Since 2021, MIAA Solutions has supported the client through multiple phases, providing expertise to accelerate Cost Improvement Programme (CIP) delivery. This has resulted in a clear corporate model for CIP planning, strong governance, risk management, and staged progress reporting. MIAA also helped drive cultural change by engaging stakeholders to identify, capture, and develop departmental ideas into actionable project plans.

The Challenge

The client has been tasked with delivering sustainable cost improvements while safeguarding quality of care. By 2024/25, the organisation faced a Cost Improvement Programme (CIP) savings target of £19.2m — with particular emphasis on securing “cash-out” savings to stabilise its financial position.

Our Approach

MIAA Solutions partnered with the organisation to accelerate progress by:

• Embedding subject matter expertise to strengthen CIP planning and delivery.
• Supporting the Director of Finance and CIP Programme Board in developing a robust corporate model for governance, risk management and reporting.
• Engaging clinical and operational leaders to identify new opportunities and build ownership across services.
• Providing hands-on delivery of projects backed by clear business cases and data analysis.

The Impact

Key Achievements 2024/25

Despite operational challenges, the partnership delivered significant results:

• £12.3m savings delivered against a £19.2m target, with £11.6m already realised by year-end.
• A stronger corporate operating model implemented — embedding PM3 for project governance, enhancing transparency, and improving board reporting.
• Cultural shift achieved, with services taking greater ownership of identifying, shaping and progressing CIP opportunities.

Service Transformation Highlights

• Frailty Strategy: Projected £5.3m savings in Year One, including reductions in hospital stays (63% fewer) and GP contacts (50% fewer).
• DOAC Anticoagulants: £86k annual savings with 70% of patients shifted to primary care, reducing costs and easing secondary care demand.
• Shared Care Programme: Released an estimated £856k per year in consultant time, with better patient access and continuity of care.
• Renal Dialysis: Net £191k savings through service reconfiguration and home dialysis expansion.
• Pharmacy Automation: £833k in efficiency savings over five years plus £150k annual stockholding reductions.
• Medical Retina Service: Reduced need for off-island treatment, with net recurrent savings of £822k per year while strengthening local capacity.

Through this collaboration, the client has:

• Achieved measurable financial savings while safeguarding quality and patient safety.
• Built a robust evidence base for decision-making, ensuring future opportunities are prioritised and tracked.
• Developed a sustainable operating model for CIP delivery, supported by enhanced governance and cultural ownership across the organisation.

Looking Ahead

Building on these achievements, the organisation has commissioned MIAA to expand its programme of support in 2025 — ensuring pace is maintained, new opportunities are captured, and financial sustainability continues to improve for the benefit of patients and services.