Presentation on theme: "Barnet and Chase Farm Hospitals NHS Trust"— Presentation transcript:
1Barnet and Chase Farm Hospitals NHS Trust Job Planning for Consultants and SAS Doctors
2ObjectivesTo gain a shared understanding of the Consultant Job Planning process and in particular:-The role of the consultantSteps in the processWho is involvedKey elements of a good Job Plan
3ContextMedical staff are professional members of staff, highly trained and committed to patient careEconomic environmentConsultants have greatest control over Trust activity, productivity and commit most resourcesNationally agreed process
4What is a Job Plan?“A consultant job plan should be a prospective agreement that sets out a consultant’s duties, responsibilities and objectives for the coming year.”“...consultant job plans should set out agreed personal objectives and their relationship with the employing organisation’s wider service objectives.”Job planning: standards of best practice, Department of Health, April 2003
5Underpinning Principles The process should be:undertaken in a spirit of collaboration and cooperationreflective of the professionalism of being a doctorfocused on measurable outcomes that benefit patientsconsistent with the objectives of the NHS, the organisation, teams and individualsclear about the supporting resources the Trust will provide to ensure that objectives can be mettransparent, fair and honestflexible and responsive to changing service needs during each job plan yearfully agreed and not imposedfocused on enhancing outcomes for patients whilst maintaining service efficiency
6Who is involved in Job Planning? ConsultantsClinical LeadsClinical DirectorsMedical DirectorGeneral ManagersWith support from HR
8Steps in Job PlanningClinical Director/Clinical Lead with General Manager, form a clear view of service requirements and the activity required for the forthcoming year;Agree tariffs and matrices;Calculate the average amount of DCC work undertaken as a result of on-call activities – this will be a 1st call on DCC timeCalculate the remaining DCC time (take care to take account of time not worked due to annual leave, bank holidays etc) and consider a 42 week yearConsider what SPA time is required by the organisation (above the base level of 1 SPA) and agreed what outcomes will be expected from this allocation of timeAgree the final job plan in conjunction with others in the same specialty (team based approach)
9In the Job Planning discussion Review organisational objectivesLocal service development strategiesNational service development strategiesService pressures due to rising or decreasing demandService pressures due to more challenging targets being setConsultant shortagesWorkload of existing consultant bodyBefore starting the job planning process, clinical and general managers need to think what are the most significant pressures faced by the specialty, in which the consultant or team works. List given not necessarily comprehensive, although most likely pressures covered.
10In the Job Planning discussion (2) Identify the issuesRelative priority of eachCan I affect through job planning?Am I dependent upon the efforts of others?Are there underlying factors I need to consider?List of pressures may be long, so need to prioritise, make sure job planning can influence and consider the potential impact of other people and factors.
11In the Job Planning discussion (3) Questions to askAre consultants working in a way that is the best way for this particular issue or service?Does the work that is currently being undertaken by consultants need to be done at all?Does all of the work that is currently being undertaken by consultants need to be done by a consultant or could some of it just as effectively be undertaken by another individual/professional?The clinical manager needs to ask him/herself six questions, 3 on this slide, 3 on next slide.
