Title: Job planning in the new NHS
1Job planning in the new NHS
- Dr Mark Porter FRCA
- Consultant anaesthetist, University Hospital
Coventry - Deputy chairman, BMA consultants committee
2Aims
- 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
3Contestability
Changed Training
Practice based commisioning
Payment by results
Market forces
Our health our care our say
competition
Patient Choice
ISTCs
New SAS contract
4Where do we go now?
- New contract
- New Context
- New NHS?
- Multi-provider environment
- Portfolio careers
52003 contract
- Professional
- Time limited
- Increased clarity
- Balances objectives and supporting resources
Something for Something Productivity Ben
efits realisation Adapt the resource to the
need
6A forty-minute seminar
- Cant cover everything
- Much advice in the public domain
- Most of it is good advice
7Sources of advice - BMA
- The British Medical Association published advice
in September 2004 - Available for download at www.bma.org.uk/
- Follow
- Consultants
- 2003 consultant contract
- Job planning
- Sample job plans are available
- Also read the Consultant Handbook May 2005
8Sources of advice - CCIT
- The NHS published advice in January 2005
- Available for download at www.wise.nhs.uk/
- Follow
- Workforce themes
- Retaining and developing staff
- Pay and Reward
- Implementing the consultant contract
- Concise guide for consultants
9Opportunity
- 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
10The 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
11Job 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
12Job 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
13Job plan other agreements
- Other comments and agreements
- Category 2
- Flexibility of location
- Additional programmed activities and private
practice - A dotted line
14Programmed 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
External Duties Royal College / Spec. Soc HMG /
Trades Union etc
Additional NHS responsibilities Lead
clinician College tutor etc
15Clinical 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
16Clinical academic job plan
- NHS PAs ratio of direct to supporting
professional activities of 31 - 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
17Two 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
- Organisation focused tightly on service delivery
- Job Plans written by service managers
- Objectives subordinated to targets
Partnership
Missed opportunities
18- 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
19Medical 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
20Job planning and appraisal cycle
Agreement of personal objectives
Appraisal meeting
Local Delivery Plan
Annual pay progression
Job plan review meeting
Business planning and service development
Agreement of service objectives (team or
individual)
21Before job planning
- 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
- 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
22Preparation for meetingcollect, 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?
23Clinical 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
24Data in job planning
- What you do
- Diary 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.)
25Getting started
- Consider issues such as
- Review corporate objectives
- Review Local Delivery Plan
- Identify service development priorities
- Payment by results
- Consider issues such as
- Identify service development priorities
- Identify PDP priorities
- Identify resource issues
- something for something approach
Clinical director
Consultant
26Process 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.
27Simple 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
28Team Approach
- 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
- Many advantages
- Team
- Individuals
- Organisation
- Need buy-in
29The 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
30Objectives
- 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
31Where How do Objectives fit in?
Agreement of personal objectives
Appraisal meeting
Annual pay progression
Business planning and service development
Job plan review meeting
Agreement of service objectives (team or
individual)
32Additional responsibilities e.g. teaching,
research
Team objectives
Service requirements Include corporate
objectives, LDP, local service developments
Personal development plan From appraisal
Clinical governance and quality issues
Objective setting discussion
Agreed support requirements
Agreed objectives Including agreed and supported
PDP
Agreed process for review of objectives
33Objectives should be
- Specific
- Measurable
- Quantified or descriptive
- Achievable and Agreed
- Relevant and Resourced
- Timed and tracked
SMART
34Examples 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
35Recording objectives
- Objective
- Actions to achieve objective
- Success criteria and measures
- Agreed review process and timetable
- Support required (including removal of
organisational barriers)
36Mediation 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
37Summary
- Prepare
- and survive
- Opportunity
- to drive and to lead change
- take control!
- New healthcare environment
- embrace, use and change
38Clinical 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/kz5a3
39Any questions or points?
40Documentation links
- Consultant job planning diary www.consultantscommi
ttee.info - Department of Health tinyurl.com/kyoml
- NHS Employers tinyurl.com/g7u8r
- NHS Modernisation Agency, Effective job
planning tinyurl.com/cazft - BMA guide to consultant job planning
tinyurl.com/potue - Advisory Committee on Clinical Excellence Awards
tinyurl.com/kz5a3