1. NBT Cardiac Physiology Review
Healthcare Consultant Advisor
December 2015

2. Objectives Clinical Governance and Patient Safety
Cardiac Physiology Management Review
Cardiac Physiology Skill mix Review
Finance and activity
Agreed objectives with the management team, physiology lead and shared with the consultants

3. Opportunities Reduce Clinical risks
Develop the Cardiac Physiology lead role to work in a more strategic way and band 7 working at operational level
Develop structures for the department to maintain standards
Agree a skill mix structure that will deliver the required activity and maintain a developed workforce
Reduce and replace High locum use – financial risk and quality issues
Improve the activity data and income to the speciality

4. Documents and Tools NBT Cardiac Physiology paper
NBT catheter lab paper
Summary and Actions
Deactivation of devices
Implementation Plan
Responsibility charts
Equipment Register
NBT Non invasive Activity
NBT Cath Lab procedure level costing

5. Additional Documents Developed by the senior CP team
Job descriptions KSF and Job Plan – B8 to B2
SOP – for each procedure and test
SOP – for clinical quality standards
Equipment Training schedule
CP strategy
IQIPS check -Improving Quality In Physiological diagnostic Services (IQIPS)
Standards and Evidence
Patient Experience
Facilities, Resources and Workforce
Safety
Clinical

6. Standards Domain 1: Patient Experience
The purpose of the Patient Experience Domain is to ensure that service delivery is patient- focused and respectful of the individual patient and their specific requirements. This is achieved through provision of appropriate information and support for patients and carers with due regard to
differences in culture, religion, age and other factors. Effective feedback systems for patients and carers are necessary.
Domain 2: Facilities, Resources and Workforce
The purpose of the Facilities, Resource and Workforce Domain is to ensure that adequate resources are provided and used effectively to provide a safe, efficient, comfortable and accessible service. This is achieved through appropriate and adequate facilities (rooms and equipment); motivated and competent staffing; and the integration of sound business planning principles within the service
Domain 3: Safety
The purpose of the Safety Domain is to ensure that services provide the highest level of safety for patients, staff and others who come into contact with the service. This is achieved through assessment and management of the risks associated with delivery of the service.
Domain 4: Clinical
The purpose of the Clinical domain is to promote the service’s role in rapid and accurate diagnosis and treatment. This is achieved through administrative and clinical practices appropriate to the patient population including children; effective management of risk and emergencies; and the review of existing and new clinical practice to develop and improve the service.

7. NB : 7 day service may additional adjustment
Skill mix change
Clinical role/activity against grade
Maximising skill from each grade and introducing new grades at B4 and B2 in line with national roles
Activity numbers and agreed job plans
Rostering to the agreed staffing levels
Clinical managerial ratio for B8 role 40:60
Reviewed the use and locum within budget line
NB : 7 day service may additional adjustment

8. Skill Mix Skill mix working towards August 2015 skill mix
This new skill mix consists of trained staff band 5 and above 62% of which 26% are of band 7 and above and 38% of staff of grades less than band 5
August 2015 skill mix
The ratio mix of staff are 67% of band 5 and above of which 28% are band 7 and above and 33% are less than band 5 grade

9. Financial position

10. Service Risks Strengths Challenge to CP leadership team Device Service
Financial Balance
MPI
Heart Failure Service
Echo Service
Community Services
Catheter Lab capacity

11. Opportunities Integrated care model – strengthen community links
Stop HF project – increase Heart failure referrals
Increase Device implant – CRT and ICD
CP – service being IQIPS accredited
Financial optimisation including income generation

12. Questions