Doncaster & Bassetlaw Hospitals NHS Foundation Trust has adopted a "Lean" philosophy as it strives to streamline working practices, cut waiting times and improve overall levels of patient care as part of one the most ambitious reform in the history of the NHS.

It is focusing on service transformation to meet key objectives in line with the 18 Week patient pathway, through which the government has decreed that by the end of 2008 no one must wait more than 18 weeks from GP referral to receiving hospital treatment.

The Trust has established a strategic partnership with the Lean Healthcare Academy, which works extensively in the UK healthcare sector delivering a range of services that are similar to those used widely in manufacturing to simplify operational procedures and boost productivity.

Administrative processes within Doncaster Royal Infirmary's Medical Records Department, a key operational area, have been reviewed by a project team from the Trust. The team has identified crucial areas where improvements can be made and these are now being implemented.

Karen Leivers, Deputy Service Improvement Manager with Doncaster & Bassetlaw Hospitals NHS Foundation Trust, said: "The project team is to be congratulated on its achievements - a prime example of how, by working together and listening to the good ideas of our staff, we can make a real difference for both patients and the public.

"We are constantly looking to improve the way in which the NHS keeps people across the region healthy. This initiative will not only help in our ongoing efforts to reduce waiting times, but also to raise the safety, quality and delivery of our patient care in general.

"Tackling hospital waiting times within the NHS is a crucial issue and, whilst locally we have achieved our 18 Weeks access target, it remains vital that we continue to build on our initial Lean successes by rolling them out more widely across the trust and getting our people to work and co-operate even more efficiently and effectively together."

Julie Butler, 18 Weeks Project Manager with Doncaster Primary Care Trust, explained: "The Strategic Health Authority provided funding to the Lean Healthcare Academy to assist Doncaster's health community in focussing on service transformation, reviewing the Medical Records Department's processes and identifying key areas for improvement.

A project team was established to map the administrative pathways. We quickly discovered that some of the current processes within the service were in need of improvement. For example, the volume of short notice cancelled appointments - and the vast administration problems this caused - was having a huge impact on the process.

"It also became clear that lack of information and communication flows between other departments and medical records were causing delays in bookings of patient appointments and tracking clinical records, also resulting in increased workload pressures on staff. In addition, we identified that, as the hub of the organisation, the profile of the department needed to be raised.

"The project team presented its findings to senior management from the hospital trust and clearly demonstrated the effect these shortcomings were having, not only on the medical records department, but also across the whole of the organisation in general.

"We obtained executive-level support to develop an action plan and drive forward and implement improvements, which is now in place. The progress and success of the initiative will be reviewed in October 2008. "

"It is now vital that the relationships built during the mapping process between the PCT, secondary care and primary care continue - and that senior management become fully involved to drive service transformation forward."

Established in 2006, the Lean Healthcare Academy, based in Ilkley, West Yorkshire, offers a vehicle that accelerates the adoption of Lean working practices as a foundation stone for sustainable service transformation across the healthcare sector.

Services available to the academy's 17-strong network of NHS member trusts across the north include staff training, development and implementation support, and flexible online e-learning programmes.

The academy this year won the "Partnership with the NHS" award at the Medilink Yorkshire and Humber Innovation Day and Healthcare Business Awards.

Lean Healthcare Academy manager Judith Clarkson, said: "By working in partnership, using practical, proven processes based on training, education and project participation, we have clearly demonstrated that sustainable service transformation can be readily delivered.

"The academy is a truly innovative partnership. It represents a platform for sharing best practice across organisations and bringing members together to create seamless patient pathways.

"We are making a real difference as we seek to roll out Lean thinking to other NHS Trusts and healthcare sector providers across the UK."

The Lean Healthcare Academy - http://www.leanhealthcareacademy.co.uk/ - is part of and the Virtual College, one of the UK's leading developers of e-learning solutions for the public sector.