Evolution of Darwin

Darwin Programme logoDuring 2018/19 a Trust-wide transformation programme, Darwin, continued to make progress. 

The programme has ambitious goals to transform the productivity and efficiency of clinical services and this year results were encouraging.

As a global leader in cardiothoracic and respiratory care, clinical teams at the Trust deliver excellent patient outcomes, while also investing in cutting-edge innovations and infrastructure. It became apparent in 2015/16, that without transformational change to make operational improvements and stabilise the Trust’s financial base, this position was at risk.

Transforming patient-facing clinical services has clearly focused on ensuring that resources were going into the things that matter most for patients:

  • In surgery, reorganising pathways to reduce the length of stay in our hospitals saved £2 million, and resulted in very encouraging feedback from patients.
  • In theatres, overhauling the approach to scheduling surgery saved money but also ensured patients were seen faster.

By the end of March 2019 – two years after the launch of Darwin, the Trust had over 50 improvement initiatives underway.

For non-patient facing functions, such as a procurement review and modernising back office services, a saving of £6 million was achieved by the end of 2018/19.

Some examples of initiatives delivered under Darwin:

  • Clare Denny, senior sister outpatients, talks to a patient at one of the Trust's new cardiology day case facilities Two new day case facilities were set up in cardiology at both hospitals which between them have allowed patients to spend 4,350 more days a year at home with their families – rather than in hospital.
  • New one-stop lung clinics are improving patient care. Interstitial lung disease and asthma patients can now get all their care in one visit meaning patients spend 1,950 fewer days in hospital each year. As one patient explained: “I used to have to stay on the ward once every month. Now I stay for a couple of hours and go home… it really does make a difference.”
  • Implementing new theatres software has increased capacity to enable 65 more major cardiac cases to be undertaken.Using the new theatres software, Mr Toufan Bahrami, consultant cardiac surgeon, can view scheduling for all the operating theatres at Harefield on one screen at the same time
  • Reviewing bed capacity in intensive care helped grow our ECMO service (extracorporeal membrane oxygenation) – a highly specialised service for critically ill patients. The Trust is one of only five commissioned ECMO centres in the UK (read more about our ECMO service here).
  • A review of bed capacity in intensive care increased bed utilisation from 66 per cent to 80 per cent, meaning 1,200 more critically ill patients can be supported each year.Patient George Coldrake at one of the new one-stop lung clinics
  • Re-designing cardiac surgery processes has meant that:
    - over half of patients now come in on the day of surgery
    - £1 million has been saved. Once again patient feedback has been positive.

"This is a really good new service provided by the hospital – it helped with the process to prepare myself before the op. First class treatment fully explained. Nothing was a problem."

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