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Job planning in the new NHSCCSC / 27 November 2006 Job planning in the new NHS Dr Mark Porter FRCA Consultant anaesthetist, University Hospital Coventry.

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Presentation on theme: "Job planning in the new NHSCCSC / 27 November 2006 Job planning in the new NHS Dr Mark Porter FRCA Consultant anaesthetist, University Hospital Coventry."— Presentation transcript:

1 Job planning in the new NHSCCSC / 27 November 2006 Job planning in the new NHS Dr Mark Porter FRCA Consultant anaesthetist, University Hospital Coventry Deputy chairman, BMA consultants committee

2 Job planning in the new NHSCCSC / 27 November 2006 Aims By the end of the seminar, we should understand: How to job plan Key skills for realising benefits Data for job plans Understanding and using objectives in job plans The context - a changing NHS, a changing environment

3 Job planning in the new NHSCCSC / 27 November 2006 Changed Training Payment by results Practice based commisioning Patient Choice Market forces ISTCs competition Contestability New SAS contract

4 Job planning in the new NHSCCSC / 27 November 2006 Where do we go now? New contract New Context New NHS? –Multi-provider environment –Portfolio careers

5 Job planning in the new NHSCCSC / 27 November contract Professional Time limited Increased clarity Balances objectives and supporting resources Something for Something Productivity Benefits realisation Adapt the resource to the need

6 Job planning in the new NHSCCSC / 27 November 2006 A forty-minute seminar… Cant cover everything Much advice in the public domain Most of it is good advice

7 Job planning in the new NHSCCSC / 27 November 2006 Sources of advice - BMA The British Medical Association published advice in September 2004 Available for download at Follow Consultants 2003 consultant contract Job planning Sample job plans are available Also read the Consultant Handbook May 2005

8 Job planning in the new NHSCCSC / 27 November 2006 Sources of advice - CCIT The NHS published advice in January 2005 Available for download at Follow Workforce themes Retaining and developing staff Pay and Reward Implementing the consultant contract Concise guide for consultants

9 Job planning in the new NHSCCSC / 27 November 2006 Opportunity Need to engage and take trusts in the right direction New skills needed –Negotiating skills –Data Key role of job planning –More than just a timetable

10 Job planning in the new NHSCCSC / 27 November 2006 The job plan (Schedule 3 TCS, Standards of Best Practice) An agreement with clinical manager (? Role for non-clinical manager) –Description of duties –Time-table –Agreed objectives –Agreed resources Annual process –Interim review –Continuous process of evolution and development Also part of the old contract

11 Job planning in the new NHSCCSC / 27 November 2006 Job plan – job content Job content – where and when –Direct clinical care Including predictable and unpredictable emergency work Including patient-related administration –Supporting professional activities –Additional NHS responsibilities –External duties –Travel time Accountability for contracted time

12 Job planning in the new NHSCCSC / 27 November 2006 Job plan: objectives and resources Availability supplement –rota and category Objectives and how they will be met –Personal objectives (appraisal) –Service objectives Supporting resources –Everything you need Additional NHS responsibilities External duties

13 Job planning in the new NHSCCSC / 27 November 2006 Job plan – other agreements Other comments and agreements –Category 2 –Flexibility of location Additional programmed activities and private practice A dotted line

14 Job planning in the new NHSCCSC / 27 November 2006 Programmed Activities Direct clinical care Work relating to prevention, Dx or Rx Emergency work (including on-call) Operating, ward rounds, clinics, treatment sessions, MDM, public health, etc Admin. related to the above Supporting PAs Work underpinning Clinical Care. Training, education, teaching CPD, Audit & Research Job planning / Appraisal Service Management Local clinical governance Typically 7.5 : 2.5 balance (you should not accept less without careful consideration) also Additional NHS responsibilities Lead clinician College tutor etc External Duties Royal College / Spec. Soc HMG / Trades Union etc

15 Job planning in the new NHSCCSC / 27 November 2006 Clinical academic job plan Applies to honorary consultant contract holders On call – same rules apply as to NHS consultants University component is based on work diary and needs of the job Can contract for additional PAs as NHS or University depending on the needs of the job

16 Job planning in the new NHSCCSC / 27 November 2006 Clinical academic job plan NHS PAs ratio of direct to supporting professional activities of 3:1 External duties will be important because of wider work for the NHS NHS-based teaching and research activity should be recognised in the NHS SPA component Flexible over a year e.g. term time teaching

17 Job planning in the new NHSCCSC / 27 November 2006 Two models of job planning Organisation has no coherent plan for service delivery Consultants make up their own job plans Focus entirely on schedule of fixed commitments Missed opportunities Organisation focused tightly on service delivery Job Plans written by service managers Objectives subordinated to targets

18 Job planning in the new NHSCCSC / 27 November 2006 a consultant job plan should be a prospective agreement that sets out a consultants duties, responsibilities and objectives for the coming year consultant job plans should set out agreed personal objectives and their relationship with the employing organisations wider service objectives

19 Job planning in the new NHSCCSC / 27 November 2006 Medical managers approach Should be fair to consultants Should respect the protections of the contracts Should endeavour to deliver the needs of the service, with the available resources Should not let consultants get away with everything and anything Should not allow ignorant managers to set the pace

20 Job planning in the new NHSCCSC / 27 November 2006 Job planning and appraisal cycle Agreement of personal objectives Job plan review meeting Appraisal meeting Business planning and service development Agreement of service objectives (team or individual) Annual pay progression Local Delivery Plan

21 Job planning in the new NHSCCSC / 27 November 2006 Before job planning Appraisal meeting –Personal development plan –Personal objectives Understand & define what is expected of you –Balance of activities –What your contract requires of you –What your profession requires of you CPD, Audit, Appraisal, revalidation What you are prepared and able to do Determine what resources you need –Time –Finances –Equipment –Managerial –Personnel Know and build in what you family and personal time require of you

22 Job planning in the new NHSCCSC / 27 November 2006 Preparation for meeting collect, reflect and share What has affected the job plan? Progress against the agreed objectives? Any changes to duties and responsibilities needed? PP commitments Data SPA Activities Internal and external commitments Next years objectives? Support needed from the organisation?

