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A case study in optimising ENT theatre scheduling

Use of Six Sigma tools and techniques optimise while reducing costs


ENT is a surgical specialty which generates £4m income for University Hospital Leicester (UHL). In spite of high demand, UHL faced an issue with under-utilisation of ENT theatre capacity. £420k of activity has been provided by out of hour initiatives at premium rates and this work could be performed by the Trust at normal rates by scheduling and planning for clinics and theatres more effectively.

At the University Hospital Leicester (UHL) the scheduled ENT theatre cases were frequently cancelled (average x12 cases per week) in response to emergency activity demand. In performance terms this led to an average theatre session utilisation rate of 50-60 percent, an 18 week waiting list "backlog" of treatments and reactive "fire-fighting" approach to waiting list management, which impacted in theatre scheduling and associated resourcing requirements.


The Accenture team recommended and helped UHL to implement a programme of work using Lean Six Sigma tools and techniques to optimise the planning and scheduling of ENT theatres. This work was commissioned with the primary objective of reducing the amount of activity performed at premium rates, optimise capacity and ultimately provide more efficient health services to patients.

Accenture’s approach and methodologies generated a series of improvements and benefits which included for example, additional theatre capacity with average of +16 hours every week, previous "out-of-hours" activities now delivered within regular lists/times, optimum theatre utilisation rates (85 percent +) could now be achieved, avoidance of premium pay costs and an overall improved patient experience as a result of earlier notice of date of surgery—among several others.