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Lean Six-Sigma: the means to healing an ailing NHS?

John Bancroft (Oxford Brookes University, Oxford, UK)
Krish Saha (Department of Strategy Management and Marketing, Birmingham City University, Birmingham, UK)
Di Li (Birmingham City Business School, Birmingham City University, Birmingham, UK)
Gabor Lukacs (Oxford Brookes University, Oxford, UK)
Xavier Pierron (Coventry University, Coventry, UK)

International Journal of Quality & Reliability Management

ISSN: 0265-671X

Article publication date: 1 October 2018




The purpose of this paper is to examine England’s Accident and Emergency (A&E) arm of the National Health Service (NHS). It considers the positive impact that Lean has had and Six-Sigma can have in A&E departments to improve the quality and reliability of the service offered, in an area that is facing performance challenges.


Independent variables average monthly temperature data (degrees Celsius) obtained from the Met Office and weekly A&E data, patient volume is analysed alongside the dependent variable, the percentage of patients seen in 4 h or less.


The model produced a robust positive impact when Lean Six-Sigma is adopted, increasing the likelihood of A&E dependents meeting their performance objective to see and treat patients in 4 h or less.

Research limitations/implications

Further variables such as staffing levels, A&E admission type should be considered in future studies. Additionally, it would add further clarity to analyse hospitals and trusts individually, to gauge which are struggling.

Practical implications

Should the NHS further its understanding and adoption of Lean Six-Sigma, it is believed this could have significant improvements in productivity, patient care and cost reduction.

Social implications

Productivity improvements will allow the NHS to do more with an equal amount of funding, therefore improving capacity and patient care.


Through observing A&E and its ability to treat patients in a timely fashion it is clear the NHS is struggling to meet its performance objectives, the recommendation of Six-Sigma in A&E should improve the reliability and quality of care offered to patients.



Bancroft, J., Saha, K., Li, D., Lukacs, G. and Pierron, X. (2018), "Lean Six-Sigma: the means to healing an ailing NHS?", International Journal of Quality & Reliability Management, Vol. 35 No. 9, pp. 1976-1988.



Emerald Publishing Limited

Copyright © 2018, Emerald Publishing Limited

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