Streamlining - navigating the maze to make it work

Kenechi Nduka-Richard

Kenechi Nduka-Richard is the Buckinghamshire Oxfordshire & Berkshire West (BOB) STP streamlining programme lead. In this blog Kenechi writes about her streamlining experiences, supporting six NHS trusts to work collaboratively and reduce duplication in the on-boarding process.


The streamlining programme’s aim is to work collaboratively to achieve improvements in quality, staff health, wellbeing and make financial savings by realising the potential value of the healthcare workforce deployed across the region. It involves six NHS trusts, four key HR workstreams and over 24 managers all producing a maze of multiple processes to support their recruitment and staff experience.


From the start of the programme, it was clear to me that there were significant variations in systems and practice across member organisations. In order to move the programme forward, I had to dedicate some time to understand each system in detail. I undertook an extensive process mapping exercise across the member trusts and workstreams which revealed several process duplications and disparities in practice from one trust to the other. To make streamlining work, we had to agree on best practice to allow for ease in data transfer from one trust to another.


To support this, I took the following steps through the course of the year:


  • Established subgroups with subject matter experts appointed as workstream leads so everyone understood their role.
  • Standardised terminology to ensure a common understanding of portability.
  • Delivered regular educational programmes to enhance skills and knowledge for trust workstream leads which was then transferred to their teams.
  • Developed a plan to achieve administrative excellence, with clear expectations for the group.
  • Ensured robust engagement with the ESR team leading to a greater appreciation and engagement with the system.
  • Identified key issues, barriers and agreed common themes to work through as a group.
  • Collated baseline data across the STP to show variances and identified a pathway to bridge these and unify processes.
  • Delivered workshops and stakeholder engagement events to support an understanding of the programme and alignment to national programmes.

The steps taken have promoted collaborative working across the BOB STP and also across the departments involved within each organisation. With the interdependencies identified as part of the programme, cross-departmental working is being encouraged with several conversations now going on within each trust around how each team can improve their process to create a positive impact.

With several ESR system developments deployed in the past few months, it has also been very helpful to have the ESR team involved with the BOB programme to date, providing advice and guidance on how best the system can support streamlining. I have an improved understanding of the scope of the system and have tried to ensure that the trust leads have benefited from the continued presence of the ESR team throughout the programme, re-educating their team and maximising the system to improve their recruitment process.

The feedback from the groups has so far been positive, with several streaming objectives already in place and notable improvements across some workstreams. There has been extensive learning for all involved and it has been really interesting to see how different people have responded to change, with some more pro-active than others.

Over the next couple of months, my focus will be on reviewing and strengthening the on-boarding arrangements across BOB to ensure consistency in the process and improve the time to hire. I am keen to ensure that these process improvements are embedded across the BOB trusts so that they continue beyond the programme tenure. To do this, we must continue to review outcomes and take steps when needed to ensure compliance and robust engagement with the process so it is fully integrated and becomes a part of business as usual for all.

Further information


This blog was published as part of NHS Streamlining Week, visit the streamlining resource hub to learn more about streamlining in the NHS and the efficiencies you can make.

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