The Masterclass Strategy What is it? Influencing AHP strategy standard Clinical Governance Elements of CG Risk management Evaluation and action planning Audit Patient and Public involvement Staffing and new roles Use of Time Process Mapping Business Case Development Marketing Introduction to AHP Management Quality matrix

What is Strategy? A plan of action designed to achieve a particular goal National Regional/Local Service specific Your role

Strategic Influencing Influence others to get results Are you trying to influence one person or a group? What is your hierarchical relationship with them? How capable/knowledgeable are they? How well do you know each other? What are their priorities?

Organogram Community care strategy group National AH Group CEO Elderly care working group DGM AH Network ME Family Physio OT Social Work Pharmacy

Your Turn! Draw an organogram Who do you influence? How do you influence them? Who influences you? What influence do you have? What could work better? Do you go directly to the person you need to influence

Behaviour Strategies Common vision Awareness of others Awareness of key people Data and information use Making others feel valued Presentation impact Negotiating/bargaining

How do you use each strategy Each table to develop ideas of how to use each influencing strategy in your work Write on a flip chart to stick up

Our AHP Strategy Standard The service has a documented strategy which is reviewed and updated annually.

Local Example of Service Strategy Evaluation

1.1 Does your organisation have a strategy? 1.2 Have you an up - to - date strategy for your service? 1.3 Is there a ‘value statement’ that is shared by staff in your service? 1.4 Service mission statement/vision; is this agreed and documented? 1.5 Is your strategy linked to: National, Regional Local? 1.6 Service portfolio – the range of services you provide is this documented?

1.7 Major goals/objectives for your service; are these documented? 1.8 Do you have service strategies 1.9 Is the overall contribution of your service (from the patients’ perspective) documented? 1.10 Do you undertake an annual service review, and document findings? 1.11 Do you have organisational charts? 1.12 Do you produce a service annual report?

Evaluate the components of your service (or part of service) Work with a partner from the same service or on your own Use the evaluation matrix Evaluate the components Summary and actions to go on post –its to be stuck on the wall when completed

Tea 10.15 – 10.30

Clinical Governance Clinical governance is  the system through which NHS organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care, by creating an environment in which clinical excellence will flourish (Department of Health1998)

Key Strands Clinical effectiveness Risk management Patient experience Communication Resource effectiveness Strategic effectiveness Learning effectiveness 

Underpinning Attributes Systems awareness Teamwork Communication Ownership Leadership Management

What is Risk Management? Risk is the combination of the likelihood of an event and its consequences Risks may have benefits as well as threats to an organisation's business Risk Management is a continuous process by which risks are recognised and managed Do you have a risk register?

Local Example of a Risk Register and its use

Clinical Audit What is Clinical audit? Who has done it? Who gets support? Have you used audit? What do you do with the results? How do you feed it back into practice? Have you identified training needs? What have your services done? is a quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria and the implementation of change.

Your Audit Plan for 2010 onwards Make a list of audits for your service. Prioritise: Organisational requirement Professional requirement Service development Service review Personal development

Patient and Public Involvement Do you include patients/service users in service development and evaluation? Do you have a service lead for this? What have you tried? Was it useful?

Local Example of Patient and Public Involvement

Evaluation and action planning Each table work together to complete the task set for you on one of the Clinical Governance strands. Fill in one flip chart sheet and stick it on the wall

Its Lunch time! 45 minutes 24

Quiz Time! How productive are you?

