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Red to Green - The legacy of a true interim

Denise Raw, Principal of Public Sector, interviews an Interim Operations Director she has placed to find out about implementing the NHS Improvement's 'Red and Green days.'

Red and Green


As part of the NHS Emergency Care Improvement Programme, a new management system has been established to assist in the identification of wasted time in the patient’s journey. ‘Red and Green Bed Days’ is a visual management system used to reduce internal and external delays and highlight the following:

Red day – when a patient receives little or no value adding acute care.

Green day – when a patient receives value adding acute care that progresses them further towards discharge.


In practice...

1. Tell me about your role/title and what have you been tasked to do? 

I am currently working as an Interim Director of Operations, required to provider varied performance improvements across access targets, with specific  focus on leadership of the urgent care pathway.


2. What impact can you as an Interim Manager make whilst in this role, how long is this role for?

The role is for 3 months. Real term improvement is multi-faceted, however performance in CA & RTT is inevitably affected by issues with urgent care (i.e elective cancellations, outliers etc). As an interim I was able to make my own rapid assessment and quickly saw the opportunity available should we implement Red to green as a process. Having seen and adopted the methodology in other organisations, I also knew that keeping it as simple as possible would have the best effect. (the text book is not right for all!)


3. What do you think are the benefits to the Trust of having an interim on site and why?

The skills and knowledge a senior interim can bring is huge. They are also used to rapid implementation and turnaround, often only held back by the substantive post holders.


4. Tell me about Red to Green and how you are rolling this out across the Trust and why this is so important?

Red to Green is part of the SAFER bundle. It is not new and the process is relatively simple, however successful and sustainable implementation takes good preparation, communication, involvement and leadership. I was fortunate to be able to drive the process and led the launch week which morphed into a daily process that is being embedded into business as usual.

The results after just 4 weeks include:

     i.      Reduction in medical outliers from 45-less than 10

    ii.      Reduction in use of escalation beds

   iii.      Reduction in cancelled surgery to 0 due to beds

    iv.      Increase on average of empty beds from 11 to 33 @ 2000

Unfortunately ED performance has not improved significantly, however it has highlighted causative factors.


5. Why do you feel that measurable results are so important for interims working as Managers?

Measurable results should be there for all, not just interims, however due to the short term nature of Interim assignments, these are key elements to support any anecdotal benefits that interims can provide.


6.  Our Return on Interim Methodology is very unique, how do you feel it has assisted you and the Trust in your role?

The principle is good, objectives have to be realistic with the end client.


7.  What advice would you give to Trusts who are in need of further support right now? 

There is a group of senior interims who can provide additional expert support to Trusts. Due diligence of candidates is crucial, more so now than ever with NHSI capped rates. Can a Band 7 experienced manager bring the same level of experience and service to a senior role? (but they will be within the cap!)


8. How would you describe your experience with Interim Partners and the service given to you?

Very good, supportive and looking after your best interest.


Denise Raw is Principal - Public Sector


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