An evaluation of Lean and Six Sigma methodologies in the national health service

Jiju Antony, James Lancastle, Olivia McDermott, Shreeranga Bhat, Ratri Parida, Elizabeth A. Cudney

    Research output: Contribution to journalArticlepeer-review

    16 Scopus citations


    Purpose: The purpose of this paper is to conduct an empirical study derived from the previous literature from the perspective of benefits, tools and techniques, continuous improvement (CI) and quality improvement (QI) methodologies and critical failure factors (CFFs) of Lean and Six Sigma (SS) in the national health service (NHS). Design/methodology/approach: A literature review was carried out to identify previous findings, empirical data and critical variables concerning Lean and SS in healthcare for over ten years. Second, primary research in quantitative surveys and qualitative interviews was carried out with 110 participants who have experience using Lean and SS in the NHS. Findings: Lean and SS have evolved into common practices within the NHS and now have an established list of tools and techniques frequently employed by staff. Lean and SS are considered robust CI methodologies capable of effectively delivering extensive benefits across many different categories. The NHS must overcome a sizable amount of highly important CFFs and divided organizational culture. Originality/value: This paper has developed the most extensive empirical study ever produced on Lean and SS in the NHS and has expanded on previous works to create new and updated research. The findings produced in this paper will assist NHS medical directors and practitioners in obtaining up-to-date insight into Lean and SS status in the NHS. The paper will also guide the NHS to critically evaluate their current CI strategy to ensure long-term sustainability and deliver improved levels of service to patients.

    Original languageBritish English
    Pages (from-to)25-52
    Number of pages28
    JournalInternational Journal of Quality and Reliability Management
    Issue number1
    StatePublished - 17 Jan 2023


    • Benefits
    • Critical failure factors
    • Lean
    • Lean Six Sigma
    • NHS
    • Six Sigma
    • Tools and techniques


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