23 Job planning in the new NHSCCSC / 27 November 2006 Clinical academic job plan Process: Integrated joint NHS and University job plan review meeting Any party may propose amendment Joint report will be submitted to the Dean of the Medical School for pay progression copied to yourself and the Trust/s CEO Mediation and appeals processes are available

24 Job planning in the new NHSCCSC / 27 November 2006 Data in job planning What you do –Diary exerciseDiary exercise –Hospital activity data What you & team do –activity data –Peer review Demand and capacity Workforce & support issues Governance data (complaints, litigation, incident reports, etc.)

25 Job planning in the new NHSCCSC / 27 November 2006 Getting started Consider issues such as: –Review corporate objectives –Review Local Delivery Plan –Identify service development priorities –Payment by results Clinical directorConsultant Consider issues such as –Identify service development priorities –Identify PDP priorities –Identify resource issues something for something approach

26 Job planning in the new NHSCCSC / 27 November 2006 Process for clinical academics Any work agreed should be joint between NHS and University There should be adequate resources to support these agreements Academic targets ie for the RAE are not part of job planning-this is a time based agreement. These issues are more appropriately dealt with in appraisal but they can inform the process particularly if more time or resources are required.

27 Job planning in the new NHSCCSC / 27 November 2006 Simple negotiating tactics What are your goals? Your bottom line –Be clear –Realistic –Bold –Honest with yourself Who are the players? –Where are they coming from? –What must they achieve? –What could they give –What cant they give Cyclical process –Meet again next year –Big wins now - later losses –Rome not built in a day Strategy –Win-win –Partnership approach

28 Job planning in the new NHSCCSC / 27 November 2006 Team Approach Many advantages –Team –Individuals –Organisation Need buy-in –Combined calculation of scheduled commitments –Accounting for cover for annual leave –Decide how to share: teaching, audit etc –Team approach may identify needs for extra staff –Cover for on-call

29 Job planning in the new NHSCCSC / 27 November 2006 The job plan review meeting Participants –Consultant(s) –Medical Manager –(non-medical manager) Purpose and capacity? Scope –Structure of meeting Resources –Data etc Review progress against objectives Agree new objectives Agree prospective work program Pay progression sign-off

30 Job planning in the new NHSCCSC / 27 November 2006 Objectives What are they? –The action points for the coming year –Mutually agreed and resourced What are they for? –Quality and Improvement –Opportunity to lead change Who are they for? –All consultants –Part of the contract –Linked to pay progression

31 Job planning in the new NHSCCSC / 27 November 2006 Where & How do Objectives fit in? Agreement of personal objectives Job plan review meeting Appraisal meeting Business planning and service development Agreement of service objectives (team or individual) Annual pay progression

32 Job planning in the new NHSCCSC / 27 November 2006 Objective setting discussion Clinical governance and quality issues Team objectives Additional responsibilities e.g. teaching, research Service requirements Include corporate objectives, LDP, local service developments Personal development plan From appraisal Agreed support requirements Agreed objectives Including agreed and supported PDP Agreed process for review of objectives

33 Job planning in the new NHSCCSC / 27 November 2006 Specific Measurable Quantified or descriptive Achievable and Agreed Relevant and Resourced Timed and tracked SMART Objectives should be…

34 Job planning in the new NHSCCSC / 27 November 2006 Examples of objectives Hard objectives –4 hour wait, 17 week OPD –Choose & Book –Workload Management –Clinical Records CNST –Absence management Recording of leave etc Soft objectives –Greater involvement of patients –Consider benchmarking –Improve communication skills SPA outcomes –Complete an audit project Team objectives –Specify individual consultants role –Plans for service development Performance standards –Successful cancer peer review Personal development objectives –Acquire a new skill

35 Job planning in the new NHSCCSC / 27 November 2006 Recording objectives Objective Actions to achieve objective Success criteria and measures Agreed review process and timetable Support required (including removal of organisational barriers)

36 Job planning in the new NHSCCSC / 27 November 2006 Mediation and appeals If you fail to agree Nationally agreed timescales Mediation largely successful –Medical director mediates CD : Consultant Small number of appeals to date –Non-exec chair –Consultant nominee –Independent member

37 Job planning in the new NHSCCSC / 27 November 2006 Summary Prepare –and survive Opportunity –to drive and to lead change –take control! New healthcare environment –embrace, use and change

38 Job planning in the new NHSCCSC / 27 November 2006 Clinical excellence awards A waiting list initiative is for Christmas, but a clinical excellence award is for life. One CEA from age 40 to age 80 is worth £92,625. Preparation starts on day 1. Just like a tax return, only more lucrative. ACCEA –http://tinyurl.com/kz5a3http://tinyurl.com/kz5a3

39 Job planning in the new NHSCCSC / 27 November 2006 Any questions or points?

40 Job planning in the new NHSCCSC / 27 November 2006 Documentation links Consultant job planning diary Department of Health tinyurl.com/kyomltinyurl.com/kyoml NHS Employers tinyurl.com/g7u8rtinyurl.com/g7u8r NHS Modernisation Agency, Effective job planning tinyurl.com/cazft tinyurl.com/cazft BMA guide to consultant job planning tinyurl.com/potuetinyurl.com/potue Advisory Committee on Clinical Excellence Awards tinyurl.com/kz5a3 tinyurl.com/kz5a3


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