12In the Job Planning discussion (4) Questions to ask 2Does the organisation give the consultants the support they need to help them work effectively?Are there models of service provision tried elsewhere that make more effective use of consultants’ time?Have any of the consultants or other members of the clinical team suggested ways in which they could be helped to work more effectively?See previous slide
13In the Job Planning discussion (5) Taking ActionPrioritise the issues that have arisenDecide how job planning helps meet the objective/address the issueIdentify the support the organisation needs to provideAction planlong timescales acceptable and may be essentialThen job planAction their reading prior to starting the job planning process
15Objective Setting (2) Agreeing SMART Objectives Specific Measurable Achievable and AgreedRelevantTimed
16Objective Setting (3) Tracking and Reviewing progress allows:- Problems to be tackled when smallIdentification of any learning or development needsFeedbackSpontaneous coaching opportunities
17Split between DCC and SPAs Full time = 10 PAs of 4hrs each (3hrs in premium time – 7pm to 7am, Monday to Friday and all weekend cover)Each consultant will have 1 baseline SPA; the final number of SPAs allocated will depend on other roles and responsibilitesand up to 2.5 SPAs (although only one is guaranteed)
18DCCDirect clinical activities such as OP clinics and operating sessions etc.,Includes:-Pre and post-operative assessmentsWard roundsPatient correspondenceEmergency workMDTs (only for core members of MDTs)
19SPAs Must be evidenced and quantified Should be timetabled wherever possibleNot a right or entitlement (exc. 1 baseline SPA)Should be undertaken on Trust premises (exc. 1 baseline SPA)Subject to annual reviewInclude Governance, Audit and Research
20TariffsAllocated for specific roles – e.g. Clinical lead or Clinical DirectorUsed to gain consistency and understanding about productivity:Admin time for clinicsNumber of new and follow upsTime for ward rounds
21BuddyingThe Trust operates a ‘buddying’ system to ensure that the most clinically and financially important areas of work are covered during annual and study leaveTo ensure robust cover for a 5 day week this requires early discussion and co-ordinated booking of leaveDirectorates to publicise the maximum number of consultants permitted to be absent without impacting on service delivery
22Dealing with Disagreements Where there is failure to agree between an individual Consultant and the Clinical Lead and manager there are two further stages.1. The consultant should refer the matter to the Clinical Director and general manager for further discussion. This must be done within 2 weeks of failing to agree.Should this further review fail to resolve the issue the Trust will consider a further process involving the Medical Director or move straight to a formal appeal which will involve a senior medical leader not already involved in the case (e.g. CD or MD), a senior manager (e.g. COO) and an independent member (e.g. NED). The appeal decision will be final.
24Private PracticeRegular, scheduled, private work should be shown in the Job Plan
25TravelFor Consultants on the new contract travel time can be allowed for traveling to and from emergencies, travel between sites but not between home and the main base unless they are undertaking an official journey in the course of the day. The main base is considered to be Barnet and Chase Farm Hospitals.Excess travel time can be claimed for travelling to one of the peripheral sites. i.e. a consultants whose normal journey to Barnet hospital is 20 minutes but travel to Potters Bar is 40 minutes may claim 20 minutes excess travel. The same principle may apply to those based at the peripheral site who have to travel to Barnet or Chase Farm hospital.
26Annualised and Team Job Planning Supports consultants to work productively as a teamServices delivered by a team of consultantsCommissioned activity determines demand to be mapped to consultant team’s capacityDCC PAs indexed to units of activityJob plans will set annualised activity assumptions for consultants
27Annualised and Team Job Planning Review of work undertaken at 6 months and 12 monthsActivity and KPIs require measurement and reportingSee Trust guidance on team job planning
28Benefits of Team Job Planning Priorities are not agreed in silosTeam working towards one ‘shared’ pictureTransparency in the Department
29Benefits of Annualised Job Planning EquityImproved patient care – better distribution of time/ service input to demandFinancial – e.g. no empty theatresEnsures adequate cover across the year
30Consultants on the ‘Old’ Contract Job planning is a mandatory contractual requirement for those remaining on the ‘old’ contract7 NHDs should be allocated to ‘DCCs’ i.e. most commonly 1 for on-call and 6 for DCC-type work (fixed NHDs)Admin time is not classed as fixed session unlike the new contract
31Having ‘Difficult’ Conversations May be necessary during the job planning processBefore addressing the issues, be clear about:-What the issues areWhat outcomes you are looking forWhere appropriate, what changed behaviour is requiredEnsure a proper environment for the conversation – i.e.:-ConfidentialNo interruptions
32Having ‘Difficult’ Conversations (2) Start with a positive toneLay out the issues, with objective evidenceSpecify outcomes requiredSeek the views of the individual concerned and incorporate these where possible and appropriateAgree a way forward and process of review
33Further HelpHelp and advice is available from the Medical Staffing Projects Manager and HR DepartmentTrust Job Planning guidanceTrust FAQsBMA/NHS Employers publication ‘A guide to Consultant Job Planning’