Twin and single theatres project


Twin and single theatres project

This NHS Trust is a world renowned centre for the diagnosis and treatment of bone and joint problems. Treating patients from across Birmingham and the West Midlands.

They provide one of the largest spinal services in the country and are one of only a handful of centres for the diagnosis and treatment of bone and soft tissue tumours.
Our team carried out diagnostic activity and the results highlighted substantial cost-effective opportunities within the Trust to improve the patient experience and support the long term viability of the Trust.

By initially concentrating upon improving the Theatre Department the Trust believes they can make a difference to not only the patient and staff experience but also to the Theatre utilisation through effective scheduling, start-up and turnarounds. This activity supports the Trusts long term expansion and efficiency strategy.


  • By optimising theatres and effective planning for bed requirements, there were 10 less cancellations per month saving £180,000
  • Used coordinator roles and responsibilities to improve theatre organisation and communication, saving £7,400
  • Increased capacity by more than 1.5 hours per day through reducing turnaround and improved team working, saving £60,000 capital expenditure with the opportunity to conduct an additional £400,000 worth of surgery
  • Eliminate late start times in theatres, saving £48,000
  • Equipment and consumables have standard locations and are visually controlled, with an opportunity to save £30,000


  • Some Theatre sessions were not used leaving them sat empty
  • Theatre operations were not started on time, causing back logs at the start of the day and patient operations being cancelled at the end of the day
  • Poor utilisation of Theatre on lease from the Private Sector
  • Low Theatre staff morale
  • Ineffective communication and planning
  • Poorly defined roles and responsibilities for the management team
  • High levels of staff sickness
  • Poor levels of house keeping


  • Create an effective standard Theatre scheduling system
  • To improve staff ability to effectively plan and measure the Theatres activity by adopting Lean tools and techniques
  • Map the patient flow, identify and eliminate waste and bottlenecks: Staff walked the patient pathway, to view it through the eyes of the patient. Improvements were made to the house keeping and layout in order to improve the patient journey


  • Status boards were designed to enable all levels of the organisation to immediately understand Theatre performance
  • A single Theatre model was created to reduce the downtime between procedures
  • A twin Theatre model was created which maximised the use of staff whilst simultaneously reducing downtime between procedures
  • Roles and Responsibilities were deployed to the Theatre management teams to improve Theatre organisation and communication
  • An effective Theatre planning meeting was implemented to enable better communication and visibility of potential problems
  • Workplace Organisation of anaesthetics rooms to introduce standard locations for equipment
  • Scheduling implemented to manage holiday bookings
  • Roistering system implemented to enable the unit to effectively use their resource

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