Administration and clerical review

The journey –

This programme was a review of administration and clerical support services within a large foundation trust.  Its aim was to reduce the overall pay bill for the trust’s two district general hospitals whilst delivering quality administrative support.  It followed an independent review by the professional services firm PwC, which identified higher numbers in this staff group than other comparable trusts. The programme aimed to reduce the number of staff and change structure, systems and processes in order to deliver efficiency savings. Between 100 and 150 staff roles were identified as in need of re-banding. This took place following an assessment process.



The restructure designed by the programme went live in April 2012.  Whilst the anticipated outcome was a reduction in headcount, the actual outcome was a complex change in skill-mix across the trust with no reduction in headcount.  However, as a result of structural and behavioural change, savings of approximately £500K will be achieved.  Release of savings is dependent on ongoing reduction in numbers of staff on pay protection and marked time.

The change required four clinical divisions to work together on a project for which there was little appetite.  A number of key learning points were identified, including communication to staff about the changes and senior management capability in leading and delivering complex organisational change.


Patient setting

In-patient Out-patient Community based
Mental health Chronic illness Cross-systems   X


Clinical area

Staying healthy Maternity and newborn Children and young people Acute care   X
Planned care   X Mental health Long-term conditions End of life


Information, tools and techniques used

This project was managed by the Trust’s Programme Management and Service Improvement team.  This team uses its own Project Management Toolkit, which provides consistency to project management across the Trust.  Staff assessments were developed and managed by the Human Resources Department.



The programme involved the two district general hospitals of the Gloucestershire Hospitals NHS Foundation Trust.  This one of the largest hospital trusts in the country and provides acute elective and specialist care for a population of more than 800,000 people.



The programme started with an information gathering phase in July 2011.  It was implemented in April 2012.


Contact details and further information

Gill Bridgland, Programme Manager Clinical Strategy:

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