Transformation Programme Manager - Private Patients

Job overview

This post exists to give the Group a single point of leadership and accountability for establishing Private Patients as a safe, well-governed and growing income stream, converting Executive-level ambition into a costed, deliverable programme. The postholder is the primary transformation partner for Private Patients across Walsall Healthcare NHS Trust (WHT) and Royal Wolverhampton NHS Trust (RWT), driving commercial, operational and governance change from business case through to mobilisation and benefits realisation, while protecting core NHS elective capacity and patient safety throughout.

Main duties of the job

• Strategic Leadership and Programme Ownership
• Programme ownership: Own the Private Patient introduction and scale-up work stream across all three strategic objectives, setting strategic direction, defining scope, and maintaining accountability for delivery against milestones, budget and benefits.
• Governance leadership: Establish and chair the Private Patient Task & Finish (Delivery) Group, owning the consolidated action log and bringing recommendations back to the Private Patient Steering Group for decision.
• Business case development: Lead development of robust business cases and options appraisals, including demand modelling, pricing strategy, capital and revenue costings, workforce implications and sensitivity analysis, including the future business case for a dedicated Private Patient facility.
• Evidencing market demand: Lead a structured assessment of genuine market demand for private patient growth, including specialty and procedure-level opportunity and points of differentiation (e.g. dermatology, robotic and complex/cardiovascular surgery), to respond to Executive-level challenge on the evidence base for growth.

Detailed job description and main responsibilities

Strategic alignment: Ensure the Private Patient programme aligns with Group strategy, NHS planning guidance and statutory requirements while protecting core NHS elective capacity.

