As part of the NHSE Investigation and Implementation Programme, MIAA Solutions were commissioned by an external consultancy to support an aspect of a wider programme to deliver expert support to an NHS Trust. The objective was to review, redesign, and mobilise a robust Cost Improvement Programme (CIP) Project Management Office (PMO) that would underpin the Trust’s ambitions for efficiency, effectiveness, and sustainable cost savings.

The Challenge

The Trust faced significant challenges with its existing PMO structure, which was described as fragmented and lacking the necessary governance to support effective CIP delivery. There was an urgent need to review current arrangements and define a new, logical structure to provide robust oversight and management of the CIP.

The client required a comprehensive review of their CIP arrangements and the development of a new operating model. The goal was to establish a PMO that could deliver strong governance, clear accountability, and effective management of cost improvement initiatives - ensuring alignment with organisational goals and regulatory requirements.

Our Approach

1. Assessment of Existing Organisation

• Conducted a deep dive into the Trust’s current state, engaging key stakeholders and reviewing audit reports (including CQC and NHS Audit Reports).
• Mapped existing PMO resources and governance structures, identifying gaps and inefficiencies.
• Evaluated the maturity of the current PMO model against industry standards.

2. Short-Term Support to the PMO

• Provided immediate support to enhance the effectiveness of the existing PMO, focusing on maximising efficiencies and addressing urgent gaps.
• Developed and introduced key tools and artefacts, including Project Initiation Documentation, risk management tools, and revised Terms of Reference.
• Facilitated the production of Equality and Quality Impact Assessments (EQIAs) for schemes representing 70% of the CIP programme’s value.

3. Production of a CIP PMO Blueprint and Mobilisation Plan

• Designed a comprehensive PMO Blueprint and mobilisation plan to guide long-term CIP success.
• Ensured alignment with Trust objectives and strategies, and determined the most suitable PMO model (centralised, decentralised, or integrated).
• Established clear frameworks for ownership, accountability, and governance.
• Developed a standardised CIP Framework and evaluated project, programme, and portfolio management (PPM) software options.
• Designed a consistent, transparent reporting approach to support effective monitoring and communication.

Outcomes

• Delivered a Blueprint for a PMO that underpins the Trust’s ambitions for efficiency and cost-effectiveness.
• Strengthened the central CIP programme office, ensuring all projects align with strategic objectives and prioritising those with the greatest value.
• Improved PMO operational efficiency by optimising resource utilisation, reducing project churn, and increasing project success rates.
• Enabled regular tracking and reporting on key performance indicators (KPIs), maintaining visibility, transparency, and accountability.
• Supported continual improvement of project management processes, embedding best practices and lessons learned.
• Enhanced stakeholder communication, keeping all parties informed about progress and benefits of cost improvement initiatives.

This case study demonstrates MIAA Solutions’ ability to deliver structured, impactful transformation for NHS clients. Our approach combines deep sector expertise, practical tools, and a commitment to sustainable improvement—making us the ideal partner for organisations seeking to strengthen their CIP delivery and governance.

For more information about our how we can support your organisation, contact Steve Warburton, Director of Director of Delivery – Healthcare & Transformation.

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