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Meet the team: Lee Scothern

Following on from last month’s spotlight on Four Eyes Insight’s Endoscopy Subject Matter Expert Debbie Johnston, this month, we spoke to incoming Managing Director Lee Scothern about his NHS background, service transformation, his people-centred approach to management and ­­passion for helping the NHS clear the elective care backlog.

Background

Having always been passionate about helping people, Lee started his career in 2005 as an NHS Theatre Support Worker where he worked for two years before moving into an Associate Nursing Practitioner role within an operating theatre department. He supported many procedures during his nine-year tenure, including upper and lower gastrointestinal, colorectal, gynaecology, urology and some light vascular surgeries.

Lee’s next career move was into a transformation lead role for the surgical division at the NHS trust he’d spent the last nine years at. He worked to transform patient care; scenario planning around current and potential theatre pathways to explore the art of the possible in terms of productivity improvement. Lee’s focus was around how theatres could better integrate with day case wards, admissions and pre-assessment services, all in pursuit of improving patient flow and experience. He also worked on an award-winning project to reduce same-day cancellations, having been instrumental in bringing together both clinical and operational teams in order to drive improvement.

During his time as transformation lead, Lee worked with the Four Eyes Insight team on an orthopaedic project where he witnessed first-hand the impact the team made, following which, he had re-engaged with them for a wider piece of work on other surgical specialties based on the results.

Soon after, in 2016, Lee transitioned over to the Four Eyes Insight team working his way up from a Consultant (Theatres Subject Matter Expert) to a Senior Consultant, Delivery Lead, Managing Consultant and Consulting Director. More recently, Lee has moved into the position of Managing Director, taking the reins from now Executive Chair Brian Wells.

What attracted you to the FEI team?

“During each stage of my NHS practitioner career, it was all about making a difference for one patient at a time – giving our entire focus to them before moving onto the next patient. As I moved out of my scrub role into a transformation role, I was able to make a difference on a wider scale but still within the community and geographical area served by the NHS trust I worked for.

“I wanted to have a bigger impact… to make a difference to millions of patients across the country – with a focus on improving the service they receive and reducing how long they wait for that service.

“The Four Eyes methodology and the use of data to help identify opportunities for improvement made an immediate impression on me. Improving productivity wasn’t just a case of asking clinicians to go quicker, efficiency gains were much more multi-faceted, and Four Eyes Insight had proven experience in implementing successful improvement programmes to help realise this.  

 “As soon as I joined Four Eyes Insight, I knew I’d made the right decision. I loved the ethos of the organisation; how approachable the team were and the respect that everyone showed each other. I also valued the fact that everyone had an input into the business which even after a period of growth is something that has been maintained.

“But the main thing that made Four Eyes Insight stand out from other consultancies was the fact that much of the business has been there and done it. We have a multidisciplinary team which includes general consulting, data analysis and programme management expertise, augmented by a wealth of clinical and operational NHS experience. As a result, we can be authentic in our engagements – we can say “I’ve been there, I feel your pain”, and that helps us get immediate buy in from programme stakeholders.”

What is the most rewarding part of your job?

“Undoubtedly it has to be the impact we have – the immediate change in practices and behaviours which leads to long-term sustainable results. I get a buzz out of implementing a programme and retrospectively analysing the impact we’ve had, much of which is often achieved under incredibly challenging circumstances.

“Over the years, this has enabled me to forge amazing relationships and build strong networks – I can reach out to any of my previous clients for catch up because the bonds and relationships that we build when delivering great work and sustainable change in the NHS are long-lasting.

“When I think about the programme that I’m most proud of, I’d have to say working with a specialist trust in the North West to drive utilisation improvements in outpatients and cath labs. The benefits we realised were sustained over time and the client is still reaching out to look at future work.

“I also can’t ignore the sense of achievement I get from supporting the Four Eyes Insight team… seeing people join the organisation and move up the business just as I have is incredible and testament to the culture and ethos we’ve built.”

Why do NHS trusts work with FEI?

“There is a great synergy between our personalities and those within the NHS and a lot of our success is driven by this. From our initial meetings, the rapport we build is critical to the ongoing relationship and because we have lived experience of the challenges many of our clients face, we’re able to more easily get to the root cause and bring people on the journey.”

“Ours is a consultative sales process and we’re not a pushy consultancy. Sometimes, we’re in discussions with an NHS trust for over a year before they commit to working with us but this means that when they do take that leap, we’ve already lived some of that journey with them and built up a mutual trust. These last two years in particular, NHS organisations have had other priorities but as we move into this elective recovery period, our clients know we’re always there for them when they’re ready to move forward.”

What are the common challenges experienced by NHS theatres teams?

“Theatre utilisation is not solely down to the theatres themselves so there is a lot of dependency on other areas of operations including pre-assessment, scheduling and patient communication – the whole pre-operative part of the pathway is where a lot of organisations experience problems.

“This can be resolved by implementing robust pre-assessment processes… creating more effective patient scheduling systems; implementing the 6-4-2 theatre planning process; ensuring patients have enough notice for their appointment; and following processes and procedures around things like annual leave.  

“Questions that need to be asked include:

• – How are you starting the day?
• – What time do your clinicians arrive?
• – Do you have ring-fenced elective bed capacity?
• – Are you implementing golden patient rules?
• – Do you have the confidence that you’re going to have a bed available post-surgery?
• – How have you aligned capacity with demand?
• – Have you done everything possible to facilitate prehibilitation?

 

“NHS trusts need to think differently about how they see and treat the patients and as we move out of ‘pandemic response mode’ into ‘elective recovery mode’, most trusts haven’t had the headspace to contemplate that yet.  

“That’s where we can help, whether it be implementing GIRFT recommendations, optimising Patient Treatment Lists (PTLs), consideration of HVLC lists or moving procedures out of theatres into treatment room settings or community settings; there are many ways in which we can contribute to improving productivity and clearing the backlog.”

How does what Four Eyes Insight do translate to a wider scale, at ICS or regional level?

“Working upwards from an acute trust, the collaboration between NHS organisations and other providers is key to success. There needs to be clear visibility of what capacity look like across the system; how you can treat certain specialities through elective hubs and what those hubs look like to achieve the aspirant utilisation.

“With additional capacity available within the private sector, NHS organisations also need look much further than their own patch. Private sector capacity is paid for whether trusts are using it or not and current scheduling systems don’t necessarily consider this.

“But the most important consideration across a system will be a shared vision. There should be an agreed programme of works with clear KPIs so that everyone understand the potential throughput expectation that can be measured on an ongoing basis.”

What does the new Four Eyes Insight Managing Director do in his spare time?

“I’m a family person. I love spending time with my partner, friends and family and especially enjoy sharing a good meal.

“I also love travelling and feel strongly about making time for holidays. After two years of travel disruption, we’re looking forward to an exciting road trip to America this year… starting in Las Vegas and making our way through Yellowstone, Jackson Hole and Denver!”

About Four Eyes Insight

We use the combined power of people, data and technology to get to the root cause of NHS elective care pathway inefficiencies; working collaboratively and engaging with all stakeholders to get buy in for change from the ground up. We implement interventions that optimise elective care pathways and provide tools to monitor their effectiveness ensuring that a culture of continuous improvement to drive long term, sustainable change is embedded along the way.

If you would like to find out more about our endoscopy services or discuss your requirements, please email info@foureyesinsight.com