Fit for the Future

Over the past four years, our Fit for the Future programme, which aims to improve the quality and safety of the care we offer our patients at the same time as saving money, has delivered over £240 million in efficiency savings.

The programme has been run though centralised activity and local action, with a strong focus on staff development and engagement.


  • 212 clinical leaders and managers at all levels have graduated from our Fit for the Future development programme, delivering live improvement projects across the Trust along the way. Thirty-two staff are currently undertaking projects for review by April 2018.
  • More than 200 patients have benefited from continued IV antibiotics at home, freeing up beds for other patients and saving £1.5 million in 'bed days'.
  • Our procurement team have saved over £34m by expanding influence over total non-pay spend, focusing on supply chain management and driving better process control. They are now preparing to deploy a pioneering 'Amazon-style' ordering system which was highlighted as a case study in Lord Carter's recent report into hospital efficiency.
  • Clinical coding has improved across the Trust, increasing income by £20 million by coding correctly for care delivered.
  • Twenty-nine improvement projects have been kickstarted through our 'Dragons' Den', delivering everything from enhanced patient information to support recovery, to an innovative solution to keep patients meals hot.
  • The Trust has been ranked top in England for its staff engagement.

Fit for the Future – next steps

We plan radical changes to the way we provide healthcare, recognising the need to deliver significant and lasting financial savings while maintaining our focus on patient safety and quality.

The drive for sustainable services and increased efficiency will continue to be delivered through our Fit for the Future transformation programmes:

  • Care Redesign which focuses on team-based service improvement
  • Digital Patient Journey which aim is to develop more efficient and responsive patient administration
  • Transforming our Ways of Working which is looking into new ways of working and creating more flexible working environments.

Established change methodologies, increased standardisation, staff development, engaging with patients and better use of digital technology underpin all our transformation activities.  

Specific initiatives are focusing on length of stay, long-term health conditions, pharmacy, outpatients, pathology, imaging services, surgical productivity, transfers of care, procurement and clinical coding.

Continuous service improvement is underpinned by our unique culture and approach – we call this the 'Guy's and St Thomas' Way'.

Pioneering 'Amazon style' procurement

Our procurement team are preparing to roll out a pioneering 'Amazon style' ordering system which was highlighted as a case study in Lord Carter's recent report into hospital efficiency.