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David introduced a consultant led a ‘Fit to Admit’ clinic 2003 – this is an extrapolation of the principles of a service that is to front load the service with experts i.e. the consultant.  This was a cost neutral change that has enhanced the patient experience and improved that patient pathway.  It has also delighted all the staff.

The benefits of the clinic have really come into their own as we are able to admit cardiac patients on the same day for surgery mitigating the lack of beds.  We even offer a taxi service to assist same day admission.  Despite the increasing complexity and co-morbidities of the patients over this period of time (percentage of patients with EuroSCORE >5 increasing from 20% to >40%) 25.3% patients are discharged on the evening of day 4 and 62.2% are discharged at by Day 6.  The saving in bed days has exceeded 2200.  This process is realising over £140 000.00 in savings every year.  He was shortlisted for a National QUIPP award in 2012.

The fit to admit process enables a flexible and responsive service mitigating cancellations.  An unnecessary admission has been avoided in over 100 cases.  Patients are welcome to challenge the need for surgery and some have even felt able to change their minds.  It is “what matters to you”  that is important!

The operational and clinical benefits of David’s’ clinic led to an executive Masters in Business Administration that was awarded with Distinction by Leeds University Business School on 2005. He was appointed tutor to the British Association of Medical Managers and has presented at National and European meetings. He has published his experience in peer review journals. He has run managerial, clinical and medical director workshops throughout the country. He teaches on the ‘business of health care’.

He is a 2008 graduate of the Executive Patient Safety Officer Program of the Institute of Health Care Improvement in Boston Massachusetts.  He has had the privilege of visiting the internationally acclaimed hospitals including Virginia Mason Medical Centre in Seattle.

David spent eighteen months on the Nye Bevan Leadership Program and was awarded the NHS leadership Academy Award for Executive Health Care Leadership 2015.

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