfer Partnerships

PCTs adopt Lean approach

The Client

Heart of Birmingham PCT and Birmingham East and North PCT (HoB and BEN, respectively).


NHS Primary Care Trusts provide health services for people in their areas. They are accountable for quality, efficiency and accessibility across GP, dental, pharmacy, opticians’ services as well as walk-in centres and voluntary sector organisations.

HoB and BEN PCTs wanted to explore the ‘Lean’ principles, which have been successfully applied in industrial environments to create service efficiencies. The PCTs were interested in applying these principles to their service portfolio, with particular focus on improving appointments processes in general medical practices.


The PCTs embarked on a 12-month KBP with the University.

KTP aims

To transfer Lean knowledge into the HoB and BEN PCTs.

The results

The University's ‘Lean’ expert, Philip Arch, was academic supervisor alongside Health colleagues. The KBP Associate was Mark Sharp, who was appointed to deliver Lean training and staff guidance.

The KBP began with a phased approach to research appointments procedures across a range of pilot GP practices. Mark became involved in HoB’s Organisational Management, Government and Workforce Project group, developing the Complete Care Initiative. The Lean elements most relevant to health care services were identified and the KBP team proposed improvements to process control. These were presented to staff in a Process Control workshop, as well as an introduction to Lean thinking. The relevant Practice staff received coaching and mentoring to implement Lean tools.

A 20 per cent reduction of reception data-access time was achieved, together with speedier patient-to-consultation-room matching. Other proposals included consolidation of reception and administration activities to improve supervision and eliminate unnecessary staff movements. Adjustment of opening times improved patient flow and relieved queuing.

As a result of the KBP, HoB will make Lean an integral part of its Complete Care Initiative and Innovation Work Streams. BEN is examining a longer term knowledge transfer scheme.

It was noted that, if GP appointment systems’ IT was standardised within the national NHS National Programme for Information Technology, Lean would have an even greater impact on processes.