Redesigning an ambulance service's operating model

Availability
12%
Decrease in total out of service
Efficiency
23%
Decrease in singles related out of service
Savings
£1m+
Reduction in annual spend

Opportunity

An ambulance service's centralised operating model had become ineffective, with a disconnect between local operations and their central supporting functions, e.g., Scheduling, Make Ready, Fleet. These departments operated in siloes, and staff feedback suggested there was a lack of clarity and operational grip of the tasks required to maintain a high-performing service. The operating model was no longer fit for purpose and bred an 'us versus them' culture that left local and central teams feeling disempowered.

This issue was reflected in Trust performance, specifically in its out of service (OOS) data. The Trust saw a high rate of 'singles' without a crewmate, with long lead times to pair up with a colleague and an increase in vehicle related OOS. A lack of accountability at the local level, couples with limited oversight / on the ground detail from central teams, led to delays in resolving these issues

Approach

TN took a three-step approach to support the Trust in designing and implementing a new operating model that would embed local ownership

  • Designing a new operating model
    Engaged 50+ stakeholders 'from the ground up', including operational teams and senior leaders, to design the new model, re-assigning high-priority functions to the local level (e.g., scheduling, vehicle allocation, managing equipment)
  • Revising roles and responsibilities
    Re-designed and codified new SOPs and governance structure with department leads across four directorates to streamline operations
  • Rollout
    Worked side by side with staff to support implementation through troubleshooting, refining, and building understanding / buy-in on the ground

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