Enthusiasts, sceptics and paternalists'

1
Enthusiasts, sceptics and paternalists.

• Clinical engagement with choosing and booking
• Dr Simon Walford
• Senior Medical Advisor, DH

2
Changing behaviour
Pre-cognitive
Cognitive
Planning Recruitment
CHANGE
Benefit Reinforcement
3
Changing behaviour
Pre-cognitive
Cognitive
Planning Recruitment
CHANGE
Benefit Reinforcement
4
What is clinical engagement?
5
Clinicians who are genuinely engaged with their
organisation..

• know they are fully informed about its priorities
  and
• are able to influence its agenda.
• They share its aims and are committed to helping
  achieve them.

6
Three groups of GPs

• Enthusiasts
• A lot of patients delegate that responsibility
  to the GP but increasingly more patients want to
  be involved in that decision, they want to be
  empowered with information. My experience is
  slightly different in that Im all for this. I
  would like to be able to complete the whole
  episode in one consultation
• Sceptics
• It needs to be Here are the options., These are
  the ones I wouldnt touch with a bargepole.
  These are the three youre left with, do your
  research, I cant be responsible for this. Ill
  do a referral for you, but again the buck stops
  with you, in a way
• Paternalists
• My consulting methods will be very directive in
  terms of I would say to the patient you have a
  choice but if I was you, if I was in your
  situation I would go here and I would say to
  them go for it
• Rosen, Florin Hutt. Kings fund 2006

7
Clinicians who are genuinely engaged with their
organisation..

• know they are fully informed about its priorities
  and
• Are the clinicians talking sense?
• are able to influence its agenda.
• They share its aims and are committed to helping
  achieve them.

8
The structure of provider services
Consultant Clinic
Specialty
Black Box
Consultant Clinic
9
The structure of provider services
Cataract
Consultant Clinic
Glaucoma
Ophthalmology
Cornea
Consultant Clinic
Diabetic Medical Retina
10
The structure of provider services
Cataract
Consultant Clinic
Glaucoma
Ophthalmology
Cornea
Consultant Clinic
Diabetic Medical Retina
11
The structure of provider services
Cataract
Consultant Clinic
Glaucoma
Ophthalmology
Cornea
Consultant Clinic
Diabetic Medical Retina
12
The structure of provider services
Cataract
Consultant Clinic
Ophthalmology
Glaucoma
Cornea
Consultant Clinic
Diabetic Medical Retina
Pregnancy and maternal
Diabetic Medicine
Consultant Clinic
Podiatry and foot
13
The structure of provider services
Cataract
Consultant Clinic
Ophthalmology
Glaucoma
Cornea
Consultant Clinic
Diabetic Medical Retina
Pregnancy and maternal
Diabetic Medicine
Consultant Clinic
Podiatry and foot
14
The structure of provider services
Cataract
Consultant Clinic
Ophthalmology
Glaucoma
Cornea
GP
Consultant Clinic
Diabetic Medical Retina
Pregnancy and maternal
Diabetic Medicine
Consultant Clinic
Podiatry and foot
15
The structure of provider services
Cataract
Consultant Clinic
Ophthalmology
Glaucoma
Cornea
GP
Consultant Clinic
Diabetic Medical Retina
Pregnancy and maternal
Diabetic Medicine
Consultant Clinic
Podiatry and foot
16
The structure of provider services
Cataract
Consultant Clinic
Ophthalmology
Glaucoma
Cornea
GP
Consultant Clinic
Diabetic Medical Retina
Pregnancy and maternal
Diabetic Medicine
Consultant Clinic
Podiatry and foot
17
Clinicians who are genuinely engaged with their
organisation..

• know they are fully informed about its priorities
  and
• Are the clinicians talking sense?
• are able to influence its agenda.
• Is the organisation, listening?
• They share its aims and are committed to helping
  achieve them.

18
National Specialty Reference Group

• Professor Angus Wallace
• Professor of Orthopaedics, Nottingham
  University
• Neal Mortimer
• South Devon Healthcare NHS Trust
• Sarah Dutton
• DoS support for East of England SHA
• Doscontent-bulletin_at_nhs.net

19
National Specialty Reference Group

• Improvements made to governance, membership and
  way of working
• Greater transparency about rationale for changes
• Prior to the end of March 2007, will review
• General Clinic Types
• Services for Children and use of the Paediatric
  Clinic Type
• Field names for Specialty and Clinic Type
• Release Gastroenterology and General Medicine
• Will begin the phasing out of unused Clinic
  Types

20
Is yours?

• Facilitative management
• Responsive IT support
• User Groups

21
Clinicians who are genuinely engaged with their
organisation..

• know they are fully informed about its priorities
  and
• Are the clinicians talking sense?
• are able to influence its agenda.
• Is the organisation, listening?
• They share its aims and are committed to helping
  achieve them.
• Is there a constructive dialogue?

22
Balancing Interests in DoS

• Desktop tool for General Practitioner
• Shop window for Providers Specialists
• Consistent and equitable framework for
  Commissioners
• Route to information for patients

23
Best Practice

• Clinical Service owns its Directory
• Service seeks Primary Care Review and feedback
• Service monitors cancellations, rebookings and
  DNAs
• Service feeds back to NSRG via new machinery

24
Materials to help

• New Guides and Tools
• National Support Team
• National User Groups
• The big picture