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    Case Study > Cardiff & Vale UHB: Theatre Improvement Programme

Cardiff & Vale UHB: Theatre Improvement Programme

Cardiff and Vale University Health Board (CAV) is one of the largest healthcare organisations in the UK, covering a wide range of specialities and services. The Health Board provides services to the local population in Cardiff and the Vale of Glamorgan in addition to the wider population across South, West and Mid Wales.

Download the full case study here.

Having completed several projects across the patient pathway, Four Eyes Insight (FEI) has built up a trusted relationship with CAV and recently undertook a 24-week Theatre Improvement programme with the health board that included:

– A four-week diagnostic to identify core issues

– 16 weeks of implementation support

– Four weeks of change integration

Following the effects of the pandemic, the volume of patients waiting for surgery and the length of wait for routine treatments increased significantly.

The Four Eyes Insight Approach

The programme was structured in 3 core phases:

Phase 1 Insight and Discovery

A four-week diagnostic was implemented to enable the Four Eyes Insight team to familiarise themselves with local structures and challenges, combining a series of observations, data analysis and engagements to understand all opportunities, operational, clinical and workforce related within the Health Board.

Phase 2 Rapid Implementation

During phase two, the programme focused on building firm foundations through governance and process changes that enabled the organisation to increase activity and productivity.

Phase two was split into three workstreams:

1 -Theatre Utilisation. During this workstream, best practice processes and rigorous performance management structures, underpinned by clinical performance and opportunity data to drive planning performance were implemented.

2 – High Volume Low Complexity (HVLC) listing. This workstream saw the FEI team support clinical leads and champions to adopt or adapt the clinical pathways for HVLC.

3 – Pre-Operative Assessment Clinics (POAC). Working in partnership with CAV, the FEI team redefined the criteria for walk-in appointments and amended clinic templates.

For more detail on these workstreams, download the full case study.

Phase 3 Embedment and Sustainability

This four-week embedment phase was where the FEI team stepped out of delivery and into an advisory role. Handing over ownership of the new processes to sustain delivery and enable the CAV team to continue to see improvements post-project.


Ensuring all benefits are tracked, measured and sustained is at the core of our business ethos. Throughout the project, we worked shoulder-to-shoulder with clinicians and operational teams to create buy-in for the project goals. This approach ensured that programme outputs became part of the organisational culture and assured the longevity of changes.

Key results:

– 47 additional cases seen per week across the delivery period

– 10% increase in the number of POAC attendances

– 4% reduction of in-session opportunity to see additional cases within lists


Learn more about the programme by downloading the full case study here.