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Consultant Job Planning: Speaker News & Updates

Today’s one day conference is a practical guide to successful consultant job planning. Through a series of presentations this one day conference provided delegates with the opportunity to develop skills in job planning and linking with pay progression, improving team performance and the role of the job plan in achieving personal development goals, individual and service objectives. Making the link between job planning, revalidation and appraisal, and also changing job plans and the consultant contract in light of the national drive towards NHS services 7 days a week which has also been covered during the day.

Speakers and Presentations from the day Include:

Mr Paul Carter Associate Medical Director & Consultant Surgeon Royal Liverpool & Broadgreen University Hospitals

Practical Experiences of Job Planning: A Clinical Directors Perspective

  • job planning examples: practical examples and a Clinical Directors perspective
  • changing job plans in light of service needs and outcomes/safety concerns
  • job planning challenges and solutions

Mr Paul Carter Full Presentation Click Here

In his presentation Paul stated: 

The issues of job planning include: 

  • Logistics
  • Time vs Activity
  • SPAs
  • Academics
  • Merit award holders
  • Management PAs
  • Oversight or Interference

“Doing Appraisal and Job Planning together is a big no, no. I would not encourage anyone to do the 2 at the same time they both have different objectives.”

“It is important for you to have a sign off time frame”

“The consultant contact is time based not activity based”

“SPAs things to consider are- How many?, For what?, Where?, Part timers, Educational supervisors, Additional posts and Hard metrics for outcomes. It is important to be clear and avoid changes.”

“Academics you need to know who is doing this and if it matches with the clinical goals/objectives. You will also need to understand the activities, clinical commitments and who pays the ferryman.”

“Management PAs thing to think about include – 11 plus contract, clinical managerial multitasking does not work, when does activity occur, back filling sessions and medical management – cheap or quality.”

“We need to make sure we have clear directives and objectives for CD/DM”

“As a Medical Director you are there always to assist with the difficult issues. You are there to help and provide support.”

“CDs and DMs need to ensure they have clear objectives for activities, governance, audit, safety, academic and development”

Mr Paul Carter Presentation Abstract:

Job planning has developed over the last 10 years. It should be undertaken by those close to the coal face, the Clinical Director and Directorate manager.

They need clear objectives for all the directorates activities (Clinical, Governance, Audit, Safety, Research and development) and should produce hard metrics to inform job plans. They need to understand the difference between the present Consultant contract and the trust and directorate needs that are activity based.

Job plans need to be signed off in a timely manner and recorded centrally. The Medical director should have oversight but only manage difficult cases.

Dr David Scott Assessment Advisor NCAS & GMC Associate & former Chairman BMA Medical Managers Committee & Consultant Paediatrician East Sussex Hospitals NHS Trust

EXTENDED SESSION: Difficult issues & Challenges in Job Planning: Renegotiating the job plan including rigid contracts, and difficult doctors

  • difficult issues in job planning
  • job planning negotiations
  • managing rigid contracts and rigid doctors
  • case studies, examples and tips for success

Dr David Scott Full Presentation Click Here

In his presentation David stated: 

 

“Clinical directors need to fair and need to be seen as being fair”

“Your role as the clinical you need to make sure that the needs of the service and met within the available resources.”

“If you are in a difficult situation stick to process – the cycle of job planning and appraisal, objective setting, supporting professional activity, clinical leadership, education and audit trail.”

“Job planning as I see it is agreeing with medical staff what they are going to be doing. Appraisal is about who you can do your job better.”

“I developed an annual cycle where appraisal takes place from April to December and Job planning from January to March.”

“A recommended process would include first divisional/ directorate job planning discussion, second team job planning discussion, and finally an annualised job plan with agreed timetable, service commitments and data (dccs) and objectives (SPAs).”

“The job plan discussion should involve, consultant(s), medical manager and non medical manager. They should have a purpose, there should be scope, resources, data. You should review progress against objectives and agree new objectives, prospective work programme and pay progression sign-off”

The Job Plan content should include:

  • Timetable of activities
  • Number of PAs of each type
  • On-call arrangements
  • Additional responsibilities – Trust related
  • External responsibilities – wider NHS
  • Arrangements for extra PAs
  • Agreed objectives
  • Supporting resources
  • Private and fee paying work information

“If you have any consultant working with more that 10 Pas – you have to be very specific what you are paying the extra money for. This should be include in the job plan and a separate contract setting out work to be done in the extra PAs – it will then be clear what goes if the extra contract ends”

“Data in job planning is very important – for keeping a record of the work you are doing. I kept a record of everything I did so that if you are challenged you have the data to back you up. always keep a diary to show the reasons for your working”

An example of a diary David have used www.consultantscommittee.info/

“Objectives should be there and should be linked to pay progression”

Objectives should be SMART..

