Countess of Chester Hospital NHS Foundation Trust (COCH FT) delivers over 519,000 patient attendances each year, but fragmented, time‑consuming procurement processes were holding theatres back.
Partnering with NHS Shared Business Services’ Consultancy team, the trust received a bespoke future‑state operating model in just eight weeks, designed for rapid implementation and built to withstand the pressures of a busy clinical environment.
12,000
Clinical hours released per year
£420k
Annual productivity savings
£69k
Cash savings
Effective theatre procurement is vital to safe, efficient and financially sustainable surgical care. When clinical needs and operational workflows align, clinicians gain back valuable time for patients
COCH FT manages £6.7m in annual theatre consumables and equipment, but fragmented, manual processes meant limited visibility, weak stock control and inefficient spend management.
Clinical staff were conducting routine stock checks and ordering, seeing 30% of their time diverted to non‑clinical tasks.
Although Omnicell cabinets (automated, secure medication dispensing units used to store, manage and dispense drugs at the point of care) held a range of items from fast‑moving, low‑value goods to slow‑moving, high‑value ones, they did not cover the entire theatre stock. A significant proportion of stock remained outside any digital system, dispersed across multiple locations and managed without formally defined Periodic Automatic Replenishment (PAR) levels. This reliance on individual judgement and visual stock checks led to duplication, excess stock and increased safety risk.
Spend data was split across multiple systems and location‑based cost centres, contributing to a 10% overspend and preventing clear insight into cost drivers or proactive planning.
Procurement and finance involvement was reactive, with no single operational forum to support co-ordinated, multidisciplinary decision‑making.
“NHS SBS’s bespoke model has delivered clear, tangible benefits for our theatres. By re-designing how we manage stock and procurement, its freed up significant clinical hours, time our staff can now re-invest directly into patient care. This partnership has set us up for sustainable improvement in one of the most pressurised parts of the hospital.”
Ben McGee,
Directorate Manager, Anaesthetics, Critical Care and Theatres
Countess of Chester Hospital
From Diagnostic to Delivery-ready Design
Centralised theatre stores operating model
- NHS SBS designed a future‑state model that removes routine stock and ordering tasks from clinical teams. It proposed adding two Band 4 Materials Management roles, reporting into Procurement but funded by Theatres, releasing clinical time without increasing central overheads.
End‑to‑End Standard Operating Procedures (SOPs)
- Comprehensive SOPs were created to standardise day‑to‑day theatre procurement, defining process flows, decision points and system use across NHS Supply Chain, eProc, Omnicell and non‑catalogue routes, with clear roles, approval levels and escalation paths.
Inventory Enablement and Digital Pathway
- PAR level methodology was aligned to demand and procedure usage. A key enabler was connecting the trust to the NHS Supply Chain Inventory Management Solution Implementation Support Programme*, providing access to a funded inventory management solution – at a time when no internal capital was available, plus guidance and next steps toward digital stock visibility and automated replenishment.
Spend Visibility Re‑design
- Cost centres were restructured around clinical specialties rather than locations, enabling clearer separation of high‑cost specialty items from general consumables.
- Cross‑specialty items were grouped under a general category, removing geographic cost centres and improving comparability, accountability and forward‑looking spend analysis.
Embedded Performance
- A new Theatre Operational Procurement Forum was proposed, with terms of reference drafted to accelerate implementation.
- A governance model set out strategic, assurance and delivery forums, defining ownership, reporting lines and meeting cadence to ensure changes are embedded, monitored and sustained.
“The support from NHS SBS has been transformational. In just eight weeks, the consultancy team gave us a clear, practical operating model that tackles long‑standing challenges in theatre procurement. The work has created a pathway to digital stock visibility, stronger governance and most importantly, meaningful clinical time released back to patient care. What’s most impressive is that these improvements go beyond theatres; the consultancy team has created a scalable blueprint we now plan to roll out across the wider trust.”
Daniel Nash
Director of Performance and Operational Improvement
Countess of Chester Hospital
Targeted inventory reviews unlock £69k in immediate savings, whilst the move to specialty‑based cost centres gives greater visibility of the trust’s £6.7m annual theatre spend.
The engagement delivered quantified operational and financial benefits while establishing the foundations for sustained improvement:
- Introduction of a centralised theatre stores operating model identified the opportunity to release 1,000 clinical hours per month from routine procurement and stock management activity, equivalent to £35k per month in non‑cash‑releasing productivity value, enabling clinical teams to refocus on patient care.
- Targeted stock reviews and inventory optimisation identified £69k of one‑off cash‑releasing stock savings through the reduction of excess and duplicated inventory.
- Re-design of cost centres around clinical specialties improved visibility and accountability across £6.7m annual non‑pay theatre spend, supporting earlier identification of cost pressures that had previously contributed to 10% overspend.
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