High Impact Pathways

The journey –

The High Impact Pathways programme was developed to reduce patient waiting times in NHS South Central to 18 weeks, a target set by the Department of Health. A more creative, sustainable solution had to be devised which would enable the ten primary care trusts across the region to meet this target.

The programme aimed to inform and share knowledge across the trusts. Based on the principles of LEAN, (an improvement methodology which focuses on process improvement, reduction of waste and efficiency), the programme involved an undertaking from each organisation involved to re-design and commit resources to three self-selected patient pathways.

The scale and transformational nature of the programme was considered highly innovative. Experts from two external management consultancies were employed, in the early stages, to provide leadership for the first of the pathways and later to offer guidance to NHS staff moving into leadership roles. The focus was primarily on quality and the change became embedded across the PCTs as a new way of working.


The programme achieved a significant saving in patient waiting times. Perhaps more significant is the step change in how those involved perceive improvement itself. The project lead has described how ‘the scene was set for a new sense of improvement culture’, with the principles of LEAN methodology becoming embedded. The most significant achievements have been attributed at a local level to strong project leadership and a cultural climate which was receptive to change. Although ultimately not all of the High Impact Pathways were implemented, the overriding feeling is one of an increased appetite for streamlining, reducing waste and standardising processes.

Patient setting

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

Clinical area

Staying healthy   X

Maternity and newborn  X

Children and young people  X

Acute care  X

Planned care  X

Mental health

Long-term conditions

End of life


Information, tools and techniques used

The programme used the principles of LEAN methodology to improve efficiency in all areas.


Across the ten primary care trusts within South Central.


High Impact Pathways was implemented over the course of one year, beginning in late summer 2007. This included an initial period of engagement at executive level and training, primarily for project managers.

Contact details and further information

Peter Loomes led the project. For any queries around the National Dementia Strategy please contact Julie Kerry on 07925 448319 or julie.kerry@southcentral.nhs.uk

Posted on Dec 28th, Cat: , , , , , , , , , , Tags: , Comments: Comments are off for this post

Comments are closed.