Centre for Logistics and Transportation, Cranfield University, UK
St James 's University Hospital in Leeds is one of the biggest teaching hospitals in Europe and one of the largest acute service units in the UK National Health Service (NHS). Granted 'trust status ' in April 1991, it employs over 5000 people and sees 450,000 patients a year (see Industry Note in Appendix 22.1). Operating income from the internal market totalled £125.8 million (1993-4) with 70% of the income coming from the contract with Leeds Healthcare. For 1994-5 the Trust has negotiated contracts with 12 health authorities and 130 general practitioner (GP) fundholders. St James 's provides services both locally and to the wider Yorkshire community against the background of national, regional and local objectives and priorities required to meet the ever-changing demand on services. In spite of increases in activity by the hospital, admissions and waiting lists are increasing, reflecting this increasing demand (Table22.1).
Table 22.1 Admissions
In-patient Day cases Acute Waiting list Total
1992-3 17,198 21,893 37,793 8723 76,884
1993-4 15,641 27,237 39,490 8820 82,368
17,444 16,136 36,459 70,039
Health authorities want the best value for money service, best use of resources,and high patient throughput. In addition, the government wanted 2% more activity itt the financial year 1994-5 plus a 1% cost-improvement programme. In view of the constraints and demands placed on the hospital and their commitment to improving both quality and value for money, St James 's began an innovative collaboration in 1991 with Lucas Engineering Systems Ltd (LES), the aerospace and automotive group. Initial contact between the two organizations was made during a working party on electronic data interchange and the NHS. A member of St James 's supplies staff encountered work done by LES, who were keen to