HR organisation

Building organisational capability to drive rapid performance improvement

The issue

  • Curzon Consulting were initially engaged to define the programme efficiencies of a public body with a target of £302m for the current investment period
  • Alignment of financial targets and scope at scheme level enabled us to provide assurance that the programme will succeed
  • It also revealed that there were some critical underlying issues around people and processes that needed practical solutions
  • Project configuration and change control were not historically managed well across the programme; project baselines were not agreed/recognised, and redesign often occurred
  • There was an embedded Process Compliance culture. People were more concerned on outputs and checklist completion than project outcomes and performance
  • There was inconsistency in capabilities and performance among the PM community. Projects seemed to follow contractor’s agenda rather than the client’s
  • Project and programme performance was poor and in general all projects were over budget and running behind schedule, costing millions to the Programme

What we did

  • Assessment of the management capability to implement change and mobilise the workforce
  • Analysis and prioritisation of the project management capability gaps for current and future operating model
  • Project lifecycle process mapping to understand gaps, levers and weak points
  • Communication of spend profiles to focus on project high cost and critical path activities
  • Reinforcement of the role of the PM in the operating model and the support available from specialist functions
  • Development of an on-the-job training approach to deliver immediate results and simultaneously start to address the capability challenges for long term results
  • Focus on people behaviours around process adherence and promote and install an intense focus on project performance to achieve the Programme’s objectives
  • Set performance indicators that were aligned towards outcomes, rather than outputs, to bring performance visibility

HR organisation

The results

  • Established a holistic view for an integrated project configuration and control framework. Programme has visibility on project progress and Project Manager development
  • Increased alignment to project configuration and adherence to the baseline
  • Created and installed a clear set of impactful project cost, schedule and risk related metrics. These are now being used for project performance management
  • Improved forecast stability and reduced risk exposure

Curzon consulting mca finalist 2019

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health insurance

Developing multiple pathways and identifying over £16m cost savings at a major health insurer

The issue

  • Pressure to increase efficiency in their claims due to rising medical costs
  • Large variation in costs between suppliers and across the UK
  • Lack of structured routing for members to effective treatments and cost efficient providers across hospitals, clinics or doctors
  • Poor cost control with growing pressure to tackle medical costs due to rising claims and pressure on margins
  • Difficulty negotiating cost reductions with hospitals, and huge number of suppliers (including doctors) to manage

What we did

  1. Initial project to identify opportunities for cost reduction for specific saving target (£16 million in year)
    – Developed and prioritised 14 opportunities
    – Integrated milestone plans to achieve savings that year
  2. Second phase project to extent treatment pathway opportunity (MSK) and develop new treatment pathways
    – Identified possible treatment pathways in major medical treatment areas
    – Developed and communicated a new analytical methodology to understand spend variance, behaviour across specialists, by hospital and pathway
    – Collaborated with medical experts to develop care journeys to triage, treat and follow up
    – Business cases developed to support cost effective pathways roll out

health insurance

The results

  • £16 million in cost savings in year identified and resource planning completed to ensure in year delivery
  • Identified a solid saving of up to £36 million cumulatively over three years via medical pathways
  • Trained out how to use new analytical methodology
  • Delivered relevant and valuable research (internal / external) to underpin treatment pathways including medical studies, historic analysis and case studies of implementation

£16m

cost savings identified

£36m

savings identified cumulatively over three years via medical pathways

Curzon consulting mca finalist 2019

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orthopaedics

Increasing patient satisfaction through orthopaedic Enhanced Recovery Programme

The issue

  • Reimbursements – Operational and commercial risk transferred from insurer to provider via fixed reimbursements
  • Pain – 45%+ patients stated moderate to severe pain within 48 hours of surgery, delaying recovery
  • Mobility – Physiotherapy started late usually within 24-48 hours post surgery causing delay in mobility
  • Length of stay – 4-6-day length of stay resulting in marginal clinical benefit, unnecessary cost and higher infection risk

