Case Study | Achieving Cost Efficiencies While Increasing Staff Engagement

Virginia Mason Institute


Leeds Teaching Hospitals NHS Trust (LTHT)


 LTHT hoped to move from a financial deficit to a sustainable surplus while boosting staff engagement and developing a culture of continuous improvement. LTHT has a goal of becoming the most efficient teaching hospital in England.


  • Coaching and mentorship through process of developing a unified management system called The Leeds Improvement Method, incorporating the focus on the patient at the top and shared vision, focus areas, goals and a single improvement methodology
  • Aligned with a primary focus of patient-focused improvements focused on achieving long-term sustainability and culture change, LTHT targeted an immediate cross-organizational waste reduction program
  • As part of the waste reduction program, LTHT developed an organizational objective to effectively manage resources across the organization and find and remove waste across their system that inefficiently uses resources
  • All clinical units across the system received advice, templates, tools and techniques to help implement the waste reduction program
  • Team members also received best practice examples and guidance on how to generate ideas for reducing waste

“It requires us to really understand what adds value from the perspective of our patients and ensure that the patient voice is central to our work.  Anything that does not add value to our patients is described as waste in our processes. Therefore, this value-based approach taken here at Leeds underpinned by the capability created by the Leeds Improvement Method provides us with an innovative opportunity for reframing the context of traditional cost improvement.”


Key areas for waste reduction identified:

graphic showcasing types of cost reductions


  • LTHT reported that our partnership supported their move from a £100 million deficit to a £19 million surplus
  • Thanks to factors including this work, LTHT saw improvements in their CQC rating (moving to an overall ‘Good’ rating) and experienced a shift in their culture and the engagement of their teams
  • Financial gains made at Leeds via their investment in training and focused improvement through our programme offset its expenses
  • Waste reductions have led to increased team engagement due to it allowing for more capital investments to support the team

“It’s important to remember leaders don’t have all the answers and the most successful and sustainable solutions are always going to come from those working on the front line. They just need to be empowered to grasp the challenge and not be afraid to test new ideas out – which is what we have been encouraging the team at Leeds to do for years.”

– Julian Hartley, CEO, Leeds Teaching Hospitals NHS Trust

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Originally published February 23, 2022, updated March 24, 2022

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