NHS Trusts across the UK are facing unprecedented financial pressures. The need to deliver significant cost savings is intensifying, and in many cases, solutions are being driven top-down - through national mandates, budget controls, or top-down cost cutting. While these approaches are often necessary, they may overlook a powerful and underutilised source of innovation and efficiency: the frontline workforce.

Doctors, nurses, AHPs, administrative and support staff interact with NHS systems, patients, and processes daily. They are uniquely placed to identify inefficiencies and generate ideas for smarter ways of working. By equipping and empowering staff with quality improvement (QI) and continuous improvement (CI) methods, Trusts can unlock bottom-up cost savings that are impactful, scalable, and sustainable.

Here are eight practical ways to do just that:

1. Launch Structured Improvement Campaigns

Run time-bound campaigns focused on cost-related themes—such as reducing unnecessary diagnostics, improving theatre efficiency, or avoiding missed appointments. Use established QI approaches like PDSA cycles or Kaizen events to support teams in testing small-scale changes.

These campaigns give staff a shared focus and framework, creating alignment and momentum while delivering measurable impact.

2. Empower Staff with “Cost-Conscious Care” Training

Offer bite-sized training to build awareness of the financial consequences of clinical and operational decisions. Introduce tools like:

• Process mapping
• Root cause analysis
• Lean’s 8 wastes

Bring QI and finance teams together to make cost data more accessible, and support frontline teams to interpret and use it in improvement efforts.

3. Run an “Ideas for Improvement” Programme

Create a structured way for staff to submit and test ideas for cost-saving improvements. Whether through digital platforms, team huddles, or regular “pitch days,” an ideas programme should include:

• A simple, inclusive submission process
• Transparent review criteria
• Rapid prototyping support
• Recognition and feedback

You might even link the best ideas to a local QI fellowship or showcase event.

4. Use Lean Value Stream Mapping (VSM)

Facilitate VSM workshops for high-volume or high-cost pathways like:

• Emergency department flow
• Discharge processes
• Outpatient referrals

By mapping these journeys from a patient’s perspective, frontline teams can identify delays, bottlenecks, and non-value-adding activities. These insights often point to practical ways to reduce waste and cost without compromising care.

5. Embed Savings Metrics in All QI Projects

Encourage every improvement initiative to consider potential financial or productivity benefits alongside traditional quality metrics. This doesn’t require complex financial modelling. Approximate figures, developed with the finance team, are enough to:

• Track potential savings
• Justify scaling
• Prioritise high-impact changes

Life QI is well suited to capturing this data as part of your project, as outlined in this blog article. And for a walkthrough of exactly how to do this, sign up to the Running Cost Saving Projects in Life QI webinar being held on 13th August 2025.

To take this a step further, consider using external benchmarking tools like Model Hospital or GIRFT to identify opportunities and validate results.

6. Create Clinical and Non-Clinical Improvement Fellowships

Offer time and support (e.g. 0.2–0.4 FTE) for motivated staff to focus on cost-saving QI projects. These fellowships work well across both clinical and operational areas.

Example projects might include:

• Rationalising use of consumables or tests
• Reducing duplication in admin workflows
• Digitalising inefficient manual processes

Fellows can also help coach peers and sustain improvements beyond their term.

7. Celebrate and Share Success

Too often, cost-saving initiatives are framed as cuts. Reframe the story—this is about delivering “smart care” that’s safer, leaner, and more sustainable. Make it easy for staff to share results and stories. Use blogs, huddles, newsletters or QI networks to highlight:

• Cost savings delivered
• Patient care improvements
• The teams and individuals behind them

Celebrate wins, and you’ll build momentum and wider engagement.

8. Leverage QI Collaboratives Across Sites

QI isn’t a solo effort. Collaborating across Trusts or Integrated Care Systems (ICSs) allows teams to:

• Share project results and cost data
• Spread proven approaches (e.g. virtual clinics, discharge redesign)
• Avoid duplicating efforts

Platforms like Life QI can be used to track shared metrics, share learning, and coordinate improvement efforts across sites.

Conclusion: Frontline-Driven Improvement is a Financial Imperative

NHS organisations are being asked to find ways to do more with less. But this shouldn’t come at the cost of staff wellbeing or patient safety. By embedding improvement capability at every level, Trusts can empower their workforce to co-create solutions that reduce waste, protect resources, and ultimately improve care.

The bottom line? Frontline-led QI is not just a quality strategy—it’s a financial one.