  • Specific
  • Measurable - Quantified or descriptive
  • Achievable and Agreed
  • Relevant
  • Timed and tracked

“Objective setting should be at the heart of the job planning process. The suggested approach is to translate corporate objective into job plan service objects, allocate SPA time to these projects and adopt a win/win philosophy”

“SPAs should be an output-based system and the should be annualised in terms of time and goals. You need to justify SPA time by taking projects from corporate objectives”

“Audit trail – use an electronic job planning system. These are the way forward”

The annual review is a contractual obligation and you need to consider, factors affectivung achievements of objectives, adequacy of resources, potential changes to duties or responsibilities, ways to improve workload management, and planning of careers. You can have interim reviews if changes happen during the year”

Issues & problems include

  • Reductions in DCC PAs
  • Reductions in SPAs
  • Not achieving 2.5 SPAs
  • Not recognising increases in workload – “best way to tackle this is to keep a diary, to prove the workload”
  • Scheduling/location of SPAs
  • Not recognising additional NHS duties
  • Not recognising external duties
  • Attendance of managers at Job Plan reviews

“Openness and transparency is the key to job planning and solving issues and problems”

“Other issue include – Age, health, lack of technical skills, unsocial hours, lack of supporting resources and reduced availability”

“Best practice for discussions are – be ‘patient-centric’, be understanding, be reasonable, be fair, be prepared to compromise and be realistic and take in to account other factors like clinical supervision, job satisfaction, productivity, flexibility, annualised contract, free time and CEAs”

“Negotiation strategy should follow the below – separate the people form the problem, focus on interests behind positions, invest options for mutual gain, insist on using job planning standards, develop your best Alternative to a negotiated agreement and be hard on the problem and soft on people.”

“You need to communicate effectively – listen actively, speak about yourself, not about them (management), speak for a purpose and control the discussion”

“You need to be able to handle emotions – recognise and understand the emotions – both yours and theirs, allow the other side to let off steam, don’t react to emotional outbursts and be empathetic”

Useful phrases for handling people problems

  • “Let me check that I understand what you have said”
  • “I can appreciate why you feel like that”
  • “My position is…..   How do you see it?”
  • “I would like your views on…..”
  • “Tell me more about…..”
  • “I’m sorry if I misunderstood…..”
  • “What do you suggest?”

Questions you might ask

  • “Why is xxx important to you?”
  • “What are you concerned about?”
  • “What’s the real problem?”
  • “What would be wrong with?”
  • “Why not xxx?”
  • “What are your worries about xxx?”

“Some people are more difficult to deal with than others, are irrational, have fixed ideas and are unwilling to negotiate”

Tips for success!!

  • Establish clinical leadership
  • Align the needs of individuals with the needs of the organisation
  • Agree the time that will be spent delivering the objectives and the resources required
  • Stick to the agreed process !

Dr David Scott Presentation Abstract:

A small proportion of doctors are difficult to job plan, either because they have additional responsibilities and, or a large number of external duties or because they have fixed ideas about what they want to do.  A team approach to job planning is a sensible and logical approach and subjects them to peer pressure.  It allows doctors to do what they are good at and recognises that doctors work in different ways and may have different priorities, skills and responsibilities.  It also provides a fair way of managing additional responsibilities and external duties and takes account of sub-specialty interests.

If team job planning does not resolve differences these will need to be addressed in Individual job planning discussions through negotiation.  Failure to achieve agreement should be dealt with formally through the Trust’s agreed disputes procedure.  Initially this is by mediation conducted through the Trust Medical Director.  If this fails, the Trust Appeals Mechanism should be used.  The result of this is binding on both parties.

Openness and transparency is encouraged during the job planning process to ensure consistency and fairness and sharing job plans between members of a team is to be encouraged.  SPA activity should be agreed on an individual basis and linked to the delivery of objectives.  Additional responsibilities and external duties should be acknowledged and have time allocated to them in the job plan.

Realistic and sensible objective setting is the key to successful job planning!

Dr David Scott Biography:

David trained at Cambridge University and Guy's Hospital Medical School and was appointed consultant paediatrician in 1983.  He became Clinical Director in 1991 and was Trust Medical Director for 12 years from 1996 until 2009.  From 2009 to 2013 he was Clinical Lead for Children and Young People’s Services and Trust KSS Deanery Leadership Tutor.  From January 2014 he was an NCAS Assessment Adviser and from May 2015 has had responsibility for the Healthcare Professional Alert Notice system.  In September 2015 he was appointed Responsible Officer for the NHS LA.  David retired from the NHS at the end of March 2016.

In the past he has undertaken work for the Healthcare Commission and NHS Employers and from 2005 to 2012 he was chair of the BMA Medical Managers Committee.  David is currently a GMC Associate (Fitness to Practise Team Leader) and undertakes case investigation and case management assignments for Bevan Brittan LLP.

Future events of interest:

Clinical Audit for Improvement
Wednesday 5 October 2016 
The Studio Conference Centre, Birmingham

Caldicott Guardians: National Annual Conference
Thursday 6 October 2016 
The Studio, Birmingham

Hospital Mortality Annual Summit: Mortality Monitoring & Reducing Avoidable Deaths attributable to problems in care
Thursday 20 October 2016 
Hallam Conference Centre, London

Effective Clinical Director
Monday 7 November 2016 
Hallam Conference Centre, London

Legal Masterclass: Confidentiality for Clinicians
Monday 5 December 2016 
Hallam Conference Centre, London

Developing the Role of the Physician Associate
Friday 9 December 2016 
Hallam Conference Centre, London

UK Physician Health Summit 2017
Wednesday 29 March 2017 
Hallam Conference Centre, London


4 October 2016

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