The Challenge 

Community services are critical to the NHS ambition of delivering more care closer to home. Yet providers face a difficult balance:  

• Meeting rising demand with finite resources  
• Ensuring financial stability in the face of national cost pressures  
• Redesigning services to improve access and outcomes  

Leadership in the CIC recognised that delivering meaningful financial efficiencies would require a structured review of how services were operating across both clinical pathways and supporting functions. The organisation therefore sought to identify a robust pipeline of initiatives capable of delivering sustainable financial improvements while supporting the wider ‘left shift’ towards community-based care. 

The Crossroads 

Working side-by-side with the CIC’s operational and corporate teams, we took a service-by-service approach to review how care was delivered and how resources were used.   

Together, we:  

• Reviewed services in depth: analysing financial, activity, and workforce data and observing teams on site, including adult community nursing, intermediate care, integrated sexual health, palliative care, care coordination, and enabling functions such as programme management, information management, and digital.  
• Identified practical opportunities for improvement: from smarter procurement and estate consolidation, to better referral and discharge management.  
• Co-developed delivery plans: ensuring each improvement was realistic, phased, and owned by operational teams.  
• Carried out robust financial modelling: working closely with the CIC’s finance team to test, validate, and sequence the opportunities.  

Through this diagnostic process, the programme identified a range of opportunities spanning service configuration, operational processes, and procurement practices. 

The Change 

The programme resulted in a detailed set of delivery plans designed to support service teams in implementing priority initiatives and realising measurable financial and patient-centred benefits: 

• Reduced waiting lists and improved access to care. 
• Standardised service offers across geographies, ensuring more consistent care for patients. 
• Projected 17% efficiency savings (3 years) in community nursing: Digitalised referrals, optimised team geographies and scheduling, better use of treatment rooms, and reduced wound dressing costs through supplier changes and stock standardisation. 
• Projected 24% reduction in intermediate care beds (1 year): Delivered through reduced length of stay, consolidating beds across fewer locations, and shifting care to community settings via a home-first model. 
• Opportunity for ~10% procurement savings on medical and surgical consumables: Achieved through supplier renegotiation and product switching, including lower-cost examination gloves and chest drains. 

Together, these initiatives form a programme of change capable of delivering £7m in financial benefit over three years – with £3m of recurrent efficiencies already on track to be delivered within 12 months of programme conclusion – while supporting the organisation to operate more efficiently and continue delivering high-quality care to its communities. 

The PSC works alongside healthcare providers to identify practical, data-driven opportunities for improvement, helping organisations deliver sustainable financial efficiencies while continuing to provide high-quality care. If we can support your organisation with transformation or efficiency programmes, get in touch with Chris Bradley or Joseph Norbury – we’d love to hear from you.