Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital “Modern Matron” Rachel Adam Physiotherapist

Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital Clinical Service Lead – Orthopaedics Hampshire Hospitals Foundation Trust – Across 3 sites 3 Fracture clinics 3 Trauma wards 2 Pre assessment clinics 2 Elective wards Staff – 164 Nursing / 64 medical / 56 admin

Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital How did the opportunity arise? Previous experience: – MSK outpatient lead for HHFT – Leading multi professional teams Hungry for new challenges and seeking greater responsibility

Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital How did the opportunity arise? Actively seeking new opportunities Open to stepping outside the known AHP highlighting opportunities where AHP can deliver what is required Convince others to take a risk to provide a personal opportunity – Highlight qualities and skills AHP’s offer

Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital Qualities and Skills Training / academic entry – Problem solving / goal setting – Organisation complex information – Theories and frame work – Autonomous – Decision makers – Communication skill – Influence and have confidence in different unknown situation – Credibility with others Career structure – Exposed to variety of role, leaders and experiences to learn and develop – Lateral thinking Fresh eyes / not historic thinkers

Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital Challenges faced………… personal and professional Painful learning curve – Challenged my personal resilience – How a ward runs and how performance is evaluated – Nursing practice and language – My role Volume of work Urgent and High Importance Eyes wide open – Level of responsibility, challenge and accountability within the main frame – Myself and nursing team – Challenged my beliefs of the practices of other professional groups Delivering safe and quality care, preventing harm to patients and staff – Ensuring patients receive safe, high quality care with dignity and respect – Safe Staffing: 24 /7 with significant staffing vacancy – Communicating and influencing a work force on shift Forgiving myself for not being a nurse

Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital Thoughts on the future The right person with the skills to deliver what is expected of the role – Look past perceived professional boundaries Need to make seek and create opportunities to demonstrate what we have to offer as credible senior leaders within the NHS – AHP’s need to rise to the challenge – Accept responsibility outside of professional boundaries and usual practice – Opportunities within a structured leadership pathway

Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital Pulling it all together, Meeting challenges – Ward level leadership – Observation of inefficiency in ward processes – Observed professional accountability mismatch at ward level Gap in leadership pathway opportunities An existing AHP lead taking responsibility for the elective orthopaedic ward……combined role trial.

Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital An AHP in a combined clinical and ward management role Laura Wines Physiotherapist

Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital The Role Clinical Specialist Physiotherapist working on trauma, elective and day surgery wards Responsible for a team of physiotherapists and a 7 day physiotherapy service Managing a 16 bed elective orthopaedic ward including staff management and day to day operation management Working with the Orthopaedic Unit nurse lead to develop services provided by the whole Orthopaedic Unit

Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital How did the opportunity arise? Elective ward charge nurse retired Clinical services lead for orthopaedics opened up job opportunity to all AHPs as well as nurses Actively seeking new opportunities

Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital Qualities and Skills Rotational physiotherapist, observe different leadership styles, different ways of operating a ward More opportunities as an AHP to move from band 5 to band 7, gaining management skills and experience as a leader Clinical reasoning/evidence based practice/problem solvers – embedded from undergraduate level and used every day 5 years in orthopaedics at RHCH – aware of the challenges and the potential of the ward. Objective for the new ward lead was to integrate nursing and therapy. Elective Orthopaedics – rehabilitation integral to patient flow Natural progression – wanting to gain more responsibility and seek new challenges and still remain in the service which I had already invested in

Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital Challenges Professional New role – no set precedent. Working out daily, weekly, monthly activities and balancing clinical physiotherapy duties with ward management Increasing awareness of my dual role, uniform challenges Exposure to the divisional operations taking place outside of the ward, no previous experience had provided a basic understanding – steep learning curve Understanding the 24/7 ward activity Ward staff VS staff on ward – non-professional ward activity and accountability for care and quality and facing inequality between professional groups in particular access to professional development Trying to bridge the gap between nursing and AHPs through stereotypes, historical processes, using my combined leadership role

Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital Challenges Personal Being under two management structures Being patient – no immediate change Feeling like a small fish in a big pond all over again Humbling experience – having to reflect back on who I was prior to the new exposure and help others to see/learn through my experiences

Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital Putting into practice Ward management recruitment - where possible, to consider applicants regardless of their professional degree but for the knowledge, skills and qualities they have gained during their experiences Managers of AHPs to support progression into ward management posts/speciality specific leadership opportunities Integration of AHPs and nurses on the ward -To ensure accountability for care and quality which is non-professional specific -To support each other to allow equality for non-clinical responsibilities -To therefore create a dynamic workforce which can deliver the needs of the patient at the time of need -May require combined leadership where there is potential for resistance

Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital AHPs interested in ward management Feeling truly part of the NHS, being at the centre of activity and involved at every level, increased job satisfaction Understand the way the NHS works not just the ward or the department you work in Potential for your work/ideas to spread to other wards and then to other Trusts, high impact

Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital From OT to Sister

Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital The Skills of an AHP Problem Solving Empowerment Working Autonomously Team Work Rehabilitation Discharge Planning

Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital The Challenges Knowledge of a ward Perceptions of others Managing nursing staff not therapists

Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital Advice Preparation Learn the ropes Support network Keep the patient at the centre

Andover War Memorial Hospital Basingstoke and North Hampshire Hospital Royal Hampshire County Hospital