PCT led review to evaluate proposals for improvements aimed at reducing fragmentation in the current care pathway of breast serviceswhich was on split sites. Therfore difficult to control costs, poor service. After formal consultatations numerous meetings it was decided to transfer the service from hosptal B to A. Factors influencing project : Reduce cancer Public perception (poor reputation of hospital B Patient focused Focus on quality Centralisation one site service Meet govement tagets Exploit ways of working and new roles in the delivery of the service. Look at strengths and weaknesses of hospital A Strengths ability to take on extra services and wanted to become a foundation trust this would enhance this. Weakness As a result of severe public involvment project had to be approached sympatheticaly Unable to increase throughput within presant staffing levels. Sreering groups set up and each given a clear mandate of what was expected of them with clear deadlines meeting on a regular basis. core group-- Identify how many servic users would be anticipated. Write an operational policy, as thiswould form basis of redsign. Estates/architect--- draw up ward plans. HR----TUPE(transfer of staff from B to A. Identify presant costing and five year plan fluctuation of staff ,turnover,retirement would we need the same grade of staff in 5 years. Ward---PPI(patient public involvment group)had to be co opted to this group. Identify incease in portering,catering,linencarparking etc. tust induction for staff Theatre---Identify increased capacity Identify down periods with new allocated capacity Identify new working practicesgroups met on a regular basis; I was a member on each to ensure continuity. Gantt chart drawn up. competion date for project 01/04/08 12 weeks to completion date I was informed that the project needed to be completed by 01.03.08 a month earlier than planned. This meant contractors working overtime and also resulted in the commisioning period being reduced to 72 hours. Lessons learnt Strenghth of publisc oppinion. A full time project manager required (as I was still carrying out my normal daily duties). Commitment from trust for time to be allocated for members of the work groups. Overspend of 200K as contractors had to work overtime,ned for finance department involment. Budget of 1.3million final expenditure 1.5 million.