What we did

  • Established one multidisciplinary team
  • Developed Evidence-Based Enhanced Recovery Programme (ERP)
  • Established ERP training programme
  • Designed and implemented pilot ERP programme (ERP)

orthopaedics

The results

  • Reduced pain scores by 45%
  • Decreased mobility times by 65%
  • Shortened hospital stays by 43%
  • Reduced hospital cost by 20%
  • Increased patient satisfaction by 37%

An award-winning team

Curzon consulting mca finalist 2019

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healthcare readmission

Reducing 30 day re-admissions by leveraging patient remote monitoring solution

The issue

  • Colorectal surgery (related to cancer) accounted for 27% of the total case mix for a large healthcare system
  • Colorectal surgery department noticed a steady increase in the number of patients returning back to the Emergency Room (ER) for non-urgent issues over a 24-month period
  • 30-day readmission rates were significantly above the national average
  • Based on an initial internal assessment, the hospital management and colorectal surgery department hypothesized an issue with the patient discharge process
  • Established a cross-functional team to perform a root-cause analysis of the entire patient journey and flow
  • Mapped the entire patient journey and flow and identified a number of improvement opportunities

What we did

  • Designed a pilot study to test a new discharge process enabled by technology
  • Enrolled 97 patients, focusing on younger more tech savvy profile who were open to self-managing recovery during post-operative phase
  • Identified root-causes of readmissions into ER (over 78% non-emergency which could have been avoided if patients were better educated and informed during the discharge process)
  • Redesigned the discharge programme with a greater focus on patient self-management enabled by smart technology
  • Sent patients electronic reminders to help keep them on-track with recovery milestones
  • Established post-discharge daily check-ins to track stoma output, incision photos, pain levels, bowel function, etc.
  • Implemented algorithms to flag patient issues and automatically provide feedback to patients on how to self-manage or how and where to find relevant support
  • Developed intelligent notifications to automatically notify clinical team members if patient at risk
  • Designed and implemented a dashboard with real-time reports and analytics to help the care team understand a patient’s post-operative concerns, trajectory of recovery and ways to improve patient experience

healthcare

The results

  • Delivered a 72% reduction in 30-day re-admissions
  • Avoided 7 ER visits which were resolved through triage via telephone consultation or outpatient clinic
  • Improved patient satisfaction scores by 24% (compared to baseline pre-launch)
  • Based on the success of the programme, supported client to identify other surgical programmes to roll-out similar solution

An award-winning team

Curzon consulting mca finalist 2019

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healthcare orthopaedics

Leveraging procurement to increase profitability of orthopaedic services

The issue

  • Many suppliers (18+) resulting in reduced spend leverage
  • Prosthesis selection based on supplier systems familiarity not generic technical spec
  • Large cost variances for similar hip and knee systems from supplier to supplier
  • Large amount of “additional” costs associated with instrumentation and loan kits
  • Huge variety in ‘same’ type of hip and knee systems (7+ systems for each)
  • Too many system variations (75+) resulting in staff needing to be trained on many systems/brands
  • Varying published data to support clinical outcomes of implants resulting in low predictability of patent outcomes
  • Huge cost-per-procedure variance impacting profitability at Orthopaedic Consultant and Hospital level
  • Need to increase profitability

What we did

  • Increased spend with fewer, more capable suppliers
  • Established patient profiles. Use patient profiles to guide system selection
    Linked into project to Care Pathways
  • Established minimum acceptance of prosthesis outcomes (leveraging ODEP ratings for both hips and knees)
  • Established dedicated training for Orthopaedic Consultants and clinical staff
  • Renegotiated with partner suppliers based on redistributed business (volumes)
  • Established traffic light reporting for Ortho hip and knee (cost and compliance to agreement)
  • Established a clinical advisory group to evaluate innovation and agree protocols to be followed by all Orthopaedic Consultants across the Group

healthcare orthopaedics

The results

  • Delivered 22% in annualised savings through volume leverage and brand/system standardisation
  • Reduced clinical risk by only allowing 10 or 10* ODEP rated products and eliminating Orthopaedic work at low volume sites
  • Increased profitability substantially which allowed the BD teams to improve NHS and PMI contract win rates
  • Reduced supplier power (demonstrated appetite and willingness to shift balance of power)
  • Improved patient satisfaction and outcomes by channeling more work to Orthopaedic Consultants with higher PROMs scores
  • Reduced subjectivity by ensuring system selection based on patient profile
  • Standardised length of stays for given procedure and patient profile