• Commercial Strategy, Contracting and Income Realisation
• Commercial model: Design and implement a commercial model for private activity including tariffs, insurer contracting, consultant agreements, and third-party arrangements.
• Price list recosting: Lead a phased recosting of the private patient price list using a Pareto approach prioritised by volume/value (Ophthalmology, Cardiac and Trauma & Orthopaedics first), dependent on Executive decisions on profit margin, out-of-hours staff uplift and local theatre rates.
• Self-pay pricing: Take forward the decision on self-pay pricing, correcting the current position where self-pay rates sit below insurer rates against market norms.
• Insurer and referrer engagement: Lead negotiations with insurers and external referrers, develop commercial terms, SLAs and referral pathways to secure sustainable income streams.
• Billing and recovery: Oversee selection and implementation of electronic billing/invoicing systems and processes to maximise coding accuracy, charge capture and timely recovery.
• Debt and administrative recovery: Close the current gap in excess, invoice and self-pay debt recovery, tightening OP70 form completion and the supporting administrative process to reduce unrecovered income.
• Income:
• Establish robust financial KPIs and forecasting processes, report income performance and variances to CFOs and Programme Director.
• Produce a realistic 2-year income growth plan increasing current baseline from circa £1m
• Service Design, Operational Readiness and Pathway Delivery
• Pathway co-design: Facilitate co-production of private patient pathways with clinical leads, divisional teams and operational managers to ensure safety, quality and patient experience, scaling up the private patient activity currently at RWT and establishing a service at WHT.
• Pathway documentation: Streamline the current end-to-end private patient pathway, moving away from the largely paper-based process to a digitally-enabled, auditable process.
• Capacity planning: Lead demand and capacity modelling for theatres, wards and outpatient clinics, design scheduling, booking and waiting-list processes to optimise utilisation and minimise impact on NHS services.
• Capacity ring-fencing: Scope options for ring-fenced weekend and out-of-hours theatre, outpatient and recovery bed capacity at both sites, seeking Executive approval to formally designate this as private capacity.
• Operational readiness: Coordinate estates, digital, workforce, procurement and clinical governance inputs to ensure facilities, systems and staff are ready for go-live, including mobilisation of a Walsall private patient offer where no current infrastructure or team exists.
• Standard operating procedures: Ensure SOPs, escalation routes, consent and information governance arrangements are in place for private patient activity.
• Programme Delivery, Governance and Assurance
• Programme plan: Maintain a detailed, costed programme plan with milestones, dependencies and resource allocation, update and reforecast regularly.
• Governance: Chair or represent the work stream at governance forums, provide timely highlight reports, exception reporting and evidence-based briefings to the Transformation Programme Director, the Private Patient Steering Group and senior stakeholders.
• Data integrity and audit: Work with Informatics to resolve the risk of mis-flagged or double-charged private activity arising from the EPR (Blueprint) transition, prioritising correction of the process on a forward-looking basis.
• Regulatory reporting compliance: Build an explicit governance requirement for PHIN (Private Healthcare Information Network) and statutory finance reporting compliance into the administrative process design.
• Risk and compliance: Maintain a live risk register, ensure clinical governance, safeguarding, Overseas Visitor Policy and data protection compliance, escalate to corporate risk systems where required.
• Benefits Realisation and Performance Management
• Benefits framework: Define and track financial (income, cost recovery) and operational (capacity release, waiting-time impact, patient satisfaction) benefits, maintain a benefits tracker and evidence base for realised savings.
• Performance dashboards: Implement KPI dashboards and reporting cadence for operational performance, income, coding accuracy and patient experience, drive continuous improvement cycles.
• Stakeholder Engagement, Communications and Business Development
• Stakeholder management: Build and sustain relationships with clinical leads, divisional teams, consultants, insurers, primary care and external referrers to secure buy-in and referral pipelines.
• External benchmarking: Lead benchmarking activity against comparable providers with an established, well-functioning private patient model (prioritising comparable District General Hospital-type trusts over central London comparators), and commission market opportunity analysis to test demand in complex/high-value specialties.
• Communications: Work with Communications and Digital teams to develop patient-facing materials, web presence and targeted marketing to support private patient uptake.
• Business development: Identify and prioritise new commercial opportunities, service lines and partnerships to grow private income across the Group, including formal proposals for third-party use of theatre/facility space where relevant.
• People Leadership and Capability Building
• Administrative resourcing: Address the current shortfall in dedicated private patient administrative capacity, including assessing options to redeploy administrative capacity released by the AVT programme.
• Equitable access to enhanced pay: Work with HR to confirm and apply a consistent policy on equal-opportunity access to enhanced private-work pay rates for staff delivering private sessions outside core hours.
• Capability building: Develop team capability in programme delivery, commercial contracting, billing, overseas visitor charging and performance management.
• Workforce planning: Coordinate recruitment and workforce planning for roles required to operate and sustain private patient services.
• Integration with NHS Services and System Partners
• System working: Engage with ICB, local authority and system partners to ensure private patient activity complements system priorities and does not adversely affect equitable access to NHS care.
• ICS and regional liaison: Represent the Group at regional or national forums as required, sharing learning and ensuring compliance with wider system expectations.
• Continuous Improvement and Strategic Development
• Horizon scanning: Monitor national policy, regulatory changes and market developments relevant to private healthcare and commercial opportunities.
• Learning and scaling: Capture learning from early delivery against Strategic Objective 1, iterate the service model, and use this to inform scale-up of Strategic Objective 2 (Walsall) and the longer-term accredited provider model under Strategic Objective 3.
• General Duties
• Comply with all Trust policies (Health & Safety, Equality & Diversity, Information Governance).
• Maintain professional development and participate in appraisal and mandatory training.
• Undertake other duties commensurate with the grade as agreed with the Transformation Programme Director.

Key Working Relationships

Internal: Transformation Programme Director, Private Patient Steering Group and Task & Finish (Delivery) Group members, CFOs and Finance Business Partners, Divisional Directors, Clinical Directors (including the responsible clinician for private work), Heads of Service, Transformation Project Managers, Private Patient operational leads, Informatics, HR/OD, Communications, Digital, Estates, Overseas Visitors and Charging teams.

External: Insurers and commercial partners, external referrers, primary care networks, ICB transformation leads, NHS England regional teams, comparator provider organisations (for benchmarking), voluntary and community sector partners.

Applicant requirements

The postholder will have access to vulnerable people in the course of their normal duties and as such this post is subject to the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (Amendment) (England and Wales) Order 2020 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service to check for any previous criminal convictions.