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Princess Alice Hospice improve service and pathway design for customers

Optimising processes and upskilling the core team

Princess Alice Hospice. Rebecca Gamlin and Konstantina Chatziargyriou

Princess Alice Hospice is an organisation that cares for around 1 million people living in Surrey, Southwest London and Middlesex. Their range of services covers patient care in patients homes as well as inpatients support for carers, wellbeing and bereavement, and are rated as outstanding by the Care Quality Commission. As a passionate believer in continuous improvement, much effort in recent times has concentrated on digital transformation. However, as a hospice with far reaching services and working within two Integrated Care Systems the Hospice approached Ad Esse Consulting to help resolve challenges that come with operating different systems and managing different requirements & interactions.

Opportunities for improvement

The health and care sector is experiencing a time of great change. The Hospice identified the need to devise a new strategy and deliver a plan that reflects these changes, but improvements were needed to the overall design of frontline services and pathways to ensure a seamless service for customers.

There was also an opportunity to reduce administration costs, remove silo working, improve the choice of services available to customers, and to increase the reach of the charity by widening the channels used to interact with customers.

The Hospice asked Ad Esse to review the service design of customer-touching services, from the point of referral into services until completion of support with bereaved carers, family, and friends.  This included training and upskilling an internal core team who Ad Esse would work with to produce a service design and pathways where the customer is fully involved in choosing their services and support from the hospice.

The approach

Led by Ad Esse Associate, Rebecca Gamlin, the review comprised four key stages.

1. Skills transfer

We transferred skills to the internal core team and explained the key issues with the current pathways, identifying customer value and waste, problem solving & process improvement, customer journey mapping, and customer centric design.

2. Customer journey engagement exercise

To deliver the customer journey engagement exercise, Rebecca worked with the team to define the purpose of the service, gather current performance information, and set parameters. The results of the exercise showed that customers value good information about the services available prior to referral, a prompt referral, an understanding of customer’s expectations built into the care, consistency of contact throughout by a single member of staff who is informed about their care, opportunities to access all services when appropriate to the customer’s needs, and a smooth transition between the hospice and other agencies.

3. Service redesign with customer requirements

After the customer journey engagement exercise, we used this information to redesign the service to incorporate customer requirements. This included defining the high-level services, criteria for an outstanding customer experience, and outputs & outcomes of each service. We also identified what the hospice needed to excel at to deliver high performing services for their customers.

4. Supporting the internal core team to deliver service improvements

Rebecca supported the internal core team to review and design the Referrals, Bereavement and Pre-bereavement Carers pathways for themselves. This involved value stream mapping the current process, analysing performance data, developing the future state process in line with customer requirements, and developing measures and an implementation plan.  

“It’s been a great experience working with the Ad Esse team and a valuable development opportunity for all of us who participated in the project. The skills transfer was done in the most respectful and empowering way; we felt mentored and guided in a way that allowed us to own the service design process and feel confident to use those skills to continuously improve our services.”

(Konstantina Chatziargyriou, Head of Service Design & Continuous Improvement at Princess Alice Hospice)

Optimised pathways for customers and a skilled core team

The service and pathway design project delivered many benefits, including a few outlined below. Pathways have been optimised with the customer in mind, and the core team have been trained to deliver continuous improvement for themselves. 

Referrals pathway improvements

One of the biggest improvements for the referrals pathway is a new digital referral form with mandatory fields to eliminate missing information, reducing ineligible referrals. We introduced a new catchment area eligibility checker for health care professionals, and telephone referrals to enable quicker processing of urgent cases. This allows referral and initial clinical assessment to be completed at the same time.

Bereavement pathway improvements

To improve the bereavement pathway, carers are proactively encouraged to self-refer into the bereavement service to ensure they start receiving support when they are ready. We reduced the checking of carer and family support information in the process, added calls to the carer to provide timely information about the services available, and introduced tracking of support through caseloads which allows greater visibility of progress.

Pre-bereavement carers pathway improvements

Carers are provided with a pack which outlines the pre-bereavement carer support services available, and a single case to centralise all information to improve the provision of services.

A skilled core team

An internal core team are skilled in continuous improvement principles & tools and can apply these across departments to identify opportunities for improvement. The Hospice can develop improved ways of working to add customer value internally. The core team are trained and experienced in customer engagement with a format that can be applied across the organisation. An Organisational Service Design, developed by the Leadership team, provides direction for the future of the Hospice’s customer facing services.

“Ad Esse have been great to work with – really flexible and adapt to what the organisation, and individuals have needed. The team here have learnt so much and have been really enthused to put their learning into action, which will make a real difference to the way in which we work to support patients and families.

Their communication has been excellent throughout the project, but also before ‘go-live’, taking the time to ensure they understood the brief and the people involved. I would highly recommend Ad Esse to any organisation.”

(Lesley Munro, Director of Patient Care & Communities at Princess Alice Hospice)

Redesign services for your customers with Ad Esse’s process / service review. We can also upskill your team to make continuous improvements across your organisation internally. We work with social purpose organisations, like social housing, charities, and local authorities. Let’s have a chat about how we can help you to improve performance at your organisation. Email