An award-winning team

Curzon consulting mca finalist 2019

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transport case study Curzon Consultin

Evaluating structural entity options for a new arm of government transport body

The issue

  • Embryonic consulting business established one year ago by a local government body responsible for transport, to monetise and deploy in-house specialist experience
  • Consulting business deeply embedded in one of the organisation’s existing holding companies
  • Business had not yet established the appropriate frameworks for managing revenue, project delivery, Intellectual Property and assets
  • The client wanted to review the optimal entity structure for its Consulting business in order to better drive commerciality
  • Strong desire to set up the Consulting business using an entity structure that fostered commerciality and leveraged in-house resources in the most optimal way
  • Clear focus on building a profitable revenue funnel, self-financed growth, better IP and asset monetization, capitalisation on tax benefits, simplified and robust governance and transparent risk management
  • Aim to start competing for, or partnering with big organisations to, deliver Advisory, IP and Operations & Maintenance contracts

What we did

  • Conducted an exhaustive benchmarking exercise to provide the client with insights into how other service utility organisations have established successful Consulting businesses
  • Defined a robust set of design principles and considerations for reference throughout the operating model design exercise
  • Identified and shortlisted a set of structural options following a complete option evaluation in terms of feasibility and suitability
  • Conducted end-to-end scenario testing, using carefully selected in-flight example bids, across the shortlisted structural options
  • Refined the final structural model based on outputs of the scenario testing, for proposing to the client’s Finance Committee.

transport case study Curzon Consultin

The results

  • A benchmarking report, providing a crystallised view of the comparator landscape, including assessment of comparator suitability, and a summary of key insights and recommendations
  • A report outlining the full assessment of entity options against a set of robust criteria and the rationale for down-selection
  • A recommended structural model, clearly outlining three distinct entity options catering to the distinct requirements of each activity stream
  • A high-level timeline illustrating implementation options and a trajectory of maturity
  • A concise, crisp report containing key messaging for the Client to socialise to key stakeholders in order to secure Board approval

An award-winning team

Curzon consulting mca finalist 2019

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Unlocking over £20m in increased gross margin at a major health insurer

The issue

  • Shrinking customer base
  • 13 legacy books and numerous policy variants causing customer and staff confusion
  • Operationally complex to manage – high cost to serve
  • Existing proposition and pricing created trigger points for customer exit
  • Customers not segmented by value
  • No differentiated renewal or save strategies
  • Not pricing for risk or maximised value retention
  • Poor customer journey: passed from function to function, advisors not empowered

What we did

Designed & executed a pricing, product and service migration of all policyholders to one new modular product

  • Developed new proposition which drove retention of high value customers and higher return from lower value customers
  • Built in upgrade/downgrade ‘right-size’ choices to mitigate competitor switching
  • Created pricing engine enabling all business to move to NCD-based policies and set renewal premiums to optimise gross margin
  • Cut expected IT lead time to launch from 12 to 3 months
  • Changed customer communications and management processes to de-risk customer disruption & loss
  • Engaged Legal and regulator on ‘automatic renewal’ plans throughout
  • Piloted the transition on 2 highest lapse-risk books to ensure error-free process and no adverse increase in lapse rates

The results

  • Exceeded the £20Mpa gross margin improvement target
  • Reduced customer loss by 25%
  • Improved operating cost ratio from 30% to 16% with greatly improved IT flexibility
  • Excellent customer and FSA feedback
  • Successfully rolled out from personal to SME & Group schemes