In an average 54 hour week what percentage of time does a leader spend on work planning reflecting and thinking? A) 7.5% B) 13% C) 18.5% D) 28% Source NHI 2007

In an average 54 hour week how many hours does a leader spend in meetings? B) 27 C) 38 D) 45 Source NHI 2007

In this time the leader attended 26 meetings, how many started on time? B) 7 C)11 D) 16 Source NHI 2007

What percentage of people actively contributed/participated in the meeting Source NHI 2007

How you and your staff spend their time? 30

Results: Outpatients by Band 7 6 5 3 OTHER CLIN. SUPERVISION TEACHING PUBLIC TEACHING HEALTH PROF TEACHING STUDENTS TEACHING PHYSIOS IN SERVICE TRNG MTGS CLINICS TRAVEL HOME VISITS MANAGEMENT ADMIN LIAISON STUDY LEAVE CASE CONFERENCE WARD ROUNDS TEL CONTACTS FACE TO FACE GRP FACE CONTACT IND 31

New Roles Ageing workforce More expensive workforce Changing individuals’ needs Changing educational opportunities Variety of providers Need to: retain staff develop staff work differently

Clinical Specialists Working at a highly specialised level within the boundary of the profession Core Professional Practice

Extended Scope Practitioners Working at specialist level within and beyond the boundary of their profession Training Regulation Extended Practice Core Professional Practice

What role(s) could you develop, why? Write a list- what would it achieve How would you progress this?

Process Mapping Puts a spotlight on waste Streamlines work processes Defines and standardises the steps and sequence Promotes understanding Builds consensus Key ‘tool’ for work re-design

How referrals are handled affects waits 37

Questions to ask Are there any wasteful handovers? Are there any bottlenecks? Could some tasks be carried out by one person instead of several? Are tasks carried out for our benefit or the patient's? Could some tasks that are performed in another process be performed here? Are the people who work in the process allowed to make decisions? Which tasks help to achieve the purpose and which ones create waste? Is there any duplication of work? How much rework is being carried out?

Prepare Decide which service you need to review Are there problems? Do you think it could function better? Are there potential gains to be made? Are there non value steps in the service? Invite the key people- give them sufficient notice Don’t assume you know!

Process Map today Let’s see how far we get!

Clinical Process Map

Business Case Development: 1 Introduction Background/context Proposed service Links to local /national priorities Predicted capacity Benefits to patients/ organisation/stakeholders Cost-benefit

Business Case Development: 2 Service evaluation Predicted outcomes Governance arrangements Risks of doing it or not Lead- in time Financial impact statement Summary

Planning a Business Case Use the headings in the template….. Start a force field analysis

Force Field Analysis

Service Development Cycle National Targets/drivers Deciding priorities Reviewing service provision Designing services Patient/Public Shaping the service structure Needs assessment Managing demand Referrals, Individual needs assessment, Patient choice re treatment Seek public and patient views Managing performance, quality, outcomes Source DH 2006 46

Local Example

Key Messages Understand the ‘politics’ Get to know those who ‘buy’ your services Make a clear business case Show how your proposal adds value Use information and data Show the likely impact

Marketing your service….. Preparation Know your service SWOT analysis Staffing and expertise Current service specification Identify your “selling” points Branding Finance

……..Marketing Needs analysis Know your competitors Who can help you? Population, users and public health Know your competitors Who can help you? Information Communication Publicity

Competitor Marketing Analysis Name of competitor Your assessment of their Strengths and weaknesses Areas of direct competition Impact on your service

Your Competitive Advantage Unique selling points Key stakeholders internal/external Stakeholder Interest and Influence

Marketing Quadrant Interest Influence High Voluntary Sector Medicine Patients Professional Bodies Medicine Surgery Women’s Health GPs Purchasers Complaints Interest Support Services Dept.Health Employers SHA Social Services Regulator Human Resources CEO Exec Team Contract Dept Finance Dept Low Low High Influence

Your Competitive Advantage Make a List

AHP Management Quality Matrix Leadership and management development Clinical excellence Communications and marketing Service improvement and re-design Risk management Corporate governance Key performance indicators Strategy Activity Patient experience Finance Staff resource effectiveness Staff management and development Information and metrics

Summary Strategy Clinical governance New roles Process mapping Business case development Marketing Introduction to AHP management quality matrix

What are you going to do? Write down the first thing you are going to improve

Any Questions or further Discussion

Full Management Quality matrix Will be made available to you

Other things we do www.jjconsulting.org.uk 60

Thank you!