Protecting the public purse

Audit Commission and Monitor guide: Delivering sustainable cost improvement programmes

The Audit Commission and Monitor have jointly published a guide called Delivering sustainable cost improvement programmes aimed at acute, ambulance, mental health and specialist NHS trusts and foundation trusts. It summarises how successful organisations approach the delivery of cost improvement programmes.

NHS organisations have successfully delivered cost improvement programmes for a number of years, but the challenge is getting tougher. The NHS needs to save up to 20 billion by 2015 _ which is an average of 5 per cent per year _ the biggest efficiency challenge the NHS has ever faced. To succeed NHS organisations will need to radically transform services.

Success varies among trusts and there is no single approach that will work for all organisations. A successful cost improvement programme saves money but also, through long-term plans to transform clinical and non-clinical services, improves patient care, satisfaction and safety.

Organisations should use the briefing and the supporting questions to review their own performance and identify areas for improvement.

Support materials

The briefing includes a set of questions to help boards review all aspects of the CIP process and to review their approach against the good practice identified. We have also developed the following supplementary questions aimed at finance staff, medical directors, and clinical and general managers to better equip them to challenge their current approach.

Case study material

Some of the case studies in the briefing refer to additional details. The trusts described in the case studies have agreed to share their approaches and make them available for download.

Case study 5: Mid Essex Hospital Services NHS Trust – spreadsheet flowchart and approval forms for new CIP schemes.

Case study 7: Coventry and Warwickshire Partnership NHS Trust _ PowerPoint presentation used by the finance department to explain the Trust’s approach to CIPs to non-finance staff.

Case study 8: University College London Hospitals NHS Foundation Trust – financial performance and productivity pack


Delivering sustainable cost improvement programmes