Case Study
Go Back-
Case Study > Case Study: Transforming Outpatient Capacity and Access at SaTH
Case Study: Transforming Outpatient Capacity and Access at SaTH
Over a two-year partnership, Prism Improvement and Four Eyes Insight (FEI) worked alongside The Shrewsbury and Telford Hospital NHS Trust (SaTH) to improve outpatient productivity, increase patient access and unlock significant financial value.
Rather than relying on additional capacity, the programme combined data-led insight, outpatient expertise, transformation delivery and clinical engagement to identify and unlock capacity within the Trust’s existing resources.
The results included:
• 30,000–35,000 appointments released
• 3% increase in booked utilisation
• £3.191m reduction in recovery spend in 2025/26
• A further £1m reduction in 2026/27
• 300 additional outpatient appointments delivered each week
“Prism and Four Eyes became a trusted part of our team, working seamlessly alongside our staff.” James Wright, Deputy Chief Operating Officer, SaTH
The challenge
The Shrewsbury and Telford Hospital NHS Trust‘s challenge was not simply a lack of outpatient capacity. Existing capacity was not consistently being converted into patient appointments. High demand, workforce constraints and pressure on RTT pathways meant the Trust needed to unlock more capacity from the resources it already had.
The programme focused on understanding where capacity was being lost and identifying practical opportunities to improve:
• Clinic utilisation
• Template design
• Workforce deployment and skill mix
• Booking processes
The aim was to increase productivity and improve patient access while ensuring changes could be sustained within existing resources.
Our approach
The programme was Trust-led, with Prism Improvement and Four Eyes Insight working as an extension of the SaTH team.
FEI provided the analytical and outpatient expertise, using detailed data analysis and scenario modelling to identify productivity opportunities, quantify variation and test potential changes.
Prism led transformation and implementation, working with clinical, nursing and operational teams to translate insight into practical changes and embed new ways of working.
SaTH provided clinical and operational leadership, ensuring changes were appropriate for individual services and could be implemented and sustained.
The programme began with a four-week Insight and Discovery phase, creating a detailed picture of outpatient capacity, activity, processes and improvement opportunities. This informed collaborative design and implementation, supported by continuous analytical insight from FEI.
A key principle was co-design. Rather than imposing standard solutions, clinical and operational teams used their own data to understand opportunities and shape the changes required.
Scenario modelling tested different approaches to clinic volumes, slot durations, clinical utilisation and workforce capacity. This gave teams evidence to support decisions and helped build confidence where there was initially resistance to change.
For example, workforce analysis identified opportunities to redesign CNS activity. In gynaecology, 20 CNS hours per week were released by transferring administrative activity to a Band 3 colleague. This created capacity for four additional clinics per week, equivalent to an estimated 1,680 additional attendances per year.
Results
The programme delivered measurable improvements in capacity, productivity, patient access and financial value.
Capacity and productivity
• 3% increase in booked utilisation, generating approximately 15,000 additional appointments
• 12,857 additional slots through clinic template redesign
• 5,605 additional slots through workforce optimisation
• 2,280 appointments moved to appropriate CNS delivery
• Approximately 30,000–35,000 appointments released overall
Patient access and recovery
Between April and September 2025:
• 18-week RTT performance improved by 14%
• Patients waiting more than 52 weeks fell by 92%
• The waiting list reduced by 10,000 patients
By March 2026, 68.9% of patients received elective care within 18 weeks, exceeding the 65% target. SaTH had also eliminated 52-week waits for English patients and was delivering an additional 300 outpatient appointments each week.
Financial impact
The programme contributed to a £3.191m reduction in recovery spend in 2025/26, with a further £1m reduction in 2026/27.
This demonstrated the value of improving productivity through existing resources — increasing utilisation, redesigning templates, optimising workforce deployment and ensuring patients were seen by the right clinical resource.
Sustaining the improvement
The programme was designed to leave SaTH with the capability, processes and governance to sustain and build on the improvements.
Daily booking huddles, live tracking of template changes, clear ownership and multidisciplinary review processes have been embedded into business-as-usual.
“The processes that were put in place are sensible, and our teams have embedded them into business-as-usual with ease. This has left us with confidence that we can sustain the improvements in the long term.” James Wright, Deputy Chief Operating Officer, SaTH
The Four Eyes Insight and Prism Improvement value
The strength of the programme came from combining FEI’s analytical and outpatient expertise with Prism’s transformation and implementation capability.
FEI provided the evidence needed to identify opportunities, quantify their impact and give clinical teams confidence in the changes.
Prism turned that insight into action — working alongside teams to implement changes, overcome barriers and embed new ways of working.
Together, the partnership helped SaTH unlock existing outpatient capacity, improve patient access, reduce recovery costs and create a more productive and sustainable model for the future.