£20m

exceeded the gross profit margin improvement target

25%

reduced customer loss

14%

reduction in operating costs

An award-winning team

Curzon consulting mca finalist 2019

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construction curzon

Performance turnaround at global construction product manufacturing group

The issue

  • A European headquartered global construction product manufacturing & distribution group with a C. and S. American Division located across 14 countries
  • The Division was consistently the worst performing business unit in the Group
  • Interventions from Europe had failed to address the issues and turn performance around
  • Performance was poor with an EBITDA generation significantly lower than the Group average
  • Underperformance was a consequence of a multitude of issues: poor sales disciplines, inefficient production, lack of adequate cost management and ineffective leadership
  • Previous attempts to turn the business around with other consultancies had failed
  • The challenge was not only to quickly improve performance, but to set up the business for sustainable profitable growth

What we did

  • With our Alliance Partner for C. and S. America, Curzon established a programme team to implement a comprehensive change effort
  • A focus on commercial performance including pricing management and product mix optimised the market opportunities and stopped margin give-away
  • Introduction of lean practices in manufacturing and distribution facilities improved productivity and started to tackle excess inventories
  • Organisational changes were made to reduce management overheads and to streamline support functions
  • Initiatives were piloted in country businesses and the learning was transferred to other business units through a centrally managed process to coordinate and accelerate the impact

construction curzon

The results

  • Within one year the division rose from the worst to the best performer in the Group
  • The combination of programme and other initiatives were delivering measurable bottom-line savings with a headline profitability run-rate that had tripled
  • Change was happening on a broad base and over 1000 staff across multiple countries were involved improving the business
  • Capability development and introduction of new tools, disciplines and ways of working had provided a solid platform to sustain the results

An award-winning team

Curzon consulting mca finalist 2019

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infrastructure sector curzon consulting water

Company-wide performance improvement at UK water utility

The issue

  • Ineffective incentive structure resulting in organisational silos & sub-optimal performance (in-house and contractors)
  • Limited long-term planning and investment as result of weak and inaccurate in-house Asset Knowledge
  • Legacy support services from merged smaller companies resulted in fragmented internal processes
  • Lack of job prioritisation and adequate planning leading to poor productivity & rework

What we did

  • Development and introduction of single performance management framework and incentive system to drive efficiency and customer focused culture
  • Implementation of an Asset Capability Centre focused on three capability areas: Physical Asset Management, Stewardship & Delivery; revalidated proposed Capex and ran adaptive approaches on costs
  • Implemented regulatory compliant Shared Services with revised governance, improved service levels and cost efficiencies
  • Redesign and implementation of new job initiation, planning and scheduling processes

infrastructure sector curzon consulting water

The results

  • 20m annualised improvement in Totex
  • Annualised Capex avoidance of c£18m throughout the regulatory period
  • Annualised Opex reduction of c.£3m
  • 25% reduction in shared service cost base
  • 20% productivity increase in Field work, 30% increase in RFT and 10% reduction in Customer Complaints

£20m

annualised improvement in Totex

£18m

annualised Capex reduction

3m

annualised Opex reduction

25%

reduction in shared service cost base

20%

productivity increase in Field work

10%

reduction in customer complaints

An award-winning team

Curzon consulting mca finalist 2019

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Change management optimisation at a UK retail bank

The issue

  • Unprecedented customer growth & branch expansion coupled with focus on improving service delivery and customer satisfaction placed pressure on our client to deliver greater and more complex change
  • A need to improve the architecture and governance of business process change
  • To ensure change management is ready and optimised for successful delivery of current and downstream change demand
  • Rapid growth brought complexity & uncertainty
  • There was a need for tightly defined governance mechanisms supported by a standardised way to adhere to change

What we did

  • Designed framework for a multilevel business change process architecture to facilitate effective governance
  • Translated the framework into a new change management model with new working practices & Balanced Scorecard
  • Consistent communication and deployment in line with organisation’s need

The results

  • Building blocks in place for bank to deliver its growth strategy securely
  • Reduced change backlog
  • Change management framework to drive sustainable change and maximise results implemented across bank operations
  • Agreed metrics/KPIs at selected organizational levels including baselines and targets

An award-winning team

Curzon consulting mca finalist 2019

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