top of page
  • Writer's pictureDr Bob Barker

Time Based Analysis in the UK NHS

My submission to the NHS enquiry hub on Friday 8th March 2024.


Accepted by the UK House of Commons Select Committee for publication.


Dear Sir/Madam.


Please find below my observations and time based analysis of the typical NHS patient journey.


Huge amounts of untapped potential and waste exist in the NHS, all the equipment, assets and infrastructure are in place. Simply throwing £s Millions at the NHS is not the answer.


Application of Time Based Analysis – Looking at the NHS patient journey through the Lens of Time.



Examples –


In one example from the Midlands an NHS Manager who was one of my MBA students at Lancaster University used my time based analysis methods to track a heart patient, she found a lot of waste, non-value adding time and areas for improvement. Value adding touch time was 14%.


She presented her findings to the Trust CEO who said "Bury that report, it’s too revealing"


In the second example see below, you will see large amounts of non-value adding time (Wait and queue) Thanks to John for the data. The value adding time here is around 8% and there is huge room for improvement.


The NHS patient journey typically reflects the management structure where specialists control the treatment islands of efficiency but nobody is responsible for the non-value adding time gaps. Hence long wait and queue times.


NHS staff could use my time based analysis framework to track the health patient journey and remove non value adding time, constraints and bottlenecks.


A time-based analysis framework visually displays the entire organisation and service through the lens of time to identify the most important constraints and waste.  It is a blank representation onto which real live data from the organisation is superimposed. It is designed to be used by NHS value adding employees, not management consultants.


Analysis has been undertaken in a wide range of manufacturing and public sector service organisations to measure overall efficiency and effectiveness. Findings to date reveal poor supply chain synchronisation and poor value adding capability Most organisations (Even those who classed themselves as Lean) added value to products, services or health patients in less than 15% of the time in the end-to-end process. ie Less than 15 days of value adding touch time in 100 days of elapsed Calendar time. Please note – This is a global view tool designed to be used by value adding employees.


To obtain data a health patient or service is tracked by value adding employees to measure value adding and non-value adding time, in addition the arrival on site of the materials being consumed by the service is recorded to measure standards of supply chain synchronisation. This real data is then superimposed on the Time Based Framework to provide a visually powerful map of the entire inputs to outputs process. A lot of waste and non-value adding time is usually found.



Dr Bob Barker     






To date I have made various enquires to the NHS to ask them for results of transformation but received no response.


My enquires to the Leeds Leadership team and Dame Linda Pollard to ask for results of the recent leadership programme were answered with the comment. We don’t know of any results.


The 10 year review of the £50 Million Productive Ward programme by Sarre et al revealed it is almost forgotten.


There are 11,000 people listed on LinkedIn with NHS titles of Transformation Manager/Director or programme Manager. I have asked many of them if they have any results of transformation and to date received no results.




In bullet point format the key to transforming the NHS patient journey is –


-        Train NHS staff in time based analysis (One day) Empower them to make changes.


-        Select a department of section of a hospital or NHS outpatient journey


-        All the equipment, assets, IT systems, etc are already in place.


-        Staff present the results of analysis and the new proposed system, agreement is sought.


-        Stakeholders agree and changes are made and results are recorded.


-        Results of transformation are communicated to other locations to build confidence.


-        Repeat in other areas, departments and locations.



Note a separate initiative regarding improvement to NHS supply chains is also needed, here once again the potential to reduce costs by installing “Pull” type control is substantial.


A few years ago, I asked a representative from an NHS supplier (A large multinational) why they did not use pull type control and direct to point of usage supply chain feeds. She answered by saying – Bob, don’t even suggest that, we make millions of £s a year profits from replenishing out of date items.



R C Barker         8th March 2024                  or


Mobile 07906 025520


2 views0 comments


Post: Blog2_Post
bottom of page